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Source: http://www.cidrap.umn.edu/news-persp...inked-seizures
Congenital Zika syndrome strongly linked to seizures
Filed Under:
Zika
Stephanie Soucheray | News Reporter | CIDRAP News
| Apr 25, 2018
A new study from Salvador, Brazil, conducted during the earliest days of the country's Zika epidemic shows that half of babies with confirmed congenital Zika syndrome (CZS) were likely to suffer seizures in their first 4 months of life, and a study in monkeys found monoclonal antibodies to be ineffective.
The human study looked at 412 births that occurred between Oct 31, 2015, and Jan 9, 2016 in Bahia state, in the northeast part of Brazil, the epicenter of early Zika virus (ZIKV) activity. The study was published in the American Journal of Tropical Medicine and Hygiene.
Fifteen percent of infants born during the study period (62 out of 412) had microcephaly, of whom 40 (whose mothers lived in Salvador) were followed for several months. The vast majority (73%) of those infants were found to have clinical evidence of CZS.
Researchers performed follow-up home visits for 27 of the CZS babies. "Mothers reported seizure-like movements among 15 (60%) of the 25 surviving infants who were not lost to follow-up. Neuropediatric evaluation and review of home video recordings confirmed the presence of seizures in 12 (48% of 25) infants, whereas the remaining three infants had non-epileptic movements such as choking."
As noted, epilepsy occurred in 48% of infants, at a rate of 15.6 cases per 100 patient-months.
"Our findings serve as an alert on the high potential risk of epilepsy and death associated with CZS in early infancy and the need to actively screen for seizures and initiate timely treatment," the authors said.
"Seizures were the major cause of hospitalization and emergency room visits among our cases. At the time of home visit (median, 99 days), seven (47%) of the 15 children with seizures were not identified as having epilepsy and receiving indicated therapy."
Fetal death, failed antibodies in monkeys
In the other study, US researchers publishing in Nature Communications demonstrated fetal demise and failed antibody therapy in pregnant rhesus macaques injected with a ZIKV isolate from Brazil. The team used an isolate found in the urine of a pregnant Brazilian woman infected with ZIKV.
To conduct the study, the scientists infected 11 monkeys at various stages of pregnancy with the isolate. ZIKV was detected in the amniotic fluid of five monkeys. Two of the three monkeys infected during the first trimester suffered fetal death.
The researchers also injected three of the Zika-infected monkeys with a cocktail of ZIKV-neutralizing human monoclonal antibodies. The antibodies failed to prevent maternal transmission of ZIKV, as evidenced by the presence of Zika in amniotic fluid, the authors said.
The authors of the study said this work demonstrates that Zika infection in the first two trimesters of pregnancy is linked to more severe fetal outcomes.
See also:
Apr 23 Am J Trop Med Hyg study
Apr 24 Nat Commun study
Congenital Zika syndrome strongly linked to seizures
Filed Under:
Zika
Stephanie Soucheray | News Reporter | CIDRAP News
| Apr 25, 2018
A new study from Salvador, Brazil, conducted during the earliest days of the country's Zika epidemic shows that half of babies with confirmed congenital Zika syndrome (CZS) were likely to suffer seizures in their first 4 months of life, and a study in monkeys found monoclonal antibodies to be ineffective.
The human study looked at 412 births that occurred between Oct 31, 2015, and Jan 9, 2016 in Bahia state, in the northeast part of Brazil, the epicenter of early Zika virus (ZIKV) activity. The study was published in the American Journal of Tropical Medicine and Hygiene.
Fifteen percent of infants born during the study period (62 out of 412) had microcephaly, of whom 40 (whose mothers lived in Salvador) were followed for several months. The vast majority (73%) of those infants were found to have clinical evidence of CZS.
Researchers performed follow-up home visits for 27 of the CZS babies. "Mothers reported seizure-like movements among 15 (60%) of the 25 surviving infants who were not lost to follow-up. Neuropediatric evaluation and review of home video recordings confirmed the presence of seizures in 12 (48% of 25) infants, whereas the remaining three infants had non-epileptic movements such as choking."
As noted, epilepsy occurred in 48% of infants, at a rate of 15.6 cases per 100 patient-months.
"Our findings serve as an alert on the high potential risk of epilepsy and death associated with CZS in early infancy and the need to actively screen for seizures and initiate timely treatment," the authors said.
"Seizures were the major cause of hospitalization and emergency room visits among our cases. At the time of home visit (median, 99 days), seven (47%) of the 15 children with seizures were not identified as having epilepsy and receiving indicated therapy."
Fetal death, failed antibodies in monkeys
In the other study, US researchers publishing in Nature Communications demonstrated fetal demise and failed antibody therapy in pregnant rhesus macaques injected with a ZIKV isolate from Brazil. The team used an isolate found in the urine of a pregnant Brazilian woman infected with ZIKV.
To conduct the study, the scientists infected 11 monkeys at various stages of pregnancy with the isolate. ZIKV was detected in the amniotic fluid of five monkeys. Two of the three monkeys infected during the first trimester suffered fetal death.
The researchers also injected three of the Zika-infected monkeys with a cocktail of ZIKV-neutralizing human monoclonal antibodies. The antibodies failed to prevent maternal transmission of ZIKV, as evidenced by the presence of Zika in amniotic fluid, the authors said.
The authors of the study said this work demonstrates that Zika infection in the first two trimesters of pregnancy is linked to more severe fetal outcomes.
See also:
Apr 23 Am J Trop Med Hyg study
Apr 24 Nat Commun study