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Most reported Zika-associated microcephaly cases are from intrauterine first trimester infection. Among perinatal, specifically third trimester and immediate post-birth, Zika cases, there are only a few case reports of brain development issues.

Reported Outcomes Of Perinatal Zika Infection

Though a mouse model of Zika infection (1), where embryos were infected in utero at embryonic age 14.5 days (mouse gestation is ~21 days), reported post-natal microcephaly, only a handful of human perinatally infected Zika-associated brain development or neurologic issues have been reported in the biomedical literature so far.

  • Reported Brain And/Or Neurologic Abnormalities
    • Two infants with laboratory-confirmed Zika infection from third trimester exposure during the 2016-16 Brazil Zika outbreak showed not microcephaly but other brain abnormalities such as subependymal cysts in both and lenticulostriate vasculopathy in one (2).
    • Paraguay reported Guillain–Barré syndrome – Wikipedia in one child after post-natal Zika in 2016 (3).
  • No Reported Brain And/Or Neurologic Abnormalities
    • Of two cases of perinatal Zika transmission from mothers infected close to delivery during the 2013-14 French Polynesia Zika outbreak, one infant remained asymptomatic while the other was diagnosed with Thrombocytopenia – Wikipedia and diffuse rash but not microcephaly (4).
    • A study (5) of 1501 live births of Zika-infected mothers during the 2015-16 Brazil Zika outbreak found first trimester infection to be most severely affected, based on head circumference z score.
    • Similarly, no apparent anomalies were reported (6) among children born to 1850 pregnant women in Colombia, >90% of them reportedly Zika infected during the third trimester.

Reported Outcomes Of Postnatal Zika Infection In Infants & Children

  • The CDC collated and analyzed (7) previously published data (8, 9, 10, 11, 12, 13) on ten 3 to 16 year old Zika-infected children from Africa, Asia, South America and the Pacific. Though none of them developed rash, all had fever, 2 each had conjunctivitis, vomiting or diarrhea while 3 had joint pain (Arthralgia – Wikipedia). No microcephaly.
  • All eight cases of travel-related Zika cases among American children as of February 2016 (7) had rash with at least one other symptom (fever, arthralgia, nonpurulent conjunctivitis). Again no microcephaly.
  • The 2007 Yap Island, Micronesia Zika virus outbreak included several infants and children. While their symptoms were similar to those in adults, namely, fever, maculopapular rash, arthralgia, Conjunctivitis – Wikipedia, 0 to 19 year olds had fewer probable and confirmed cases of Zika compared to 20 to 59 year olds (14). No microcephaly.
  • No single case of microcephaly reported to CDC from US states among 150 probable or confirmed Zika cases among children <18 years of age (15). Ranging from 1 month to 17 years in age with median age of 14 years, all infections were travel-associated.
    • 129 (82%) had rash.
    • 87 (55%) had fever.
    • 45 (29%) had conjunctivitis.
    • 44 (28%) had arthralgia.

Bibliography

1. Shao, Qiang, et al. “Zika virus infection disrupts neurovascular development and results in postnatal microcephaly with brain damage.” Development 143.22 (2016): 4127-4136.

2. de Souza, Antonio Soares, et al. “Fetal infection by Zika virus in the third trimester: report of 2 cases.” Clinical Infectious Diseases 63.12 (2016): 1622-1625.

3. Lovera, Dolores, et al. “Neurologic syndrome associated with Zika postnatal acquisition. With regard to the first case in Paraguay.” Revista del Instituto de Medicina Tropical 11.2 (2016): 36-41.

4. Besnard, M., et al. “Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014.” Euro surveill 19.13 (2014): 20751. http://www.eurosurveillance.org/…

5. França, Giovanny VA, et al. “Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation.” The Lancet 388.10047 (2016): 891-897. https://www.researchgate.net/pro…

6. Pacheco, Oscar, et al. “Zika virus disease in Colombia—preliminary report.” New England Journal of Medicine (2016). http://www.nejm.org/doi/pdf/10.1…

7. Fleming-Dutra, Katherine E. “Update: interim guidelines for health care providers caring for infants and children with possible Zika virus infection—United States, February 2016.” MMWR. Morbidity and mortality weekly report 65 (2016). https://www.cdc.gov/mmwr/volumes…

8. Macnamara, F. N. “Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria.” Transactions of the royal society of tropical medicine and hygiene 48.2 (1954): 139-145. http://icmr.nic.in/zika/publicat…

9. Olson, J. G., and T. G. Ksiazek. “Zika virus, a cause of fever in Central Java, Indonesia.” Transactions of the Royal Society of Tropical Medicine and Hygiene 75.3 (1981): 389-393. http://www.dtic.mil/cgi-bin/GetT…

10. Heang, Vireak. “Zika Virus Infection, Cambodia, 2010-Volume 18, Number 2—February 2012-Emerging Infectious Disease journal-CDC.” (2012). https://www.ncbi.nlm.nih.gov/pmc…

11. Alera, Maria Theresa, et al. “Zika virus infection, Philippines, 2012.” Emerging infectious diseases 21.4 (2015): 722. https://www.ncbi.nlm.nih.gov/pmc…

12. Dupont-Rouzeyrol, Myrielle. “Co-infection with Zika and Dengue Viruses in 2 Patients, New Caledonia, 2014-Volume 21, Number 2—February 2015-Emerging Infectious Disease journal-CDC.” (2015). https://www.researchgate.net/pro…

13. Arzuza-Ortega, Laura, et al. “Fatal sickle cell disease and Zika virus infection in girl from Colombia.” Emerging infectious diseases 22.5 (2016): 925. https://www.ncbi.nlm.nih.gov/pmc…

14. Duffy, Mark R., et al. “Zika virus outbreak on Yap Island, federated states of Micronesia.” N Engl J Med 2009.360 (2009): 2536-2543. http://www.nejm.org/doi/pdf/10.1…

15. Goodman, Alyson B. “Characteristics of Children Aged< 18 Years with Zika Virus Disease Acquired Postnatally—US States, January 2015–July 2016.” MMWR. Morbidity and Mortality Weekly Report 65 (2016). https://www.cdc.gov/mmwr/volumes…

https://www.quora.com/Is-there-any-evidence-that-the-Zika-virus-hurts-the-brain-development-of-infants-or-young-children-if-theyre-infected-after-theyre-born/answer/Tirumalai-Kamala

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