Study suggests key Zika, microcephaly link

- We might be one step closer to confirming a link between the Zika virus and a serious birth defect, microcephaly.  

Researchers have found millions of copies of the genetic material, RNA, from the Zika virus in the brain tissue of a fetus with severe microcephaly, according to a study published in the New England Journal of Medicine

The mother of the child is European, but was working in Brazil during a pregnancy that began in February 2015.  During her 13th week of pregnancy, she developed high fever, followed by muscle and joint pain, pain in the back of her eyes, and a rash with some itching.   Ultrasounds at 14 and 20 weeks were normal.

Upon her return to her home in Slovenia, a subsequent ultrasound at 29 weeks began to show abnormalities.  She also noticed the fetus wasn’t moving as much.  At 32 weeks, a second ultrasound confirmed microcephaly.  Brain structures were described as “blurred” and there were multiple calcifications in various locations the brain.  The areas in the brain that contain fluid, the ventricles, were enlarged.

The fetus was given a very poor prognosis for neonatal health, and after approval by the hospital ethics committee, a late stage termination was performed, followed by an autopsy on the fetus.   The baby was found to be small for gestational age (5th percentile) and head size was only at the 1st percentile.  

Within the brain, they found clusters of virus particles in the cells.  There was also degeneration of the spinal cord that controls movements as well as in the brain stem, an area responsible for breathing.  

In an accompanying NEJM editorial, Dr. Eric Rubin of the Harvard College of Public Health writes that this case “helps to strengthen” the link between Zika virus infection in pregnancy and microcephaly. 

Dr. Rubin believes more answers will come when a rapid, accurate, scalable test to detect Zika virus is developed.    It will help determine who has been infected and whether mild, asymptomatic infections in expectant mothers put their babies at risk.  

The authors of the paper also believe women in these areas need to have access to “relevant health care services, including contraception, diagnostics, and pregnancy termination services.”  

There will also be need to care for affected children. 

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