Children with Zika face challenges beyond infancy

Photo of Brenda Fitzgerald
Brenda Fitzgerald

Children born with microcephaly who test positive for Zika virus infection face challenges beyond infancy that range from motor impairment to eating and sleeping difficulties, according to researchers.

An assessment of almost 20 young children is the first to show early childhood difficulties in those with congenital Zika virus infection, researchers wrote in MMWR.

“Children severely affected by Zika virus are falling far behind age-appropriate developmental milestones,” CDC Director Brenda Fitzgerald, MD, said in a press release. “Continued monitoring of all children with congenital Zika exposure is critical to understanding the full impact of the infection during pregnancy and to support these families for the long term.”

The researchers assessed 19 children, aged 19 to 24 months, who had previously been evaluated in the Zika Outcomes and Development in Infants and Children (ZODIAC) study. That investigation evaluated children in the state of Paraíba, Brazil, who had congenital Zika virus infection.

All 19 children in the new assessment had at least one adverse outcome. Eleven tested positive for nonfebrile seizures, “indicating possible seizure disorder,” the researchers said.

According to caregivers, eight of the children had been hospitalized, including six for bronchitis or pneumonia. Ten children reportedly had frequent sleep problems, and nine had eating or swallowing difficulties.

Thirteen children had hearing impairment, 11 had visual impairment and four had retinal abnormalities.

Fifteen of the children did not pass the Ages and Stages Questionnaire, which screens for potential developmental delays.

Fifteen scored below 40 on the Hammersmith Infant Neurological Examination, “indicating severe motor impairment, including 14 who had findings consistent with cerebral palsy,” the researchers said. “Outcomes including feeding challenges, sleeping difficulties, severe motor impairment, vision and hearing abnormalities and seizures tended to co-occur.”

Twelve children had three to five of the outcomes assessed in the study, and two had all six outcomes, the researchers added.

They concluded that the report can help guide clinicians on what interventions to pursue for children affected by Zika virus.

“These findings allow for anticipation of medical and social service needs of affected children and their families, including early intervention services and planning for resources to support these families in health care and community settings in Brazil, the United States and other countries,” researcher Ashley Satterfield-Nash, DrPH, of the Oak Ridge Institute for Science and Education in Oak Ridge, Tennessee, and colleagues wrote. “Long- term follow-up and measurement of developmental progression of children affected by Zika virus can inform intervention services and subspecialties needed to provide optimal care for these children.” – by Joe Green

Disclosures: Fitzgerald reports no relevant financial disclosures. Please see the study for all authors’ relevant financial disclosures.

Photo of Brenda Fitzgerald
Brenda Fitzgerald

Children born with microcephaly who test positive for Zika virus infection face challenges beyond infancy that range from motor impairment to eating and sleeping difficulties, according to researchers.

An assessment of almost 20 young children is the first to show early childhood difficulties in those with congenital Zika virus infection, researchers wrote in MMWR.

“Children severely affected by Zika virus are falling far behind age-appropriate developmental milestones,” CDC Director Brenda Fitzgerald, MD, said in a press release. “Continued monitoring of all children with congenital Zika exposure is critical to understanding the full impact of the infection during pregnancy and to support these families for the long term.”

The researchers assessed 19 children, aged 19 to 24 months, who had previously been evaluated in the Zika Outcomes and Development in Infants and Children (ZODIAC) study. That investigation evaluated children in the state of Paraíba, Brazil, who had congenital Zika virus infection.

All 19 children in the new assessment had at least one adverse outcome. Eleven tested positive for nonfebrile seizures, “indicating possible seizure disorder,” the researchers said.

According to caregivers, eight of the children had been hospitalized, including six for bronchitis or pneumonia. Ten children reportedly had frequent sleep problems, and nine had eating or swallowing difficulties.

Thirteen children had hearing impairment, 11 had visual impairment and four had retinal abnormalities.

Fifteen of the children did not pass the Ages and Stages Questionnaire, which screens for potential developmental delays.

Fifteen scored below 40 on the Hammersmith Infant Neurological Examination, “indicating severe motor impairment, including 14 who had findings consistent with cerebral palsy,” the researchers said. “Outcomes including feeding challenges, sleeping difficulties, severe motor impairment, vision and hearing abnormalities and seizures tended to co-occur.”

Twelve children had three to five of the outcomes assessed in the study, and two had all six outcomes, the researchers added.

They concluded that the report can help guide clinicians on what interventions to pursue for children affected by Zika virus.

“These findings allow for anticipation of medical and social service needs of affected children and their families, including early intervention services and planning for resources to support these families in health care and community settings in Brazil, the United States and other countries,” researcher Ashley Satterfield-Nash, DrPH, of the Oak Ridge Institute for Science and Education in Oak Ridge, Tennessee, and colleagues wrote. “Long- term follow-up and measurement of developmental progression of children affected by Zika virus can inform intervention services and subspecialties needed to provide optimal care for these children.” – by Joe Green

Disclosures: Fitzgerald reports no relevant financial disclosures. Please see the study for all authors’ relevant financial disclosures.

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