In:

Morbidity and Mortality Weekly Report

Authors: 

Lavinia Schuler-Faccini, PhD; Erlane M. Ribeiro, PhD; Ian M.L. Feitosa, MD; Dafne D.G. Horovitz, PhD; Denise P. Cavalcanti, PhD, MD; André Pessoa; Maria Juliana R. Doriqui, MD; Joao Ivanildo Neri, MD; Joao Monteiro de Pina Neto, PhD; Hector Y.C. Wanderley, MD; Mirlene Cernach, PhD; Antonette S. El-Husny, PhD; Marcos V.S. Pone, PhD; Cassio L.C. Serao, MD; Maria Teresa V. Sanseverino, PhD; Brazilian Medical Genetics Society–Zika Embryopathy Task Forc

In early 2015, an outbreak of Zika virus, a flavivirus trans- mitted by Aedes mosquitoes, was identified in northeast Brazil, an area where dengue virus was also circulating. By September, reports of an increase in the number of infants born with microcephaly in Zika virus-affected areas began to emerge, and Zika virus RNA was identified in the amniotic fluid of two women whose fetuses had been found to have microcephaly by prenatal ultrasound. The Brazil Ministry of Health (MoH) established a task force to investigate the possible association of microcephaly with Zika virus infection during pregnancy and a registry for incident microcephaly cases (head circumference ≥2 standard deviations [SD] below the mean for sex and ges- tational age at birth) and pregnancy outcomes among women suspected to have had Zika virus infection during pregnancy. Among a cohort of 35 infants with microcephaly born dur- ing August–October 2015 in eight of Brazil’s 26 states and reported to the registry, the mothers of all 35 had lived in or visited Zika virus-affected areas during pregnancy, 25 (71%) infants had severe microcephaly (head circumference >3 SD below the mean for sex and gestational age), 17 (49%) had at least one neurologic abnormality, and among 27 infants who hadneuroimagingstudies, allhadabnormalities.Testsforother congenital infections were negative. All infants had a lumbar puncture as part of the evaluation and cerebrospinal fluid (CSF) samples were sent to a reference laboratory in Brazil for Zika virus testing; results are not yet available. Further studies are needed to confirm the association of microcephaly with Zika virus infection during pregnancy and to understand any other adverse pregnancy outcomes associated with Zika virus infec- tion. Pregnant women in Zika virus-affected areas should pro- tectthemselvesfrommosquitobitesbyusingairconditioning, screens, or nets when indoors, wearing long sleeves and pants, using permethrin-treated clothing and gear, and using insect repellents when outdoors. Pregnant and lactating women can use all U.S. Environmental Protection Agency (EPA)-registered insect repellents according to the product label.

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