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What is Microcephaly & what is it caused by?

View profile for Kimmo Boote
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The literal translation of Microcephaly is ‘small headedness’.

Infants with Microcephaly are born with either a normal or reduced head size. Subsequently, the head fails to grow, while the face continues to develop at a normal rate, producing a child with a small head, a receding forehead, and a loose, often wrinkled scalp. As the child grows older, the decreased size of the skull becomes more obvious, although the entire body is also often underweight and dwarfed. Development of motor functions and speech may be delayed. Hyperactivity and intellectual disability are common occurrences, although the degree of each varies. Convulsions may also occur. Motor ability varies, ranging from clumsiness in some to spastic quadriplegia in others.

There are numerous causes, such as:

  • the mother suffering from malnutrition
  • being exposed to radiation
  • hyperthermia
  • poorly controlled gestational diabetes
  • the Zika virus (which has been widely reported in the news recently)  

The diagnosis of microcephaly in a baby can also be an indication that the baby suffered hypoxic ischemic encephalopathy (HIE)during childbirth, and it also makes it more likely that the baby will have cerebral palsy.

The World Health Organisation recognised Zika, a viral disease carried by a type of mosquito, to be classified as an epidemic in 7 countries in South America, including the largest country, Brazil. The disease is also present in parts of Central America, the Caribbean, Africa and some Pacific nations such as Samoa. In the whole of the Americas, only Canada is said not to be at risk from Zika, as the climate is not suitable for the mosquito to thrive and to infect people.

As reported in the media, Zika is believed to affect foetuses altering their brain development in utero, leading to microcephaly.

In Brazil, on a yearly basis there were about 300-400 cases of microcephaly being recorded in newborns. However there has been a huge increase in reported cases, with over 4000 cases being reported in 2015. There are predicted to be 4 million cases over the next few years in South America alone.

The virus is presumed to pass across the placenta (indeed, the virus has been located in placental tissue in newborns with microcephaly), and there have been case reports that propose that transmission can occur by sexual intercourse (cases involving a person having had sex with someone who had returned from South America).

What is slightly odd is that the Zika virus has been in South Asia and Africa for many years without the phenomenon of producing babies with smaller than expected heads. The virus was named after the Zika Forest in Uganda in 1947 where it was first discovered but only recently, has microcephaly been associated with infection during pregnancy. A mutation in the virus has been suggested.

Symptoms of Zika commonly include:

  • a raised temperature
  • conjunctivitis
  • joint pains and rash

The symptoms usually last from 2-3 days to 1 week, with many cases passing off without ill effect.

Zika is related to a group of viruses that include:

  • dengue fever
  • tick borne encephalitis
  • yellow fever

These viruses can all cause death and be associated with debilitating disease but, unlike Zika, do not tend to cause malformations in the foetus in utero. These viruses are carried by an insect, usually ticks or mosquitoes.

There is no treatment for infection by Zika, though at the time of writing, scientists in the USA are to begin vaccine trials in either August or September 2016, with the hope that a vaccine will be ready by 2018.
 
For people intending to travel, for example to the Olympic Games in Rio this summer, the Foreign Office and Public Health England carry the news on the disease status in countries around the world, on their websites, and offer useful advice on how to reduce the risks of acquiring Zika virus.

   To discuss whether or not you may have a potential claim for compensation arising from clinical negligence during childbirth that resulted in microcephaly and/or cerebral palsy, please do not hesitate to contact the Clinical Negligence Team at Dutton Gregory Solicitors in Bournemouth on 01202 315005, or email k.marden@duttongregory.co.uk.