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Lancet Infect Dis. 2018 Jan;18(1):e1-e13. doi: 10.1016/S1473-3099(17)30398-5. Epub 2017 Aug 30.

Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management.

Author information

1
Institute for Global Health, University College London, London, UK. Electronic address: d.devakumar@ucl.ac.uk.
2
Infectious Diseases Department, Great Ormond Street Hospital, London, UK; Great Ormond Street Institute of Child Health, University College London, London, UK.
3
Department of Parasitology, Institute for Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
4
Department of Paediatrics, University of Oxford, Oxford, UK.
5
Great Ormond Street Institute of Child Health, University College London, London, UK.
6
Leonard Cheshire Disability and Inclusive Development Centre, University College London, London, UK.
7
Division of Infection and Immunity, University College London, London, UK.
8
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
9
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
10
Institute for Global Health, University College London, London, UK.

Abstract

Microcephaly is an important sign of neurological malformation and a predictor of future disability. The 2015-16 outbreak of Zika virus and congenital Zika infection brought the world's attention to links between Zika infection and microcephaly. However, Zika virus is only one of the infectious causes of microcephaly and, although the contexts in which they occur vary greatly, all are of concern. In this Review, we summarise important aspects of major congenital infections that can cause microcephaly, and describe the epidemiology, transmission, clinical features, pathogenesis, management, and long-term consequences of these infections. We include infections that cause substantial impairment: cytomegalovirus, herpes simplex virus, rubella virus, Toxoplasma gondii, and Zika virus. We highlight potential issues with classification of microcephaly and show how some infants affected by congenital infection might be missed or incorrectly diagnosed. Although Zika virus has brought the attention of the world to the problem of microcephaly, prevention of all infectious causes of microcephaly and appropriately managing its consequences remain important global public health priorities.

PMID:
28844634
DOI:
10.1016/S1473-3099(17)30398-5
[Indexed for MEDLINE]

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