Underreporting of #Fatal #Congenital #Zika #Syndrome, #Mexico, 2016–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 8—August 2019 / Dispatch

Underreporting of Fatal Congenital Zika Syndrome, Mexico, 2016–2017

Victor M. Cardenas  , Angel Jose Paternina-Caicedo, and Ernesto Benito Salvatierra

Author affiliations: University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (V.M. Cardenas); Universidad Nacional de Colombia, Bogota, Colombia (A.J. Paternina-Caicedo); Unidad San Cristóbal, Chiapas, Mexico (E.B. Salvatierra)



To determine completeness of fatal congenital Zika syndrome reporting in Mexico, we examined data from the Mexican National Institute of Statistics and Geography. We found that an estimated 50% more infants died from microcephaly attributable to congenital Zika syndrome during 2016–2017 than were reported by the existing surveillance system.

Keywords: Zika Virus; Microcephaly; Zika Congenital Syndrome; Mexico.



Alterations in #visual acuity and visual #development in #infants 1-24 months old either exposed to or infected by #Zika virus during #gestation, with and without #microcephaly (J AAPOS., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J AAPOS. 2019 Jun 20. pii: S1091-8531(19)30137-5. doi: 10.1016/j.jaapos.2019.03.005. [Epub ahead of print]

Alterations in visual acuity and visual development in infants 1-24 months old either exposed to or infected by Zika virus during gestation, with and without microcephaly.

Baran LCP1, da Costa MF2, Vidal KS2, Damico FM3, Barboni MTS4, da S Lima D2, de C R de M França V5, Martins CMG2, Tabares HS2, Dias SL5, Silva LA2, Decleva D2, Hamer RD6, Zatz M7, Bertozzi APAP8, Gazeta RE8, Passos SD8, Ventura DF2.

Author information: 1 Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil. Electronic address: baranejbio@gmail.com. 2 Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil. 3 Department of Ophthalmology, University of São Paulo College of Medicine, São Paulo, SP, Brazil. 4 Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil; Department of Ophthalmology, Semmelweis University, Budapest, Hungary. 5 Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil. 6 Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil; Department of Psychology, Florida Atlantic University, Boca Raton, Florida. 7 Human Genome and Stem Cells Center, Bioscience Institute, University of São Paulo. 8 University of Jundiai Medical School, Jundiai, São Paulo, SP, Brazil.




To evaluate visual acuity and visual acuity development in children from the state of São Paulo, Brazil, who were exposed to the Zika virus (ZIKV) gestationally.


Children who had been exposed to ZIKV during gestation and age-matched control subjects received visual acuity and funduscopic examination. ZIKV exposure was confirmed by maternal quantitative polymerase chain reaction testing or serology assay. The ZIKV group was divided into two subgroups: Zika-exposed (ZE), with only the mother having confirmed ZIKV-infection, and Zika-infected (ZI), with confirmed infection. Visual acuity development was compared with prior norms and quantified by measuring visual acuity correlation with age.


A total of 110 children were included: 47 who had been exposed to ZIKV (ZE, 23; ZI, 24) and 63 controls. Abnormal visual acuity was found in 5 of 24 ZI children. Of the 4 children with microcephaly, only 2 had visual acuity loss (only 1 also had abnormal funduscopic findings). There was significant correlation between age and visual acuity in both the control group (R2 = 0.8; P < 0.0000) and the ZE subgroup (R2 = 0.6; P < 0.0000). However, visual acuity did not correlate with age in the ZI subgroup (R2 = 0.04; P = 0.38). Furthermore, the increment in octaves/month was much lower in the ZI subgroup.


Our data indicates that visual acuity losses only occur in infants who suffered gestational-infection, not simply exposure. Lack of correlation between age and visual acuity in the ZI subgroup suggests a slowing of visual development even in the absence of microcephaly. This result may have broad implications for the deleterious effects of ZIKV on the central nervous system.

Copyright © 2019 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

PMID: 31229606 DOI: 10.1016/j.jaapos.2019.03.005

Keywords: Zika Virus; Zika Congenital Infection; Zika Congenital Syndrome; Microcephaly; Pediatrics; Ophthalmology; Neurology.


#Understanding the #relation between #Zika virus #infection during #pregnancy and adverse #fetal, #infant and #child #outcomes: a protocol … (BMJ Open., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMJ Open. 2019 Jun 18;9(6):e026092. doi: 10.1136/bmjopen-2018-026092.

Understanding the relation between Zika virus infection during pregnancy and adverse fetal, infant and child outcomes: a protocol for a systematic review and individual participant data meta-analysis of longitudinal studies of pregnant women and their infants and children.

