Born with virus

As ba­bies stricken by Zika turn 1, health prob­lems mount

China Daily (USA) - - FRONT PAGE - By AS­SO­CI­ATED PRESS in Recife, Brazil Dr Vanessa Van der Lin­den, pe­di­atric neu­rol­o­gist

Two weeks shy of his first birth­day, doc­tors be­gan feed­ing Jose Wes­ley Cam­pos through a nose tube be­cause swal­low­ing prob­lems had left him dan­ger­ously un­der weight.

Learn­ing how to feed is the baby’s lat­est strug­gle as med­i­cal prob­lems mount for him and many other in­fants born with small heads to moth­ers in­fected with the Zika virus in Brazil.

“It hurts me to see him like this. I didn’t want this for him,’’ said Jose’s mother, Solange Fer­reira, break­ing into tears as she cra­dled her son.

A year af­ter a spike in the num­ber of new­borns with the de­fect known as mi­cro­cephaly, doc­tors and re­searchers have seen many of the ba­bies de­velop swal­low­ing dif­fi­cul­ties, epilep­tic seizures and vi­sion and hear­ing prob­lems.

While more study is needed, the con­di­tions ap­pear to be caus­ing more se­vere prob­lems in th­ese in­fants than in pa­tients born with small heads be­cause of the other in­fec­tions known to cause mi­cro­cephaly, such as Ger­man measles and her­pes. The prob­lems are so par­tic­u­lar that doc­tors are now call­ing the con­di­tion con­gen­i­tal Zika syn­drome.

“We are see­ing a lot of seizures. And now they are hav­ing many prob­lems eat­ing, so a lot of th­ese chil­dren start us­ing feed­ing tubes,’’ said Dr Vanessa Van der Lin­den, a pe­di­atric neu­rol­o­gist in Recife who was one of the first doc­tors to sus­pect that Zika caused mi­cro­cephaly.

Zika, mainly trans­mit­ted by mos­qui­tos, was not known to cause birth de­fects un­til a large out­break swept through north­east­ern states in Latin Amer­ica’s largest na­tion, set­ting off alarm world­wide. Nu­mer­ous stud­ies con­firmed the link.

Seven per­cent of the ba­bies with mi­cro­cephaly that Van der Lin­den and her team have treated were also born with arm and leg de­for­mi­ties that had not pre­vi­ously been linked to other causes of mi­cro­cephaly, she said.

To com­pli­cate mat­ters, there are ba­bies whose heads were nor­mal at birth but stopped grow­ing pro­por­tion­ally months later. Other in­fants in­fected with the virus in the womb did not have mi­cro­cephaly but de­vel­oped dif­fer­ent prob­lems, such as a pa­tient of Van der Lin­den’s who started hav­ing dif­fi­cul­ties mov­ing his left hand.

“We may not even know about the ones with slight prob­lems out there,’’ Van der Lin­den said. “We are writ­ing the his­tory of this dis­ease.’’

On a re­cent day, Jose laid on a blue mat wear­ing just brown moc­casins and a di­a­per, his bony chest pressed by a res­pi­ra­tory ther­a­pist help­ing him clear con­gested air­ways.

Jose, who has been vis­ited by The As­so­ci­ated Press three times in the last year, is like a new­born. He is slow to fol­low ob­jects with his crossed eyes. His head is un­steady when he tries to hold it up, and he weighs less than 5.8 kilo- grams, far be­low the 10kg that is av­er­age for a baby his age.

Breath­ing prob­lems make his cries sound like gar­gling, and his legs stiffen when he is picked up. To see, he must wear tiny blue-rim med glasses, which makes him ag­i­tated.

Stud­ies are un­der­way to de­ter­mine if the tim­ing of the in­fec­tion dur­ing preg­nancy af­fects the sever­ity of the ab­nor­mal­i­ties, said Ri­cardo Ximenes, a re­searcher at the Fiocruz In­sti­tute in Recife.

Also, three groups of ba­bies whose moth­ers were in­fected with Zika are be­ing fol­lowed for a study funded by the US Na­tional In­sti­tutes of Health. The groups in­clude in­fants born with mi­cro­cephaly, some born with nor­mal-sized heads found to have brain dam­age or other phys­i­cal prob­lems and ba­bies who have not had any symp­toms or de­vel­op­men­tal de­lays.

In Brazil, the gov­ern­ment has re­ported 2,001 cases of mi­cro­cephaly or other brain mal­for­ma­tions in the last year. So far, only 343 have been con­firmed by tests to have been caused by Zika, but the Health Min­istry ar­gues that the rest are most likely caused by the virus.

Health Min­is­ter Ri­cardo Bar­ros said there was a drop of 85 per­cent in mi­cro­cephaly cases in Au­gust and Septem­ber com­pared to those months last year, when the first births started wor­ry­ing pe­di­a­tri­cians. He cred­ited grow­ing aware­ness of the virus and gov­ern­ment at­tempts to com­bat mos quit os through spray­ing cam­paigns.

De­spite the prob­lems, some in­fants with the syn­drome are show­ing signs of progress.

On a re­cent night, 11-month-old Joao Miguel Silva Nunes pulled him­self up in his playpen and played peeka-boo with his mother, Rosileide da Silva.

“He is my source of pride,’’ Silva said. “He makes me feel that things are work­ing out.’’

We are see­ing a lot of seizures. And now they are hav­ing prob­lems eat­ing, so a lot of chil­dren use feed­ing tubes.”

FELIPE DANA / AS­SO­CI­ATED PRESS

Jose Wes­ley Cam­pos, who was born with mi­cro­cephaly, cries dur­ing his phys­i­cal ther­apy ses­sion at the AACD re­ha­bil­i­ta­tion cen­ter in Recife, Brazil. Jose has vi­sion and breath­ing prob­lems and is se­verely un­der­weight at 5.8 kilo­grams.

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