Zika and Microcephaly: How Doctors Made the Link
Feb. 3, 2016 -- The first ultrasound scans were devastating.
In grainy black and white, doctors peeking into the wombs of pregnant women in Brazil could see trouble.
The brains of their tiny patients weren’t keeping pace with the rest of their growth. And something was badly wrong. The brain’s inner chambers seemed enlarged and deformed, and other key structures were altered -- a condition known as microcephaly.
Most puzzling to Adriana Melo, MD, PhD, an obstetrician and fetal medicine specialist in Campina Grande, Brazil, were the bright spots called calcifications that dotted the brain tissue.
“Since the first exams, when I started to see a strange pattern, I thought that this was something different, something new in Brazil,” Melo says. She says when the brain’s inner chambers are enlarged, it usually points to a genetic problem, but “...calcification suggests infection. So the combination of these findings was confusing.”
In an average year, a doctor in Brazil might see one or two pregnancies with birth defects like these. But by October, Melo had heard about more than 60 of these babies.
Fear took hold.
“There was a terrible rumor that vaccines were the cause,” Melo says. “And that was very hard for us, because people would talk about microcephaly and then someone would say, ‘Oh, just don’t get any vaccines,’” she says. “People started to believe that it was related.”
But Melo knew it had to be something else, and she raced to find it.
“We couldn’t just sit here,” she says. “I knew what I was seeing was something different, something new that we hadn’t seen before.”
Her first patient was a 34-year-old first-time mom. Melo had been her doctor from the beginning of her pregnancy. The woman had no risk factors for microcephaly. She didn’t smoke, didn’t drink, didn’t use drugs, and had no family history of genetic problems that might cause the condition.
What she did have was a rash and achy joints when she was about 8 weeks pregnant. Her symptoms had faded and she had seemingly recovered without a problem.
Nobody suspected Zika virus.
“We’ve had dengue here for years, and we just haven’t been that worried about that virus, and we thought this was going to be same,” Melo says.