Wilder-Smith A1, Wei Y2, Araújo TVB3, VanKerkhove M4, Turchi Martelli CM5, Turchi MD6, Teixeira M7, Tami A8, Souza J9, Sousa P10, Soriano-Arandes A11, Soria-Segarra C12, Sanchez Clemente N13, Rosenberger KD14, Reveiz L15, Prata-Barbosa A16, Pomar L17, Pelá Rosado LE18, Perez F19, Passos SD20, Nogueira M21, Noel TP22, Moura da Silva A23, Moreira ME24, Morales I14, Miranda Montoya MC25, Miranda-Filho DB26, Maxwell L27,28, Macpherson CNL22, Low N29, Lan Z30, LaBeaud AD31, Koopmans M32, Kim C33, João E34, Jaenisch T14, Hofer CB35, Gustafson P36, Gérardin P37,38, Ganz JS39, Dias ACF7, Elias V40, Duarte G41, Debray TPA42, Cafferata ML43, Buekens P44, Broutet N33, Brickley EB45, Brasil P46, Brant F7, Bethencourt S47, Benedetti A48, Avelino-Silva VL49, Ximenes RAA50, Alves da Cunha A51, Alger J52; Zika Virus Individual Participant Data Consortium.

Collaborators (33): Abreu de Carvalho LM, Batista R, Bertozzi AP, Carles G, Cotrim D, Damasceno L, Dimitrakis L, Duarte Rodrigues MM, Estofolete CF, Fragoso da Silveira Gouvêa MI, Fumadó-Pérez V, Gazeta RE, Kaydos-Daniels N, Gilboa S, Krystosik A, Lambert V, López-Hortelano MG, Mussi-Pinhata MM, Nelson C, Nielsen K, Oliani DM, Rabello R, Ribeiro M, Rockx B, Rodrigues LC, Salgado S, Silveira K, Sulleiro E, Tong V, Valencia D, De Souza WV, Villar Centeno LA, Zin A.

Author information: 1 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. 2 Centre for Mathematical Sciences, University of Plymouth, Plymouth, UK. 3 Department of Social Medicine, Universidade Federal de Pernambuco, Recife, Brazil. 4 Health Emergencies Programme, Organisation mondiale de la Sante, Geneve, Switzerland. 5 Department of Collective Health, Institute Aggeu Magalhães (CPqAM), Oswaldo Cruz Foundation, Recife, Brazil. 6 Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil. 7 Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 8 Department of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands. 9 Department of Social Medicine, University of São Paulo, São Paulo, Brazil. 10 Reference Center for Neurodevelopment, Assistance, and Rehabilitation of Children, State Department of Health of Maranhão, Sao Luís, Brazil. 11 Department of Pediatrics, University Hospital Vall d’Hebron, Barcelona, Spain. 12 SOSECALI C. Ltda, Guayaquil, Ecuador. 13 Department of Epidemiology, University of São Paulo, São Paulo, Brazil. 14 Department of Infectious Diseases, Section Clinical Tropical Medicine, UniversitatsKlinikum Heidelberg, Heidelberg, Germany. 15 Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, District of Columbia, USA. 16 Department of Pediatrics, D’Or Institute for Research & Education, Rio de Janeiro, Brazil. 17 Department of Obstetrics and Gynecology, Centre Hospitalier de l’Ouest Guyanais, Saint-Laurent du Maroni, French Guiana. 18 Hospital Materno Infantil de Goiânia, Goiânia State Health Secretary, Goiás, Brazil. 19 Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington, District of Columbia, USA. 20 Department of Pediatrics, FMJ, São Paulo, Brazil. 21 Faculdade de Medicina de Sao Jose do Rio Preto, Department of Dermatologic Diseases, São José do Rio Preto, Brazil. 22 Windward Islands Research and Education Foundation, St. George’s University, True Blue Point, Grenada. 23 Department of Public Health, Universidade Federal do Maranhão – São Luís, São Luís, Brazil. 24 Department of Neonatology, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil. 25 Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia. 26 Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil. 27 Reproductive Health and Research, World Health Organization, Geneva, Switzerland. 28 Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA. 29 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. 30 McGill University Health Centre, McGill University, Montréal, Canada. 31 Pediatric Infectious Diseases, Stanford Hospital, Palo Alto, California, USA. 32 Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands. 33 Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. 34 Department of Infectious Diseases, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil. 35 Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. 36 Statistics, University of British Columbia, British Columbia, Vancouver, Canada. 37 INSERM CIC1410 Clinical Epidemiology, CHU La Réunion, Saint Pierre, Réunion. 38 UM 134 PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de la Réunion), Universite de la Reunion, Sainte Clotilde, Réunion. 39 Children’s Hospital Juvencio Matos, São Luís, Brazil. 40 Sustainable Development and Environmental Health, Pan American Health Organization, Washington, District of Columbia, USA. 41 Department of Gynecology and Obstetrics, University of São Paulo, São Paulo, Brazil. 42 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 43 Mother and Children Health Research Department, Instituto de Efectividad Clinica y Sanitaria, Buenos Aires, Argentina. 44 School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA. 45 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 46 Instituto de pesquisa Clínica Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil. 47 Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia, Carabobo, Bolivarian Republic of Venezuela. 48 Departments of Medicine and of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada. 49 Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil. 50 Department of Tropical Medicine, Federal University of Pernambuco, Recife, Brazil. 51 Department of Pediatrics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 52 Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.




