Zika in the US: How Doctors Help Infants With Microcephaly
Woman gave birth to child with microcephaly in New Jersey.
— -- An infant born in New Jersey yesterday is the second known baby born in the U.S. suspected of having Zika-related microcephaly
The case has highlighted how medical officials in the U.S. are monitoring pregnant women amid fears that the Zika virus could be transmitted locally.
At the Hackensack University Medical Center, where the infant was born, Dr. Abdulla al-Khan said there is a multidisciplinary team to assist the infant and mother. But it can offer only mental and physical supportive care for them.
"The damage is already done. You cannot allow the brain to regenerate itself," he said. "It's going to impact the mother and her relationships. It will impact her socially and financially."
Al-Khan said that the baby and mother are "relatively stable" and that employees are counseling the mother through the stress and anxiety of having an infant with microcephaly. The team assisting the pair includes specialists in pediatric infectious disease, pediatric neurology and a pediatric genetics.
"You don't appreciate the magnitude of this problem until you see [an affected infant] and share the pain of what the mother is going through," he said.
The birth defect, characterized by an abnormally small head, has a wide range of associated symptoms, depending on the condition's severity.
"Very mildly affected kids, if they have full heads of hair, you may not be able to tell," said Dr. Amy Edwards, a pediatric infectious disease specialist at Rainbow Babies and Children's Hospital in Cleveland. "Neurologically they may be very normal. It can be from that to kids who can't feed themselves, can't bathe, can't see, can't hear."
She said some children may have brains that are so "profoundly microcephalic," they will "not survive past infancy, because some of the deep brain structures important for basic functions, if these are affected, it will affect a child's ability to breathe or to swallow."
When children are born with microcephaly, doctors immediately perform an ultrasound on the head and brain to determine which structures may be underdeveloped, said Edwards.
The link between the condition and the Zika virus is a recent discovery. The CDC confirmed in April that infection by the virus during pregnancy was one cause. Other causes of microcephaly, which existed long before it was linked to the Zika virus, include other diseases such as rubella, toxoplasmosis and infection by cytomegalovirus (CMV), a common virus that usually leads to coughing. CMV infection is one of the most common causes of microcephaly in the U.S. The condition is rare, affecting 2 to 12 babies per 10,000 live births, according to the U.S. Centers for Disease Control and Prevention.
Edwards said pediatricians should regularly monitor children with microcephaly and get them extra support if they start to miss major developmental milestones.
"Having a small head is not a problem. It is when they are failing to meet milestones [that] the pediatrician will step in and have interventions for the child," she said. "We have speech therapy for kids with language development, tutoring at school for kids with learning disability. It depends on the pathway their developmental problems take."
As of May 20, the CDC was monitoring at least 157 pregnant women in U.S. states and 122 pregnant women in U.S. territories with laboratory evidence of possible Zika infection. There is no known way to reverse the complications associated with Zika.
Dr. Kester Wong contributed to this report. He is a family medicine resident at the University of California at Davis and a resident in the ABC News Medical Unit.