Microcephaly and Zika virus during pregnancy and cephalic perimeter curve

Yasri, Sora; Wiwanitkit, Viroj

doi:10.1590/1806-9282.65.6.744

KEYWORDS:
Zika Virus; Microcephaly; Pregnancy

PALAVRAS CHAVE:
Zika Virus; Microcefalia; Gravidez

Dear Editor

We read the publication “Relationship between microcephaly and Zika virus during pregnancy: a review” with a great interest¹1. Santos GRBD, Aragão FBA, Lobão WJM, Lima FR, Andrade LMRL, Furtado QR, et al. Relationship between microcephaly and Zika virus during pregnancy: a review. Rev Assoc Med Bras. 2018;64(7):635-42.. Santos et al.¹1. Santos GRBD, Aragão FBA, Lobão WJM, Lima FR, Andrade LMRL, Furtado QR, et al. Relationship between microcephaly and Zika virus during pregnancy: a review. Rev Assoc Med Bras. 2018;64(7):635-42. mentioned that “Epidemiological data suggest a temporal association between the quantitative increase and the Zika virus epidemic, especially in Northeast Brasil. It is not consensual to measure the cephalic perimeter curve to be considered.” Indeed, it is agreeable that there is an observation of the Zika-virus epidemic and microcephaly in Brasil. However, this interrelation is not observed in other endemic areas such as Southeast Asia²2. Wiwanitkit V. The current status of Zika virus in Southeast Asia. Epidemiol Health. 2016;38:e2016026.. The usefulness of cephalic perimeter should be discussed. There is no doubt that the cephalic perimeter can help identify microcephaly, but it cannot help diagnose the etiology of the microcephaly. Aiming at finding a pathological clue for Zika virus infection, a better investigation tool might be transfontanellar ultrasonography ³3. Ximenes ASFC, Pires P, Werner H, Jungmann PM, Rolim Filho EL, Andrade EP, et al. Neuroimaging findings using transfontanellar ultrasound in newborns with microcephaly: a possible association with congenital Zika virus infection. J Matern Fetal Neonatal Med. 2019;32(3):493-501.. In addition, in a setting where there is a Zika virus epidemic without increased incidence of microcephaly, the usefulness of the cephalic perimeter is reduced if one focuses to specifically use it for the Zika virus infection problem.

REFERENCES

¹
Santos GRBD, Aragão FBA, Lobão WJM, Lima FR, Andrade LMRL, Furtado QR, et al. Relationship between microcephaly and Zika virus during pregnancy: a review. Rev Assoc Med Bras. 2018;64(7):635-42.
²
Wiwanitkit V. The current status of Zika virus in Southeast Asia. Epidemiol Health. 2016;38:e2016026.
³
Ximenes ASFC, Pires P, Werner H, Jungmann PM, Rolim Filho EL, Andrade EP, et al. Neuroimaging findings using transfontanellar ultrasound in newborns with microcephaly: a possible association with congenital Zika virus infection. J Matern Fetal Neonatal Med. 2019;32(3):493-501.

Publication Dates

Publication in this collection
22 July 2019
Date of issue
June 2019

History

Received
30 Oct 2018
Accepted
03 Nov 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[1] ¹
Santos GRBD, Aragão FBA, Lobão WJM, Lima FR, Andrade LMRL, Furtado QR, et al. Relationship between microcephaly and Zika virus during pregnancy: a review. Rev Assoc Med Bras. 2018;64(7):635-42.

[2] ²
Wiwanitkit V. The current status of Zika virus in Southeast Asia. Epidemiol Health. 2016;38:e2016026.

[3] ³
Ximenes ASFC, Pires P, Werner H, Jungmann PM, Rolim Filho EL, Andrade EP, et al. Neuroimaging findings using transfontanellar ultrasound in newborns with microcephaly: a possible association with congenital Zika virus infection. J Matern Fetal Neonatal Med. 2019;32(3):493-501.