Zika virus (ZIKV) infection during pregnancy is a known cause of microcephaly and other congenital and developmental anomalies. In the absence of a ZIKV vaccine or prophylactics, principal investigators (PIs) and international leaders in ZIKV research have formed the ZIKV Individual Participant Data (IPD) Consortium to identify, collect and synthesise IPD from longitudinal studies of pregnant women that measure ZIKV infection during pregnancy and fetal, infant or child outcomes.


We will identify eligible studies through the ZIKV IPD Consortium membership and a systematic review and invite study PIs to participate in the IPD meta-analysis (IPD-MA). We will use the combined dataset to estimate the relative and absolute risk of congenital Zika syndrome (CZS), including microcephaly and late symptomatic congenital infections; identify and explore sources of heterogeneity in those estimates and develop and validate a risk prediction model to identify the pregnancies at the highest risk of CZS or adverse developmental outcomes. The variable accuracy of diagnostic assays and differences in exposure and outcome definitions means that included studies will have a higher level of systematic variability, a component of measurement error, than an IPD-MA of studies of an established pathogen. We will use expert testimony, existing internal and external diagnostic accuracy validation studies and laboratory external quality assessments to inform the distribution of measurement error in our models. We will apply both Bayesian and frequentist methods to directly account for these and other sources of uncertainty.


The IPD-MA was deemed exempt from ethical review. We will convene a group of patient advocates to evaluate the ethical implications and utility of the risk stratification tool. Findings from these analyses will be shared via national and international conferences and through publication in open access, peer-reviewed journals.


PROSPERO International prospective register of systematic reviews (CRD42017068915).

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

KEYWORDS: Microcephaly; Zika Virus; congenital Zika syndrome; individual participant data meta-analysisis; prognosis; risk prediction model

PMID: 31217315 DOI: 10.1136/bmjopen-2018-026092

Keywords: Zika Virus; Microcephaly; Pregnancy; Zika Congenital Infection; Zika Congenital Syndrome.


A Single-Center #Experience with a #Pregnant #Immigrant #Population and #Zika Virus Serologic #Screening in #NYC (Am J Perinatol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Am J Perinatol. 2019 May 30. doi: 10.1055/s-0039-1688819. [Epub ahead of print]

A Single-Center Experience with a Pregnant Immigrant Population and Zika Virus Serologic Screening in New York City.

Merriam AA1, Nhan-Chang CL1, Huerta-Bogdan BI1, Wapner R1, Gyamfi-Bannerman C1.

Author information: 1 Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, New York.




Our institution is in an area of New York City with a large population of immigrants from Zika virus endemic areas. With the recent Zika virus outbreak, we sought to examine our center’s experience with screening for Zika virus and outcomes among patients who tested positive for the disease during pregnancy.


We performed a chart review of all pregnant patients who tested positive (positive serum or urine polymerase chain reaction [PCR]) or presumed positive (immunoglobulin M [IgM] enzyme-linked immunosorbent assay [ELISA] positive or IgM ELISA equivocal with positive plaque reduction neutralization test) for Zika virus. All tests were performed by the Department of Health (DOH) and followed Centers for Disease Control and Prevention guidelines in effect at the time of specimen collection. Testing of cord blood, placenta, and/or neonatal blood were/was performed by the DOH for New York County. Prenatal ultrasounds for fetal head size and surveillance for calcifications were performed by maternal-fetal medicine specialists. Infant head ultrasound results were included when available.


