A síndrome congênita do Zica vírus e os aspectos neurológicos que a caracterizam: revisão sistemática.

Abstract

Introduction. The Zika virus (ZIKV) has been known since 1947, when it was isolated from from a feverish monkey. Only in 1954 was there knowledge of the first human infection. In Brazil, the first indigenous detection was reported in 2015, where patients manifested a benign disease characterized by mild fever, macopapular rash, headache, conjunctivitis, arthralgia and edema. Due to the space-time coincidence of the first report of autochthonous transmission in the country and confirmation of Asian lineage of the circulating virus, its entry into the country was prompted by the FIFA World Cup football in 2014 or during world racing championship. In 2015, from October, there was an incidence of microcephaly (perimeter head pain below -2 standard deviations from the mean for age and sex) exceptionally high in newborns. Most women who had these children exhibited symptoms consistent with ZIKV during the first few months of pregnancy, suggesting the possibility of transmission vertical. In February 2016, there was an increase in reports of microcephaly by more than twenty times the historical average of the last five years and 120 suspected ZIKV-related microcephaly deaths. Goals. Develop a systematic review on the epidemiological profile of abnormalities neurological disorders that congenital Zika virus syndrome causes in newborns; Identify in which semester of pregnancy there was infection further development of the congenital syndrome; Stratify sequelae in severity and prognosis; To analyze the symptomatic profile of mothers during gestation; Identify proportion of newborns with head circumference normal with neurological manifestations. Methodology. Revision systematic review of 19 studies selected from a bibliographical survey on congenital Zika virus syndrome and its neurological manifestations in electronic databases MEDLINE/PubMED, Web Of Science, Scopus from January 2008 to January 2018. They were selected from of terms together with the descriptors: ―Zika virus infection‖, ―nervous system malformations” and “congenital abnormalities". discarded for Zika virus infection have lower rates of mortality than definite or probable cases. In 39.7% of pregnancies, the mothers were asymptomatic. Birth defects were reported in a higher proportion of fetuses or babies whose mothers were infected during the first trimester of pregnancy (58.2%). Microcephaly, on birth, represented 45.8% of the cases. post-birth microcephaly represented 35.3% and was absent in 18.9% of the fetuses/babies studied. You main findings in the neuroimaging exams were: ventriculomegaly (80.3%), parenchymal calcifications (91.5%), malformations of the cortical development (77.2%), hypoplasia of the brainstem or cerebellum (31.6%) and corpus callosum hypoplasia (24.5%). Conclusion. The findings combined clinical, laboratory and imaging tests provided a more complete picture of severe damage and developmental abnormalities caused by ZIKV infection. We need to pay more attention to the women infected with ZIKV, especially in the first trimester of pregnancy, given the very high number of vertical transmissions causing of fetal malformations. Due to this serious impact on society, it is prevention is essential. If transmission takes place, it is necessary to an early diagnosis, bearing in mind that this disease brings serious physical and social consequences.