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Pediatrics175 papers

Congenital infection caused by Zika virus

Last edited: 4/14/2026

Overview

Congenital Zika syndrome (CZS) results from vertical transmission of Zika virus during pregnancy, leading to a spectrum of neurological and developmental abnormalities in newborns, most notably microcephaly, but also including ocular, dental, and cerebral malformations 16910.

Diagnosis

  • Key Diagnostic Criteria: Microcephaly, neuroimaging findings such as calcifications, cortical malformations, ventriculomegaly, and reduced brain volume 914.
  • Recommended Tests: Amniocentesis, cord blood testing, placental tissue analysis, and postnatal neuroimaging (MRI/CT) 4914.
  • Clinical Features: Includes developmental delays, seizures, hearing and vision impairments, and musculoskeletal abnormalities 6815.

    • Management

  • Supportive Care: Focus on multidisciplinary interventions including physical, occupational, and speech therapy 113.
  • Monitoring: Regular developmental assessments and neuroimaging to track progression and identify complications 1316.
  • No Specific Antiviral Treatment: Current guidelines do not recommend specific antiviral therapies for CZS 10.

    • Special Populations

  • Pregnancy: Pregnant women exposed to Zika virus require close monitoring and counseling on potential risks 110.
  • Pediatrics: Early intervention programs are crucial for managing developmental delays and associated disabilities 11316.

    • Key Recommendations

  • Screen and Monitor High-Risk Pregnancies: Implement rigorous screening and monitoring protocols for pregnant women in endemic areas to detect Zika virus infection early (Evidence: Strong 110).
  • Comprehensive Developmental Follow-Up: Provide comprehensive developmental follow-up for infants exposed to Zika virus, including regular neurological and imaging assessments (Evidence: Moderate 1316).
  • Multidisciplinary Support Teams: Establish multidisciplinary teams to support affected children, focusing on physical, cognitive, and sensory rehabilitation (Evidence: Expert opinion 1).
  • Awareness and Counseling: Enhance public health awareness and provide counseling to women of reproductive age regarding Zika virus risks and preventive measures (Evidence: Moderate 12).

    • References

    1 Wenham C, Abagaro C, Arévalo A, Coast E, Corrêa S, Cuéllar K et al.. Analysing the intersection between health emergencies and abortion during Zika in Brazil, El Salvador and Colombia. Social science & medicine (1982) 2021. link 2 Costa PRLA, Aragão FBA, Serra JDN, Andrade MS, Reis AD, Nascimento MDDSB. QUALITY OF LIFE OF MOTHERS OF CHILDREN WITH CONGENITAL SYNDROME AFFECTED BY ZIKA VIRUS. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo 2021. link 3 Veiga RV, Schuler-Faccini L, França GVA, Andrade RFS, Teixeira MG, Costa LC et al.. Classification algorithm for congenital Zika Syndrome: characterizations, diagnosis and validation. Scientific reports 2021. link 4 Melo A, de Sales Tavares J, de Assis Costa M, Santana de Aguiar R, Malinger G, de Oliveira Melo F et al.. Obstetric and perinatal outcomes in cases of congenital Zika syndrome. Prenatal diagnosis 2020. link 5 Silva MCPMD, Arnaud MA, Lyra MCA, Alencar Filho AV, Rocha MÂW, Ramos RCF et al.. Dental development in children born to Zikv-infected mothers: a case-based study. Archives of oral biology 2020. link 6 Freitas DA, Souza-Santos R, Carvalho LMA, Barros WB, Neves LM, Brasil P et al.. Congenital Zika syndrome: A systematic review. PloS one 2020. link 7 Aguiar RS, Pohl F, Morais GL, Nogueira FCS, Carvalho JB, Guida L et al.. Molecular alterations in the extracellular matrix in the brains of newborns with congenital Zika syndrome. Science signaling 2020. link 8 Ventura CV, Ventura Filho MC, Ventura LO. Ocular Manifestations and Visual Outcome in Children With Congenital Zika Syndrome. Topics in magnetic resonance imaging : TMRI 2019. link 9 de Fatima Viana Vasco Aragao M, de Lima Petribu NC, van der Linden V, Valenca MM, de Brito CAA, Parizel PM. Updated Imaging Findings in Congenital Zika Syndrome: A Disease Story That is Still Being Written. Topics in magnetic resonance imaging : TMRI 2019. link 10 Stockwell S. The CDC Updates Guidelines for Congenital Zika. The American journal of nursing 2018. link 11 Martins RS, Fróes MH, Saad LDC, Ignácio Junior SM, Prado WDA, Figueiredo EM et al.. Descriptive report of cases of congenital syndrome associated with Zika virus infection in the state of São Paulo, Brazil, from 2015 to 2017. Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil 2018. link 12 França GVA, Pedi VD, Garcia MHO, Carmo GMID, Leal MB, Garcia LP. Congenital syndrome associated with Zika virus infection among live births in Brazil: a description of the distribution of reported and confirmed cases in 2015-2016. Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil 2018. link 13 França TLB, Medeiros WR, Souza NL, Longo E, Pereira SA, França TBO et al.. Growth and Development of Children with Microcephaly Associated with Congenital Zika Virus Syndrome in Brazil. International journal of environmental research and public health 2018. link 14 Aragao MFVV, Holanda AC, Brainer-Lima AM, Petribu NCL, Castillo M, van der Linden V et al.. Nonmicrocephalic Infants with Congenital Zika Syndrome Suspected Only after Neuroimaging Evaluation Compared with Those with Microcephaly at Birth and Postnatally: How Large Is the Zika Virus "Iceberg"?. AJNR. American journal of neuroradiology 2017. link 15 Ventura CV, Fernandez MP, Gonzalez IA, Rivera-Hernandez DM, Lopez-Alberola R, Peinado M et al.. First Travel-Associated Congenital Zika Syndrome in the US: Ocular and Neurological Findings in the Absence of Microcephaly. Ophthalmic surgery, lasers & imaging retina 2016. link 16 França GV, Schuler-Faccini L, Oliveira WK, Henriques CM, Carmo EH, Pedi VD et al.. Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation. Lancet (London, England) 2016. link30902-3) 17 Miranda-Filho Dde B, Martelli CM, Ximenes RA, Araújo TV, Rocha MA, Ramos RC et al.. Initial Description of the Presumed Congenital Zika Syndrome. American journal of public health 2016. link 18 Martines RB, Bhatnagar J, de Oliveira Ramos AM, Davi HP, Iglezias SD, Kanamura CT et al.. Pathology of congenital Zika syndrome in Brazil: a case series. Lancet (London, England) 2016. link30883-2)

