Children with Congenital Zika Virus Infection Face Serious Challenges

On December 14, 2017, the CDC published the first report to show severe impairments of children with congenital Zika virus infection become more evident over time. The report found that most children born with microcephaly – small head size for age – and evidence of congenital Zika virus infection face severe health and developmental challenges at ages 19 to 24 months.


The report was the first to describe the health and developmental effects of congenital Zika virus infection in children with microcephaly through two years of age. These problems include an inability to sit independently, difficulties with sleeping and feeding, seizures, and hearing and vision problems. Many of the children faced challenges in multiple areas.


Although previous publications described the health effects in infants born with microcephaly during the Zika outbreak, this was the first investigation to characterize the health and development of these children as they age. The findings gave a more complete picture of the lifelong challenges that will affect children born with microcephaly during the Zika outbreaks. The investigation took place in northeastern Brazil, where Zika affected thousands of children born during 2015 and 2016. The results provided important information to help the United States, Brazil, and other countries prepare for the unprecedented challenges posed for children affected by Zika virus infection.


“Children severely affected by Zika virus are falling far behind age-appropriate developmental milestones, and their challenges are becoming more evident as they age,” said CDC Director Brenda Fitzgerald, MD. “Continued monitoring of all children with congenital Zika exposure is critical to understand the full impact of the infection during pregnancy and to support these families for the long-term.”


The investigation compiled a comprehensive description of the health and development of 19 children with microcephaly and laboratory evidence of congenital Zika virus. The investigation relied on direct clinical assessments, caregiver interviews, and medical record review.


Investigators found that, of the 19 children, 11 had indications of possible seizure disorder; 10 had sleep difficulties; nine had feeding difficulties, such as trouble swallowing; 13 had hearing problems, such as not responding to the sound of a rattle; 11 had vision problems, such as not being able to follow a moving object with their eyes; and 15 had severe motor impairments, including inability to sit independently. Of the 19 children, 14 had at least three of these challenges, complicating their care. Additionally, eight of the 19 children had been previously hospitalized, with bronchitis/pneumonia being the most commonly reported reason for hospitalization (six of the eight).


“As children born affected by Zika virus grow up, they will need specialized care from many types of healthcare providers and caregivers,” said Georgina Peacock, M.D., M.P.H., director of the CDC’s Division of Human Development and Disability. “It’s important that we use these findings to start planning now for their long-term care and stay vigilant in Zika prevention efforts in the United States and around the world.”


See the CDC Announcement


Also see the CDC Report


See also Medical Law Perspectives Report: Vectors of Risk: Zika, West Nile, and Similar Tick and Mosquito Disease Litigation


See also Medical Law Perspectives Report: Pneumonia Complications, Hospitalizations, Death: Risks and Liabilities


See also Medical Law Perspectives Report: Pediatrician Liability Involving Diseases and Conditions of Childhood


See also Medical Law Perspectives Report: Epilepsy and Seizure Disorders: Malpractice in Diagnosis and Treatment