The most recent Zika outbreak ended at the close of 2016. It is reasonable to assume that neurologists will be major players as the full consequences of the outbreak become clear, even though we don’t fully understand its long-term impact today. In August, the CDC published new information about the effect of Zika on children born to women infected during pregnancy.
Researchers gathered information on children who met three criteria:
- They were at least one year old.
- They were born in US territories or associated states.
- Their mothers had laboratory-confirmed known or possible Zika infection during pregnancy.
This cohort of children is enrolled in the U.S. Zika Pregnancy and Infant Registry (USZPIR), and they are followed with active surveillance methods.
Of the 1,450 children for whom surveillance information was available, nine percent had at least one neurodevelopmental anomaly. These included seizures, hearing and swallowing problems, and movement issues. Another six percent had a Zika-related birth defect, and one percent had both. In total, 14 percent of the infants were affected in one or both ways.
One percent of the children showed postnatal-onset microcephaly that was not evident at birth.
This is consistent with reports from other countries of neurological and developmental issues arising later in childhood. The authors suggest it is possible that more of these issues will arise as these children grow.
Of further concern is the roughly one-third of infants in the registry for whom researchers found no records of follow-up. And of the children who did have some follow-up reported, most did not have all of the recommended evaluations.
These are missed opportunities for early intervention designed to improve neurological, social and cognitive function. This increases the likelihood that neurologists will be caring for children who are faced with long-term effects of Congenital Zika Syndrome.
This is an opportunity and a call-to-action for neurologists to take the lead in their communities to be sure these children have appropriate follow-up. By coordinating with obstetricians, pediatricians, and family medicine specialists, neurologists can help ensure that these children receive needed follow-ups and evaluations so intervention can be implemented in a timely manner.
The benefits of neurologists taking such a step are twofold. First, it may help these children attain the best outcomes possible through early intervention. Second, it provides needed information for use in future outbreaks of Zika virus.
As the authors explain, this information can inform and guide future responses to outbreaks of Zika virus. These outbreaks are inevitable, and they will disproportionately affect pregnant women and their children. By intervening now, neurologists give themselves the opportunity to provide the best possible care later.