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Baby sleeping under a mosquito net in cradle.

Researchers from the CDC and Brazil’s Ministry of Health released key findings from a study that monitored the growth and development of children affected by Zika and microcephaly at birth.

The Brazilian Ministry of Health (MOH) declared Zika a public health emergency in November 2015. Over the following year, 15 states in Brazil with laboratory-confirmed Zika virus transmission reported an increase in birth prevalence of microcephaly. The prevalence increased to 2.8 cases per 10,000 live births compared to states without confirmed transmission at .6 per 10,000.

Microcephaly occurs when a fetus is exposed to the Zika virus, and results in a child being born with a smaller-than-average head size. Out of the thousands of children born in northern Brazil in 2015-2016 and affected by Zika, one of the most predominant and severe issues seen was microcephaly.

The CDC report is among the first to demonstrate the potential long-term effects of Zika and microcephaly.

The researchers recorded the health and developmental challenges of 19 children with microcephaly and confirmed Zika exposure at birth. They assessed the study participants through clinical evaluations, caregiver interviews and medical record reviews. Physicians were trained to use the Hammersmith Infant Neurological Examination (HINE), a standardized neurologic exam, to evaluate neuromotor function and visual and auditory responses, according to the CDC.

The challenges and effects were examined when the children were between 19 and 24 months of age, with the median age being 22 months. The group of children included 10 males and nine females.

The report’s main findings include:

  • 11 of the 19 children showed indications of a possible seizure disorder
  • 10 had sleeping problems
  • Nine had trouble swallowing or other feeding challenges
  • 13 demonstrated hearing issues, with some not reacting to the sound of a rattle
  • 11 had vision problems
  • 15 showed severe motor impairments, 14 of whom had symptoms consistent with cerebral palsy

All of the children had at least one of the above challenges, while 12 out of the 19 children suffered from three to five of the issues, and two experienced all six problems.

Further troubles included hospital visits, which eight endured, most commonly because of bouts of bronchitis or pneumonia.

“This report expands on initial findings by demonstrating that specific outcomes, such as severe motor impairment and impaired visual and auditory response to stimuli, affect the majority of children with evidence of congenital Zika virus infection and microcephaly and become more apparent as these children age,” the CDC wrote.

The report went on to outline the effects of physical growth among the group of children as well. At the time of the assessment, 15 children (seven males, eight females) had head circumference measurements that were more than 3 standard deviations (SDs) below the average for their age and sex.

Thirteen (six males, seven females) had length measurements 1 to 3 SDs below the average, and 13 children also had weight measurements 1 to 3 SDs below average for their age and sex.

As of September 2017, 2,986 newborns with microcephaly were reported to Brazil’s national microcephaly registry, according to the CDC. Of those, 2,959 cases are currently being monitored.

The CDC states that the findings of this follow-up analysis can provide beneficial information to families and medical professionals regarding the specialized care and services children will need as they continue to age.

“Children with disabilities related to congenital Zika virus infection will need multidisciplinary care from various pediatric subspecialists,” according to the CDC.

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