Between March 2016 and April 2017, 70 pregnant patients were positive or presumed positive for Zika infection during pregnancy. Of those, 16 women had positive urine or serum PCR and the remaining 54 were presumed positive. Among positive cases, five women tested positive via urine PCR only, nine women tested positive via serum PCR only, and two women had both positive urine and serum PCR. Fifteen of 67 infants (22%) born during the study period were born to mothers with positive urine or serum PCR testing. Sixty-five newborns were clinically normal with normal head measurements. Of the intracranial ultrasound performed, one infant had a grade 1 intraventricular hemorrhage, four had incidental choroid plexus cysts, and one had severe ventriculomegaly that was also noted antenatally. There were 2 positive and 15 equivocal infant serum IgM samples and 1 positive placental PCR from these pregnancies. There were four pregnancy terminations and two cases with fetal anomalies in this population that were split evenly between patients who tested positive and those who tested presumed positive for Zika virus during pregnancy.


We found no differences in pregnancy or neonatal outcomes between women who tested positive and presumed positive for Zika virus during pregnancy. Testing of infants and placenta tissue after delivery was largely inconclusive. Improvement in testing for Zika virus infection is needed to determine which pregnancies are at risk for congenital anomalies. Further research is still needed to determine which children are at risk for poor neurodevelopmental outcomes related to Zika virus and how to best coordinate care among the immigrant population during a new disease epidemic.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID: 31146294 DOI: 10.1055/s-0039-1688819

Keywords: Zika Virus; Zika Congenital Syndrome; Pregnancy; USA; NYC; Serology.


#Family-Centered Early #Intervention Program for #Brazilian #Infants with #Congenital #Zika Virus #Syndrome: A Pilot Study (Phys Occup Ther Pediatr., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Phys Occup Ther Pediatr. 2019 May 30:1-13. doi: 10.1080/01942638.2019.1600100. [Epub ahead of print]

Family-Centered Early Intervention Program for Brazilian Infants with Congenital Zika Virus Syndrome: A Pilot Study.

Brandão MB1, Frota LMDCP1,2, Miranda JL2,3, Cavalcante Brasil RM2, Mancini MC1.

Author information: 1a Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil. 2b Núcleo de Tratamento e Estimulação Precoce (NUTEP) , Fortaleza , Brazil. 3c Department of Maternal and Child Health , Universidade Federal do Ceará (UFC) , Fortaleza , Brazil.




To evaluate the effects of a 16-week program based on Goals-Activity-Motor Enrichment (GAME) principles on infants with congenital Zika virus syndrome (CZS)’s mother report of functional goal achievement, motor and cognitive abilities, home enrichment, and parents’ perceptions regarding the service provided.


Quasi-experimental study with infants (n = 32) with CZS and their mothers. Twenty-two infants composed the GAME-based group and 10 were included in the control group. The primary outcome measure was the Canadian Occupational Performance Measure. Secondary outcome measures were the Bayley Scales of Infant and Toddler Development, the Affordances in the Home Environment for Motor Development-Infant Scale, and the Measure of Processes of Care. All measures were performed by blinded assessors.


Mothers of infants in the GAME-based group reported significant improvements in their infants’ performance on functional priorities (p = 0.0001) and satisfaction with their infants’ performance (p = 0.0001), the extent in which services promoted enabling and partnership (p = 0.021), provided general information (p = 0.039), specific information (p = 0.0001), and an enriched home environment (p = 0.0001). Infants in both groups did not improve in motor or cognitive abilities.


A family-centered early intervention program based on GAME principles improved mothers’ individualized outcomes and enriched infants with CZS’s environment. Future studies should elucidate long-term benefits of interventions for this population.

KEYWORDS: Family; Zika virus; goals; infants; intervention; occupational therapy; physical therapy; speech therapy

PMID: 31144558 DOI: 10.1080/01942638.2019.1600100

Keywords: Zika Virus; Zika Congenital Syndrome; Society; Psychiatry.


#Neurogenic #bladder in the settings of #congenital #Zika #syndrome: a confirmed and unknown condition for #urologists (J Pediatr Urol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Pediatr Urol. 2019 Apr 30. pii: S1477-5131(19)30090-7. doi: 10.1016/j.jpurol.2019.04.018. [Epub ahead of print]

Neurogenic bladder in the settings of congenital Zika syndrome: a confirmed and unknown condition for urologists.

Costa Monteiro LM1, Cruz GNO2, Fontes JM2, de Araujo GF2, Ventura T3, Monteiro AC4, Moreira MEL2.

Author information: 1 Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/FIOCRUZ), RJ, Brazil. Electronic address: luciacostamonteiro@gmail.com. 2 Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/FIOCRUZ), RJ, Brazil. 3 CAPES Research Student at Instituto Nacional de Saúde da Mulher, da Criança e Do Adolescente Fernandes Figueira (IFF/FIOCRUZ), RJ, Brazil. 4 UCLA. Division of Pulmonary and Critical Care Medicine, CA, USA.




