T

wo years ago at this time, heart-stopping pictures of infants with shrunken heads began appear in the news. The world met the Zika babies of Brazil.

But what has happened to those children whose life trajectories were altered when Zika-infected mosquitoes bit their pregnant mothers? A new report paints a bleak picture, one that suggests Brazilian children who were born with severe microcephaly and whose blood showed signs of prior Zika infection are at increased risk of cerebral palsy, seizures, vision problems, and many other conditions.

Those findings — published Thursday in Morbidity and Mortality Weekly Report, a journal published by the Centers for Disease Control and Prevention — come from a small study of the health status of 19 babies born with Zika-related microcephaly.

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The children, who ranged from 19 months to 2 years of age when the assessments were done, were all born between Oct. 1, 2015, and Jan. 31, 2016.

The assessments involved interviews with their caregivers, clinical evaluations, and reviews of their medical histories. The infants were given a standardized neurological exam aimed at seeing if they are developing at the same rate as healthy children, called the Ages and Stages Questionnaires.

Fifteen of the 19 children had not met the developmental milestones — like being able to sit up by themselves — that a healthy 6-month-old would meet, the authors reported.

“They’re profoundly affected, in both their health and their development,” said Dr. Cynthia Moore, chief medical officer in CDC’s division of congenital and developmental disorders.

And Moore admitted they are not likely to grow out of their problems.

“Any babies that have this degree of microcephaly, we would not expect them to catch up,” she said. “We can’t make predictions about exactly what’s going to be their status as they go through childhood into adulthood. But we believe they’ll have lifelong challenges.”

Four of the children had heads that were only slightly smaller than the average head size for their age, and their growth and development was typical for their age. But it’s probably not the case that they caught up with their peers, but rather that they were mistakenly identified as having microcephaly at birth, Moore said.

Ten of the children had frequent sleeping difficulties and nine had eating and swallowing problems. Fourteen had motor impairment problems that appeared to be cerebral palsy and a number had vision and hearing anomalies.
The majority of the children had multiple problems.

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Medical and social services systems that have children with Zika microcephaly in their care are going to need to plan to provide services for them and their families, the report noted, saying these children “will require specialized care from clinicians and caregivers as they age.”

Moore said the CDC plans to monitor the development of babies in the United States who have been born with Zika-related microcephaly, noting the full picture of the damage the virus causes to children infected while they are in the womb will take years to chart out.

“We do not know the spectrum of problems that can happen with Zika virus infection congenitally or in utero. We don’t know the end of it,” she said.

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