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Am J Trop Med Hyg. 2018 Jun;98(6):1860-1862. doi: 10.4269/ajtmh.17-1020. Epub 2018 Apr 19.

Seizures as a Complication of Congenital Zika Syndrome in Early Infancy.

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Postgraduate Program in Health Sciences, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.
Escola de Enfermagem, Instituto da Saúde Coletiva and Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.
Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Sáude, Salvador, Brazil.
Hospital Geral Roberto Santos, Secretaria Estadual da Saúde da Bahia, Salvador, Brazil.
Instituto Evandro Chagas, Belem, Brazil.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.


Zika virus transmission in Brazil was linked to a large outbreak of microcephaly but less is known about longer term anthropometric and neurological outcomes. We studied a cohort of infants born between October 31, 2015, and January 9, 2016, in a state maternity hospital, followed up for 101 ± 28 days by home visits. Microcephaly (< 2 standard deviations, Intergrowth standard) occurred in 62 of 412 (15%) births. Congenital Zika syndrome (CZS) was diagnosed in 29 patients. Among CZS patients, we observed a significant gain in anthropometric measures (P < 0.001) but no significant gain in percentile for these measures. The main neurological outcome was epilepsy, occurring in 48% of infants at a rate of 15.6 cases per 100 patient-months, frequently requiring multiple anti-seizure medications. The cumulative fatality rate was 7.4% (95% confidence interval: 2.1-23.4%). Health-care professionals should be alerted on the high risk of epilepsy and death associated with CZS in early infancy and the need to actively screen for seizures and initiate timely treatment.

[Available on 2019-06-01]

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