Abstract
The recent epidemic of Zika virus (ZIKV) infection in Central and South America is one of the most serious global public health emergencies since the Ebola outbreak in West Africa. In Brazil, especially in the north, northeast, and southeast parts of the country, the ZIKV outbreak is a cause of concern for pregnant women because ZIKV intrauterine infection has been found to be associated with multiple brain malformations and microcephaly. In Brazil, the number of newborns with confirmed microcephaly per year recorded during the ZIKV outbreak, has been approximately 15 times greater than previously reported. Considering that the infection is self-limiting and symptomatic, it is usually diagnosed at the time of routine prenatal scan, especially in the third trimester. In other cases, the disease is detected after childbirth through neuroimaging. This study provides an insight into the history and evolution of ZIKV in Brazil, including current knowledge concerning the transmission, diagnosis, and pathogenesis of the infection. In addition, this review describes the pre- and postnatal neuroimaging findings obtained using ultrasound, magnetic resonance imaging, and computed tomography.
Highlights
A significant epidemiologic surge of registered cases of newborns affected by microcephaly has occurred in the past two years in Brazil
Further evidence has highlighted a possible association of microcephaly with fever, cutaneous rash, and Guillan-Barré syndrome (GBS) in pregnant women living in areas where Zika virus (ZIKV) is endemic [1,2,3,4]
Until the ZIKV genome was isolated and extracted from the brain cells of a third trimester aborted fetus affected by severe microcephaly in a mother who had a presumed ZIKV intrauterine infection in the first trimester of pregnancy [6], the relationship between viral infection and microcephaly remained a conundrum for healthcare providers
Summary
A significant epidemiologic surge of registered cases of newborns affected by microcephaly has occurred in the past two years in Brazil. Until the ZIKV genome was isolated and extracted from the brain cells of a third trimester aborted fetus affected by severe microcephaly in a mother who had a presumed ZIKV intrauterine infection in the first trimester of pregnancy [6], the relationship between viral infection and microcephaly remained a conundrum for healthcare providers. This discovery represents a milestone in the understanding of the infectious disease while confirming a direct pathogenetic and teratogenetic role of ZIKV in cases of congenital infection. As with other Flaviviruses, the transmission cycle of ZIKV between primates and mosquitoes is complex, and man
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