SEROLOGICAL RESPONSE AND CLINICAL OUTCOMES OF CHILDREN EXPOSED TO ZIKA VIRUS DURING GESTATION: PRELIMINARY RESULTS OF A PROSPECTIVE PAEDIATRIC COHORT STUDY IN A NON-ENDEMIC COUNTRY
ESPID Education. Soriano Arandes A. May 30, 2018; 218737
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Dr. Antoni Soriano Arandes
Dr. Antoni Soriano Arandes

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Abstract
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Background: Zika virus (ZIKV) infection has been associated to microcephaly and other neuro-developmental abnormalities. An ongoing Spanish database of ZIKV-exposed mother-child pair was created in May 2016. Our aim was to describe the first preliminary clinical/serological outcomes of ZIKV-exposed children followed-up in the main referral paediatric tropical medicine centres of a non-endemic country.
Methods: multicentric prospective observational cohort study of ZIKV-exposed mother-child pair (May 2016-January 2018). Children were recruited at birth and laboratory/clinical data from mothers were obtained from gestational database. ZIKV-infected mothers were defined as confirmed or probable following national guidelines. Epidemiological, clinical and laboratory data were registered on a RedCAP® database. Statistical analysis was carried out through Statav13. Ethical approval was obtained from participating centres.
Results: overall, 119 children (52.6% male) were included; median[IQR] gestational age at birth was 39[38-40] weeks. ZIKV-infected pregnant-women (n=113) were from South-America 34.5%(39/113), Dominican Republic 37.2%(42/113), Central-America 24.8%(28/113), and other countries 3.6%(4/113). A 1.7%(2/119, CI95%:0.4-6.6%) of children presented at birth clinical/radiological signs of ZIKV Congenital Syndrome, up to 25% (CI95%:4.1-72.4%) for children born to ZIKV-confirmed mothers. Seven children showed audiological adverse outcomes (7/119, 8.1%; CI95%:3.9-16.3%) with mild/moderate hearing loss, congenital cytomegalovirus infection was ruled out at birth. All ZIKV-exposed children, except one, showed negative ZIKV results (IgM/RT-PCR) at birth. Among 12-m old children (n=39), serorreversion for IgG-ZIKV was achieved at a mean (SD) of 7.2 (3.7) months (figure).
Conclusions: the largest series of prenatally ZIKV-exposed children in Europe estimated an overall ZIKV-congenital syndrome prevalence of 1.7% (CI95%:0.4-6.6%), up to 25% (CI95%: 4.1-72.4%) in the small group of children born to ZIKV-confirmed mothers. A considerable percentage of these children had adverse audiological outcomes (8.1%(CI95%:3.9-16.3%)), and a IgG-ZIKV serorreversion was achieved at a mean of 7.2 months after birth.
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