Congenital Zika virus infection: an emerging challenge in perinatal medicine

Congenital Zika syndrome (CZS) is caused by a flavivirus and is characterized by various clinical manifestations, the most common of which are congenital brain and eye malformations. The first mention of Zika virus (Zika-virus, A92.5) dates back to the 1940s. It is primarily transmitted through the bite of infected Aedes mosquitoes and can also be transmitted sexually, through blood and saliva. More recently, it has been found that Zika virus can pass from a pregnant woman to her fetus, causing congenital Zika syndrome (P35.4), intrauterine growth restriction and, in some cases, pregnancy loss. The risk of congenital neurological defects associated with Zika virus infection ranges from 6% to 42% in various reports. The similarity of clinical manifestations, as well as ontogenetic commonality with other infectious agents argue the need for differential diagnosis between congenital infection associated with Zika virus and infections caused by yellow fever, Dengue fever, Japanese encephalitis, West Nile fever, Chikungunya, and TORCH infections (rubella, toxoplasmosis, cytomegalovirus, etc.). In 2023, 89 countries have already reported Zika virus circulation in their territories, but sanitary surveillance worldwide remains limited. All of the above cannot but cause concern for specialists in perinatal medicine. This article presents relevant data on the clinical features, early and late complications of congenital Zika virus infection. Key words: congenital Zika syndrome, Zika virus, newborns, pregnancy, microcephaly, calcifications, arthrogryposis