Autor(es): Oliveira Filho, Jamary ; Felzemburgh, Ridalva ; Costa, Federico ; Nery Jr, Nivison ; Mattos, Adriana ; Henriques, Daniele Freitas ; Ko, Albert I
Data: 2018
Origem: Oasisbr
Assunto(s): Zika virus / patogenicidade; Microcefalia / complica??es; Epilepsia; Convuls?es; Anormalidades Cong?nitas / embriologia; Rec?m-Nascido; Infec??o pelo Zika virus / embriologia; Salvador (BA)
This study was supported by NIH Grants RO1 NS064905, NIH R01 AI052473, U01 AI088752, and R25 TW009338, and the Oswaldo Cruz Foundation
Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Postgraduate Program in Health Sciences. Salvador, BA, Brazil.
Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Instituto da Sa?de Coletiva. Escola de Enfermagem. Salvador, BA, Brazil.
Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Instituto da Sa?de Coletiva. Escola de Enfermagem. Salvador, BA, Brazil.
Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Centro de Pesquisas Gon?alo Moniz. Salvador, BA, Brazil.
Secretaria Estadual da Sa?de da Bahia. Hospital Geral Roberto Santos. Salvador, BA, Brazil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Funda??o Oswaldo Cruz. Centro de Pesquisas Gon?alo Moniz. Salvador, BA, Brazil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut.
Abstract. Zika virus transmission in Brazil was linked to a large outbreak of microcephaly but less is known about longer term anthropometric and neurological outcomes. We studied a cohort of infants born between October 31, 2015, and January 9, 2016, in a state maternity hospital, followed up for 101 ? 28 days by home visits. Microcephaly (< 2 standard deviations, Intergrowth standard) occurred in 62 of 412 (15%) births. Congenital Zika syndrome (CZS) was diagnosed in 29 patients. Among CZS patients, we observed a significant gain in anthropometric measures (P < 0.001) but no significant gain in percentile for these measures. The main neurological outcome was epilepsy, occurring in 48% of infants at a rate of 15.6 cases per 100 patient-months, frequently requiring multiple anti-seizure medications. The cumulative fatality rate was 7.4% (95% confidence interval: 2.1?23.4%). Health-care professionals should be alerted on the high risk of epilepsy and death associated with CZS in early infancy and the need to actively screen for seizures and initiate timely treatment.
