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 The study showed the baby's brain was absent, a condition
known as hydranencephaly. Instead of tissue, the brain cavities were
filled with fluid. The baby also had abnormal pools of fluid in
other parts of its body.
The case, published in the journal PLOS Neglected Tropical Diseases,
is the first to link Zika virus with damage to fetal tissues outside
the central nervous system.
So far, birth defects associated with the rapidly spreading Zika
virus have been almost entirely confined to Brazil and linked to
microcephaly, a condition in which babies are born with abnormally
small heads.
Brazil has confirmed more than 580 cases of microcephaly and is
investigating more than 4,100 suspected cases.
Although Zika has not been proven to cause microcephaly, scientists
say the evidence is growing stronger. On Feb. 1, the World Health
Organization declared Zika a global health emergency. The WHO
estimates Zika could eventually affect as many as 4 million people
in the Americas and may spread to parts of Africa and Asia.
The new study was led by Yale University tropical disease expert Dr.
Albert Ko along with Dr. Antônio Raimundo de Almeida of Roberto
Santos General Hospital in Salvador, Brazil.
Ko said the study's findings are hard to generalize because they are
on just one case, but they are unusual. In addition to microcephaly,
he noted that the fetus had no brain tissue left. "It was just
fluid."
Fluid also filled the lungs, abdomen and other tissues. These
resulted from a condition known as hydrops fetalis in which the
fetus loses the ability to manage body fluids. The fetus also had
arthrogryposis, a condition in which joints don't move normally and
may be stuck in place.
Ko has worked with Brazilian colleagues to understand the Zika
outbreak since shortly after the first cases of the mosquito-borne
virus were reported in the country in early 2015.
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There is no vaccine or treatment for Zika, which causes mild fever,
rash and red eyes. An estimated 80 percent of people infected have
no symptoms, making it difficult for pregnant women to know whether
they have been infected.
The researchers describe a 20-year-old Brazilian woman who showed no
signs of Zika infection or other related viruses, such as dengue and
or chikungunya. Her pregnancy appeared normal through the first
trimester, and she tested negative for other potential causes of
microcephaly such as HIV, hepatitis C, rubella and toxoplasmosis.
During a routine ultrasound in her 18th week, doctors noticed the
fetus was severely underweight. By the 30th week, the fetus had
severe microcephaly and a range of other birth defects. At 32 weeks,
the fetus had died and doctors induced labor.
Ko said the case suggests that the virus may be associated with
stillbirths, which doctors should be looking for, especially in
pregnant women who may not show signs of Zika infection.
"We can't really prove there's a causal association, but it raises
concerns," he said.
(Reporting by Julie Steenhuysen; Editing by Andrew Hay)
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