Congenital Zika syndrome (CZS) is a recently discovered condition that affects central nervous system structures that control the lower urinary tract. The first cases of neurogenic bladder (NB) were recently reported as a sequalae of CZS in neurologically impaired children.


Our goal is to further evaluate NB in the setting of CZS, identifying urological risk indicators in hopes that early diagnosis will mitigate the impact of the disease.


Urological assessment was performed in all patients with CZS and neurological impairment who were referred to our urodynamic clinic between June 2016 and May 2018. Neurogenic bladder was confirmed by urodynamic evaluation, and urological risk was based on urodynamic results.


Sixty-nine patients with CZS were tested. The majority (63 patients, 91.3%) presented with overactive bladder with increased pressures and reduced capacity for age (table 1). Different urodynamic patterns were observed, and the association of reduced bladder capacity for age, high bladder-filling pressure, and increased postvoid residual were frequently observed.


NB continues to be consistently diagnosed in our cohort of CZS, mostly with high-risk indicators for renal impairment. When not intervened upon in a timely manner, NB can cause progressive damage to the urinary tract, but the lack of knowledge that CZS causes NB delays investigation and treatment. Parents and health professionals will need to be sensitized to the risks that ZIKV can pose to the urinary tract so that appropriate therapies are initiated to prevent irreversible renal damage.


NB is a common condition among our patients with CZS and microcephaly. This is a new cause of NB, unknown to urologists. While further investigation is necessary to understand long-term disease behavior and therapeutic response, increased knowledge among urologists may help to reduce morbidity related to untreated NB and to mitigate the disease burden for patients and families.

Copyright © 2019 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

KEYWORDS: Congenital Zika syndrome; Microcephaly; Neurogenic bladder; Urinary tract infection; Zika virus

PMID: 31142443 DOI: 10.1016/j.jpurol.2019.04.018

Keywords: Zika Virus; Zika Congenital Syndrome; Neurogenic bladder; Neurology; Pediatrics.


#Clinical and x-ray #oral #evaluation in patients with #congenital #Zika Virus (J Appl Oral Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Appl Oral Sci. 2019 May 20;27:e20180276. doi: 10.1590/1678-7757-2018-0276.

Clinical and x-ray oral evaluation in patients with congenital Zika Virus.

Carvalho IF1, Alencar PNB1, Carvalho de Andrade MD1, Silva PGB1, Carvalho EDF1, Araújo LS1, Cavalcante MPM1, Sousa FB1.

Author information: 1 Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brasil.




The aim of this study was to investigate possible malformations in the soft, bone and/or dental tissues in patients with congenital Zika Virus (ZIKV) by clinical and x-ray evaluation.


Thirty children born with ZIKV and 30 children born without ZIKV (control group) were included in the study. Patients were evaluated over 24 consecutive months according to the variables: sex, age, cleft palates, soft tissue lesions, alveolar ridge hyperplasia, short labial and lingual frenums, inadequate posture of the lingual and perioral muscles at rest, micrognathia, narrow palatine vaults, changes in the teeth shape and/or number, sequence eruption, spasms, seizures and eruption delay were evaluated. Chi-square test, Student’s t-test and nominal logistic regression were used (p<0.05).


Among the 30 babies examined, the mean age of the first dental eruption was 10.8±3.8 with almost two-thirds of the children (n=18, 60%) experiencing eruptions of their first tooth after 9 months of age, nine children (30%) had inadequate lingual posture at rest, more than half of the children (n=18, 60%) had short labial or lingual frenums. ZIKV babies showed a high prevalence of clef palate (p<0.001), inadequate lingual posture at rest (p=0.004), micrognathia (p=0.002), changes in the shape and/or number of teeth (p=0.006), alteration in sequence of dental eruption (p<0.001) and muscles spasms (p=0.002). The delay eruption was associated with inadequate lingual posture at rest (p=0.047), micrognathia (p=0.002) and changes in the shape and/or number of teeth (p=0.021). The delayed eruption (p=0.006) and narrow palatine vaults (p=0.008) were independently associated with ZIKV. Moreover, female patients showed the most narrow palatine vaults (p=0.010).


The children with ZIKV showed a greater tendency to have delayed eruption of the first deciduous tooth, inadequate lingual posture and short labial and lingual frenums.

PMID: 31116278 DOI: 10.1590/1678-7757-2018-0276

Keywords: Zika Virus; Zika Congenital Syndrome; Brazil.