Library

| Daily Briefing

The first Zika-infected babies are growing up. How are they doing?


Children ages 19 months to 24 months with microcephaly and laboratory evidence of Zika virus infection are facing functional and medical challenges across several areas of development, according to CDC's Morbidity and Mortality Weekly Report released last month.  

Report details

For the report, CDC researchers collaborated with the Brazilian Ministry of Health and other organizations to assess the growth and development of children born in Paraíba state of Brazil between Oct. 1, 2015, and Jan. 31, 2016. The report focuses on a subsample of 19 of the "most severe" cases of infants who were born with microcephaly and had laboratory evidence of Zika virus infection.

The researchers evaluated the children based on clinical evaluations, caregiver interviews, and a review of medical records. Each of the children involved in the report also completed a standardized neurological exam.

Findings

CDC researchers found all 19 children had at least one adverse outcome, including:

  • Feeding challenges;
  • Seizures;
  • Severe motor impairments;
  • Sleeping difficulties; and
  • Vision and hearing abnormalities.

These challenges tended to co-occur in children, the CDC researchers found.

Specifically, the CDC researchers found:

  • 13 children had impaired responses to visual stimuli;
  • 11 children screened positive for nonfebrile seizures, which indicates the possibility of a seizure disorder;
  • 10 children frequently experienced difficulty sleep;
  • Nine children had challenges with eating and swallowing; and
  • Eight children were previously hospitalized—including six children who had bronchitis/pneumonia.

According to the report, 15 of the children did not meet developmental milestones—such as being able to sit up by themselves—under the Ages and Stages Questionnaires for children ages six months. The CDC researchers found 15 children had Hammersmith Infant Neurological Examination scores that indicate severe motor impairments, of which 14 had scores consistent with cerebral palsy, the researchers found.

Four of the children showed very few symptoms and typical development and growth patterns, which Cynthia Moore, CMO in CDC's division of congenital and development disorders, said indicates they were mistakenly identified as having Zika-related microcephaly at birth.

Implications

CDC Director Brenda Fitzgerald said, "We would expect that these children are going to require enormous amounts of work and require enormous amounts of care." For instance, CDC researchers in the report wrote that "the data allow for [the] anticipation of medical and social services needs of affected children and families, such as early intervention services, and planning for resources to support these families in health care and community settings."

Moore said CDC plans to monitor the development of U.S. babies born with Zika-related microcephaly to better understand the effects of the Zika virus. She said, "We do not know the spectrum of problems that can happen with Zika virus infection congenitally or in utero" and "[w]e don't know the end of it" (Branswell, STAT News, 12/14; Belluck, New York Times, 12/14; CDC's Morbidity and Mortality Weekly Report, 12/15).

Zika and beyond: Help your physicians consistently follow care standards

Frontline staff need to consistently follow care standards to deliver highly reliable care. But the overwhelming pace of changes to evidence-based guidelines means they often struggle to integrate new standards into their daily practice.

Our new study profiles how Midland Memorial Hospital introduced a peer coaching program, paring high-performing frontline nurses on their pain assessment protocol with lower-performing nurses—and achieved a 50 percent point gain in compliance.

Get the Insight

[an error occurred while processing this directive]

SPONSORED BY

INTENDED AUDIENCE

AFTER YOU READ THIS

AUTHORS

TOPICS

Don't miss out on the latest Advisory Board insights

Create your free account to access 1 resource, including the latest research and webinars.

Want access without creating an account?

   

You have 1 free members-only resource remaining this month.

1 free members-only resources remaining

1 free members-only resources remaining

You've reached your limit of free insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox

You've reached your limit of free insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox
AB
Thank you! Your updates have been made successfully.
Oh no! There was a problem with your request.
Error in form submission. Please try again.