Fellowship Site: Oswald Cruz Foundation
U.S. Institution: Yale University School of Medicine
Project Title: Risk factors for Zika Virus associated Microcephaly
Zika virus (ZIKV), a flavivirus transmitted by Aedes aegypti mosquitos, was originally
discovered in Zika forest in Uganda in 1947. The virus remained relatively unknown for 60 years until it caused an outbreak in Micronesia in 2007. Subsequently, the largest known epidemic of ZIKV began in early 2015. Since then, ongoing transmission of ZIKV has been reported in 45 new countries. ZIKV is a relatively mild illness with symptomatic patients experiencing headache, fever, arthralgia and rash for a few days to a week (80% of patients are asymptomatic). However, in October 2015, increased reports of microcephaly became a cause of alarm in Brazil. By February 2016, the World Health Organization declared the increased cases of microcephaly in Brazil a Public Health Emergency of International Concern. Experts proposed a link between the ZIKV epidemic in early 2015 and the subsequent increase in microcephaly.
This study aims to identify risk factors for ZIKV-associated microcephaly in Salvador, Brazil at three study hospitals. The proposed is a case control study where cases are children born within the epidemic time frame who have characteristic signs of ZIKV-associated microcephaly on imaging and controls are children born in the same hospital and month of birth. We hypothesize that the interaction of ZIKV and another factor is leading to the development of ZIKV-associated microcephaly.