    Original source

    1. [1]
      Analysing the intersection between health emergencies and abortion during Zika in Brazil, El Salvador and Colombia. — Wenham C, Abagaro C, Arévalo A, Coast E, Corrêa S, Cuéllar K et al. Social science & medicine (1982) (2021)
    2. [2]
      QUALITY OF LIFE OF MOTHERS OF CHILDREN WITH CONGENITAL SYNDROME AFFECTED BY ZIKA VIRUS. — Costa PRLA, Aragão FBA, Serra JDN, Andrade MS, Reis AD, Nascimento MDDSB Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo (2021)
    3. [3]
      Classification algorithm for congenital Zika Syndrome: characterizations, diagnosis and validation. — Veiga RV, Schuler-Faccini L, França GVA, Andrade RFS, Teixeira MG, Costa LC et al. Scientific reports (2021)
    4. [4]
      Obstetric and perinatal outcomes in cases of congenital Zika syndrome. — Melo A, de Sales Tavares J, de Assis Costa M, Santana de Aguiar R, Malinger G, de Oliveira Melo F et al. Prenatal diagnosis (2020)
    5. [5]
      Dental development in children born to Zikv-infected mothers: a case-based study. — Silva MCPMD, Arnaud MA, Lyra MCA, Alencar Filho AV, Rocha MÂW, Ramos RCF et al. Archives of oral biology (2020)
    6. [6]
      Congenital Zika syndrome: A systematic review. — Freitas DA, Souza-Santos R, Carvalho LMA, Barros WB, Neves LM, Brasil P et al. PloS one (2020)
    7. [7]
      Molecular alterations in the extracellular matrix in the brains of newborns with congenital Zika syndrome. — Aguiar RS, Pohl F, Morais GL, Nogueira FCS, Carvalho JB, Guida L et al. Science signaling (2020)
    8. [8]
      Ocular Manifestations and Visual Outcome in Children With Congenital Zika Syndrome. — Ventura CV, Ventura Filho MC, Ventura LO Topics in magnetic resonance imaging : TMRI (2019)
    9. [9]
      Updated Imaging Findings in Congenital Zika Syndrome: A Disease Story That is Still Being Written. — de Fatima Viana Vasco Aragao M, de Lima Petribu NC, van der Linden V, Valenca MM, de Brito CAA, Parizel PM Topics in magnetic resonance imaging : TMRI (2019)
    10. [10]
      The CDC Updates Guidelines for Congenital Zika. — Stockwell S The American journal of nursing (2018)
    11. [11]
      Descriptive report of cases of congenital syndrome associated with Zika virus infection in the state of São Paulo, Brazil, from 2015 to 2017. — Martins RS, Fróes MH, Saad LDC, Ignácio Junior SM, Prado WDA, Figueiredo EM et al. Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil (2018)
    12. [12]
      Congenital syndrome associated with Zika virus infection among live births in Brazil: a description of the distribution of reported and confirmed cases in 2015-2016. — França GVA, Pedi VD, Garcia MHO, Carmo GMID, Leal MB, Garcia LP Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil (2018)
    13. [13]
      Growth and Development of Children with Microcephaly Associated with Congenital Zika Virus Syndrome in Brazil. — França TLB, Medeiros WR, Souza NL, Longo E, Pereira SA, França TBO et al. International journal of environmental research and public health (2018)
    14. [14]
      Nonmicrocephalic Infants with Congenital Zika Syndrome Suspected Only after Neuroimaging Evaluation Compared with Those with Microcephaly at Birth and Postnatally: How Large Is the Zika Virus "Iceberg"? — Aragao MFVV, Holanda AC, Brainer-Lima AM, Petribu NCL, Castillo M, van der Linden V et al. AJNR. American journal of neuroradiology (2017)
    15. [15]
      First Travel-Associated Congenital Zika Syndrome in the US: Ocular and Neurological Findings in the Absence of Microcephaly. — Ventura CV, Fernandez MP, Gonzalez IA, Rivera-Hernandez DM, Lopez-Alberola R, Peinado M et al. Ophthalmic surgery, lasers & imaging retina (2016)
    16. [16]
      Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation. — França GV, Schuler-Faccini L, Oliveira WK, Henriques CM, Carmo EH, Pedi VD et al. Lancet (London, England) (2016)
    17. [17]
      Initial Description of the Presumed Congenital Zika Syndrome. — Miranda-Filho Dde B, Martelli CM, Ximenes RA, Araújo TV, Rocha MA, Ramos RC et al. American journal of public health (2016)
    18. [18]
      Pathology of congenital Zika syndrome in Brazil: a case series. — Martines RB, Bhatnagar J, de Oliveira Ramos AM, Davi HP, Iglezias SD, Kanamura CT et al. Lancet (London, England) (2016)
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