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Zika virus: Stillbirth points to clues of damage beyond the brain in babies

Sexual transmission of the Zika virus appears to be more common that doctors thought. The virus has been strongly linked to severe birth defects. Erika Edwards reports – Feb 23, 2016

It’s been tied to a rare defect in which babies are born with irregularly small heads and underdeveloped brains, but is Zika virus also linked to stillbirths?

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New research out of Yale University documents the case study of a pregnant Brazilian woman infected with Zika virus who lost her baby in January. The scientists say it’s the first study that points to a possible link to the virus and damage beyond the developing brain.

The stillborn baby had signs of severe tissue swelling as well as the brain defects that cause parts of the cerebral hemispheres to be missing, according to researchers out of the university’s School of Public Health.

“These findings raise concerns that the virus may cause severe damage to fetuses leading to stillbirths and may be associated with effects other than those seen in the central nervous system,” study co-author, Dr. Albert Ko, said.

“Additional work is needed to understand if this is an isolated finding and to confirm whether Zika virus can actually cause [other issues],” he said in a university statement.
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READ MORE: Trip booked to Zika-affected region? Here’s how Canadian airlines will help you

Ko and his team warn that this single case – along with growing evidence linking Zika to microcephaly – is pointing to Zika’s ties to hydrops fetalis (an abnormal accumulation of fluid), hydranencephaly (an almost complete loss of brain tissue) and fetal demise (more commonly known as stillbirth).

They say it’s too hard to tell from a single case what the overall risk for these complications are if women are exposed to Zika virus during their pregnancy.

The patient in this case is a 20-year-old woman. She had a normal first trimester but her pregnancy took a turn for the worse during her 18th week of pregnancy. That’s when an ultrasound reveled the fetus’ weight was way below where it should have been.

But the woman didn’t report any symptoms that allude to Zika, such as a rash, fever or body aches. She also didn’t have symptoms of chikungunya, dengue or other mosquito-borne diseases.

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READ MORE: What pregnant women need to know about Zika virus and travel

By her 30th week of pregnancy, the fetus had a wide range of birth defects. Two weeks later the fetus died, and doctors induced her labour. That’s how they learned Zika was present in the baby. The strain was also identical to what’s been spreading through Brazil.

The researchers say they need to further investigate to see if the risk of stillbirth is widespread.

The medical community is working quickly to piece together Zika’s potential ties to birth defects.

Earlier this month, the Centers for Disease Control and Prevention in Atlanta said Zika virus was found in tissue samples from two babies with microcephaly who died within 20 hours of birth along with two miscarried fetuses.

All four mothers had signs of Zika virus during the first trimester of pregnancy.

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In another case, academics documented an incident involving a European woman who had spent time in Brazil. In February 2015, she became pregnant there and fell ill 13 weeks later, with what was suspected to be Zika virus.

She returned to Europe at 28 weeks pregnant and terminated her pregnancy four weeks later. Testing pointed to fetal anomalies. The fetus showed “prominent microcephaly.”

READ MORE: Is Zika virus causing a spike in microcephaly in babies?

For months, global health officials have suspected a link between Zika virus and microcephaly as Brazil grapples with the biggest epidemic of the virus to date.

Health officials in El Salvador, Brazil, Jamaica, Ecuador, Honduras and Colombia told residents to stave off pregnancy until doctors better understand if the infection tampers with brain development in infants. So far, it’s been linked to a 20-fold increase in microcephaly in babies.

Ko’s full findings were published Thursday in the journal PLoS Neglected Tropical Diseases.

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carmen.chai@globalnews.ca

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