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Scotto G, Massa S, Spirito F, Fazio V. Congenital Zika Virus Syndrome: Microcephaly and Orofacial Anomalies. Life (Basel) 2023; 14:55. [PMID: 38255670 PMCID: PMC10820182 DOI: 10.3390/life14010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
The progressive reappearance of Zika virus (ZIKV) infections since October 2013 and its circulation in >70 countries and territories (from French Polynesia to Brazil and other countries in the Americas, with sporadic spread in Europe and the East) has long been reported as a global public health emergency. ZIKV is a virus transmitted by arthropods (arboviruses), mainly by Aedes mosquitoes. ZIKV can also be transmitted to humans through mechanisms other than vector infection such as sexual intercourse, blood transfusions, and mother-to-child transmission. The latter mode of transmission can give rise to a severe clinical form called congenital Zika syndrome (CZS), which can result in spontaneous abortion or serious pathological alterations in the fetus such as microcephaly or neurological and orofacial anomalies. In this study, beside a succinct overview of the etiological, microbiological, and epidemiological aspects and modes of transmission of Zika virus infections, we have focused our attention on the pathogenetic and histopathological aspects in pregnancy and the pathogenetic and molecular mechanisms that can determine microcephaly, and consequently the clinical alterations, typical of the fetus and newborns, in a subject affected by CZS.
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Affiliation(s)
- Gaetano Scotto
- Infectious Diseases Unit, University Hospital “OORR” Foggia, 71122 Foggia, Italy
| | - Salvatore Massa
- Department of Agriculture, Food, Natural Resource and Engineering, University of Foggia, 71122 Foggia, Italy;
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Vincenzina Fazio
- Clinical Chemistry Laboratory, Virology Unit, University Hospital “OORR” Foggia, 71122 Foggia, Italy;
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Rodrigues CDS, Souza RKS, Rocha Neto CV, Otani RH, Batista DDM, Maia AKNDO, Filho KPDO, de Andrade TD, de Andrade Almeida E, Maciel LHG, Castro LDFAAP, Abtibol-Bernardino MR, Baia-da-Silva DC, Benzecry SG, Castilho MDC, Martínez-Espinosa FE, Alecrim MDGC, Santos RS, Botto-Menezes C. Clinical and Acoustic Alterations of Swallowing in Children Exposed to Zika Virus during Pregnancy in a Cohort in Amazonas, Brazil: A Case Series Study. Viruses 2023; 15:2363. [PMID: 38140604 PMCID: PMC10747239 DOI: 10.3390/v15122363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023] Open
Abstract
Oropharyngeal dysphagia (OD) is a swallowing disorder that involves difficulty in safely passing the food bolus from the oral cavity to the stomach. OD is a common problem in children with congenital Zika virus syndrome (CZS). In this case series, we describe the clinical and acoustic alterations of swallowing in children exposed to the Zika virus during pregnancy in a cohort from Amazonas, Brazil. From July 2019 to January 2020, 22 children were evaluated, 6 with microcephaly and 16 without microcephaly. The mean age among the participants was 35 months (±4.6 months). All children with microcephaly had alterations in oral motricity, mainly in the lips and cheeks. Other alterations were in vocal quality, hard palate, and soft palate. Half of the children with microcephaly showed changes in cervical auscultation during breast milk swallowing. In children without microcephaly, the most frequently observed alteration was in lip motricity, but alterations in auscultation during the swallowing of breast milk were not observed. Regarding swallowing food of a liquid and pasty consistency, the most frequent alterations were incomplete verbal closure, increased oral transit time, inadequacy in capturing the spoon, anterior labial leakage, and increased oral transit time. Although these events are more frequent in microcephalic children, they can also be seen in non-microcephalic children, which points to the need for an indistinct evaluation of children exposed in utero to ZIKV.
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Affiliation(s)
- Cristina de Souza Rodrigues
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
| | | | - Cosmo Vieira Rocha Neto
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | - Rodrigo Haruo Otani
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | - Daniel de Medeiros Batista
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | - Ana Karla Nelson de Oliveira Maia
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | | | | | | | - Luiz Henrique Gonçalves Maciel
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
| | | | - Marília Rosa Abtibol-Bernardino
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- Department of Maternal and Child Health, Medical School, Federal University of Amazonas, Manaus 69020-160, Brazil
| | - Djane Clarys Baia-da-Silva
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
- Faculty of Pharmacy, University Nilton Lins, Manaus 69058-030, Brazil; (K.P.d.O.F.); (T.D.d.A.)
- Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil
| | - Silvana Gomes Benzecry
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | | | - Flor Ernestina Martínez-Espinosa
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil
- Tropical Medicine Foundation Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil;
| | - Maria das Graças Costa Alecrim
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- Medical Course Coordination at Manaus Metropolitan College/FAMETRO, Manaus 69050-000, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders (PPGDIC), University of Tuiuti do Paraná (UTP), Paraná 82010-210, Brazil;
| | - Camila Botto-Menezes
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
- Tropical Medicine Foundation Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil;
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