Because of the devastating effects, scientists began dedicating their efforts to explain how Zika has evolved “from an endemic arbovirus causing sporadic mild illness across equatorial Africa and Asia” into the virus that is known today, one that can result in a number of severe complications and rapidly spread across the world. As time went on, researchers started conducting more studies in an effort to understand “the full spectrum of the disease.” One such study worked to characterize the pattern of anomalies in congenital Zika syndrome. Although the spectrum is still not fully understood, Dr. Wilder-Smith feels that there is “enough data to show a very distinctive pattern of congenital Zika syndrome that is quite unique to Zika and the first is cranial morphology,” which can present in the form of a collapsed skull, an excessive scalp with folds, or occidental bone prominence.
To bring the message home, Dr. Wilder-Smith provided the audience with a series of photos that illustrated infants with a number Zika-related complications, chief among them, microcephaly. However, she reminded the audience that microcephaly is not the only serious complication that resulted in Zika being deemed a problem of international concern: “GBS needs to be taken seriously,” Dr. Wilder-Smith warned. She then shared that she is working with Galsgow colleagues to identify biomarkers that will help predict the development of GBS in Zika infections. There are a number of additional research efforts being made that are dedicated to differentiating between complications associated with asymptomatic and symptomatic Zika in pregnant women and identifying the risk of abnormalities in asymptomatically infected women.
Dr. Wilder-Smith stressed that in order to understand how the Zika virus will evolve further, researchers must look back at the past for insight. In order to illustrate this, she provided attendees with a snapshot summary of outbreaks that have occurred in the past, the sero-prevalence at the end of each outbreak, and the prevalence of microcephaly per annual 1000 livebirths. For example, Yap has a population of 7391 and the outbreak lasted for 3 months; sporadic cases after the outbreak have not been noted and the sero-prevalence at the end of the outbreak was 73%. For French Polynesia, with a population of 268,270 individuals, they expereinced an outbreak that lasted for four months. No sporadic cases were noted after the outbreak and the sero-prevalence at the end of the outbreak was 66%; the prevalence of microcephaly per annual 1000 livebirths was 2/1000.