The Spectrum of Developmental Disability with Zika Exposure: What Is Known, What Is Unknown, and Implications for Clinicians.
Eliza Gordon-Lipkin, Georgina Peacock
PMID 30921103WHAT IT FOUND
Children with congenital Zika syndrome often have severe brain, vision, feeding, motor, language, and seizure problems, and hearing impairment is variable.
Not all exposed infants are affected. Screening and multidisciplinary follow-up are recommended, but rehabilitation effects are unknown.
Key findings
01Most newborns born to mothers with positive laboratory tests for Zika virus infection during pregnancy have a typical appearance at birth.
02Motor impairment is a major feature of congenital Zika syndrome, with hypertonia reported in 37% to 100% and 14 of 15 infants aged 19 to 24 months having findings consistent with cerebral palsy.
03Severe language and swallowing problems have been reported: in one series of 19 infants aged 19 to 24 months all were nonverbal, and dysphagia frequency in case series was 14% to 77%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not an original study, and it does not describe how studies were selected or combined. Most evidence comes from case series, reports, and small follow-up studies, mostly in infants and children under 2 years, so long-term outcomes are not known. Hearing, vision, growth, and dysphagia estimates come from different studies with different methods, so the numbers cannot be treated as one population. Laboratory testing for Zika is imperfect, so some infants counted as exposed may not have been infected and some uninfected may have been missed. Many interventions recommended in the paper have not been studied in congenital Zika syndrome. The paper reports CDC and expert recommendations, not tested rehabilitation interventions. Data on families, social impact, and postnatal microcephaly are limited to small series or public health reports.
Declared interests
The authors declared no conflict of interest. The text does not report a funding source.
The easy way to misread this
Do not conclude that prenatal Zika exposure always causes congenital Zika syndrome or that rehabilitation improves outcomes. Most infants born to mothers with positive Zika tests have a typical appearance at birth, and the paper states that outcomes of interventions such as eyeglasses, patching, visual stimulation, strabismus surgery, amplification, cochlear implants, and feeding tubes have not been studied in congenital Zika syndrome.