Brazil scientists seek to unravel mystery of Zika twins

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Brazilian twins, one with Zika microcephaly and one without
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Brazil scientists seek to unravel mystery of Zika twins
Five-month-old twins Laura (R) and Lucas lie on a bed at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline (R), 25, stands next to her mother Manyara (C), 46, who holds her five-month-old granddaughter Laura, as Paulo (L), 8, holds his five-month-old brother Lucas at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline (L), 25, holds her five-month-old twins, Laura (R) and Lucas at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES TPX IMAGES OF THE DAY
Five-month-old twins, Laura (L) and Lucas lie in a buggy at an entrance of their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline, 25, holds her five-month-old daughter Laura as her twin brother Lucas (R), lies in a buggy at an entrance of their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline, 25, holds her five-month-old daughter Laura as she uses her mobile phone at the end of an evaluation session with a physiotherapist at the Casa da Esperanca Hospital (Hope House Hospital) in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
A physiotherapist gestures as Jaqueline (R), 25, holds her five-month-old daughter Laura during an evaluation session at the Casa da Esperanca Hospital (Hope House Hospital) in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline (R), 25, holds her five-month-old son Lucas while her mother Manyara (L), 46, holds her five-month-old granddaughter Laura at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline (L), 25, and her five-month-old daughter Laura (C) are seen during a session with a physiotherapist at the Casa da Esperanca Hospital (Hope House Hospital) in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline, 25, holds her five-month-old son Lucas as she gives a pacifier to her five-month-old daughter Laura at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline (C), 25, holds her five-month-old daughter Laura, as she takes a selfie with her children Gabrielle (2nd L), 4, and Paulo (R), 8, and her mother Manyara (L), 46, who holds five-month-old Lucas in front of their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Five-month-old Laura undergoes a medical test at the University of Sao Paulo (USP) in Sao Paulo, Brazil April 28, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES TPX IMAGES OF THE DAY
A physiotherapist exercises five-month-old Laura during an evaluation session at the Casa da Esperanca Hospital (Hope House Hospital) in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline, 25, holds her five-month-old daughter Laura as they wait for a session with a physiotherapist at the Casa da Esperanca Hospital (Hope House Hospital) in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Five-month-old Laura gets her head measured by the neurologist, Maria Leal Santos, at the Casa da Esperanca Hospital (Hope House Hospital) in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline, 25, bathes her five-month-old daughter Laura at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition.. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Five-month-old twins, Laura (L) and Lucas lie in their bed at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Jaqueline (C), 25, breastfeeds her five-month-old daughter Laura as a doctor (back) holds five-month-old Lucas during a medical test at the University of Sao Paulo (USP) in Sao Paulo, Brazil April 28, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES
Paulo (C), 8, holds his five-month-old sister Laura as his grandmother Manyara (back), 46, holds her five-month-old grandson Lucas at their house in Santos, Sao Paulo state, Brazil April 20, 2016. Among the mysteries facing doctors in Brazil battling an epidemic of the little-known Zika virus are cases of women giving birth to twins with only one suffering from microcephaly, a birth defect associated with the disease. Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues. "When I found out one of them had microcephaly the ground fell out from beneath me," she said. Laura was born with the microcephaly while her twin brother Lucas does not suffer from the condition. REUTERS/Nacho Doce SEARCH "NACHO TWINS" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES TPX IMAGES OF THE DAY
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SAO PAULO, May 6 (Reuters) - Scientists struggling to unravel the mysteries of a Zika epidemic in Brazil hope they can learn from cases of women giving birth to twins in which only one child is afflicted by the microcephaly birth defect associated with the virus.

Jaqueline Jessica Silva de Oliveira hoped doctors were wrong when a routine ultrasound showed that one of her unborn twins would be born with the condition, marked by stunted head size and developmental issues.

"When I found out one of them had microcephaly, the ground fell out from beneath me," the 25-year-old said as she sat on the sofa of her home in the city of Santos. "You always hope that they will be born well, thinking that it could be a mistake by the doctor or in the ultrasound."

Her son Lucas, who she holds in her arms, was born healthy in November. His twin sister Laura, whose head is visibly much smaller, requires regular treatment by a team of neurologists and physiotherapists in nearby Sao Paulo.

With two young children already, Oliveira - who suffered the symptoms of Zika early in pregnancy - knew that life would be difficult with a child with developmental problems. Her husband, the family's only breadwinner, brings home just over 2,000 reais ($566) a month.

"I thank God for giving her to me... I would never abandon her," Oliveira said, adding she had never questioned why only one child was born with microcephaly. "The doctors want to study them so they can see what protected Lucas in case it can help other children."

Zika Twins Under the Microscope in Brazil

CLUES TO NATURE OF DISEASE

Cases of only one twin developing a disease, such as rheumatoid arthritis or diabetes, have been widely documented. Medical research has focused on the interaction between the environment and genetic issues.

Lucas and Laura are one of five cases of Zika twins scientists are studying in Sao Paulo.

Similar cases of newborn twins - one with and one without microcephaly - caught the attention of doctors last year in northeastern Brazil, where the mosquito-borne Zika was detected for the first time in the Americas. The divergence in twins was one reason why researchers began to suspect the presence of a new disease.

Brazil has since registered nearly 5,000 confirmed and suspected cases of microcephaly associated with Zika, according to the Health Ministry. The outbreak, and its impact on pregnant women, has cast a shadow over the upcoming summer Olympics in Rio de Janeiro on August.

The Zika outbreak is affecting large parts of Latin America and the Caribbean, with Brazil the hardest hit so far. It is likely to spread to all countries in the Americas except for Canada and Chile, the World Health Organization has said.

Last month, the U.S. Center for Disease Control and Prevention officially confirmed that infection with Zika in pregnant women is a cause of microcephaly and other severe brain abnormalities in babies.

A team from Sao Paulo University studying the five cases believes they may hold clues to the nature of the disease itself and hope to have results from their investigation in a year's time.

"The importance of these twins...is that they could give us some very important answers," said Mayana Zatz, director of the Human Genome Research Center at the university.

"How can we explain that one of the twins was not affected: did they have a gene that protected them? Do they have a different genome that disposes them to the infection or not?"

Recent studies have shown evidence of Zika in amniotic fluid, placenta and fetal brain tissue. Zatz said the placenta of one twin may be permeable to Zika, while the other may not, barring the virus from attacking the fetus.

Another possibility is that the virus penetrates both placentas but that the neurons of one baby are resistant, while the other's are not.

"The third possibility that we want to investigate is that certain genes predispose the child to microcephaly, and they are altered by the presence of the Zika virus," Zatz said, noting that around 15 genes are believed to govern microcephaly.

($1 = 3.5313 Brazilian reais)

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