Zika might cause worse birth defects than feared

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The case of a Brazilian woman whose unborn baby died may show that Zika is causing even worse birth defects than feared, doctors reported Thursday.

The fetus had virtually no brain at all, and died seven months into the pregnancy, the doctors reported.

An autopsy showed Zika in the brain of the fetus but nowhere else in the body — a finding that supports what other doctors have found. Zika seems to pile up in the brains of babies killed by birth defects.

Perhaps even more worrying, the 20-year-old mother did not remember having had a Zika-like illness. That raises the possibility that the virus can cause birth defects even when it doesn't make the mother sick.

"The first indication of an abnormal pregnancy was the ultrasound finding of intrauterine growth retardation in the 18th gestational week," Dr. Albert Ko of Yale University and colleagues wrote in their report, published in the Public Library of Science journal PLoS Neglected Tropical Diseases.

Related: Zika Found in Brain of Fetus With Severe Defect

The fetus was much smaller than it should have been. Later ultrasounds showed the fetus had hydranencephaly, a condition in which much of the brain is missing and fluid is there instead.

"The whole brain was filled with liquid," Ko told a recent meeting of researchers. The area around the lungs and in the chest was also filled with liquid.

Other doctors have found Zika in the bodies of babies that miscarried and in amniotic fluid - clear evidence the virus is passing from mother to child in the womb, and that it can kill the fetus.

"Given the recent spread of the virus, systematic investigation of spontaneous abortions and stillbirths may be warranted to evaluate the risk that Zika virus infection imparts on these outcomes," Ko's team wrote.

Zika is spreading fast across the Americas and the World Health Organization and Centers for Disease Control and Prevention have both warned pregnant women to avoid countries where the virus is circulating.

Photos of babies in Brazil with cases of microcephaly:

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Brazil reporting more microcephaly cases, defect cause by Zika
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Brazil has reported a worrying rise in cases of a birth defect called microcephaly, caused when the developing brain is damaged by an infection, alcohol poisoning or a genetic condition.

CDC, WHO and Brazilian experts are fanning out across the worst-hit areas, comparing healthy babies to babies with microcephaly to see if they can pin down Zika as the cause.

One puzzling question is why it would be causing birth defects in Brazil when it has not been known to cause birth defects before - and the virus has been identified since 1947.

Experts say it could be this is the first really big epidemic of Zika, hitting a big country with 3 million births a year for the first time. Or it could be that in the densely populated slums where Zika is hitting hardest, people get bitten multiple times by the mosquitoes that spread it and get super-intense infections, Ko and colleagues write in a second research paper published Wednesday.

It could be that the virus has mutated just a bit, they added in their commentary published in the Annals of Internal Medicine.

"Unfortunately, the immediate prospects for controlling the magnitude and spread of the current Zika virus epidemic are not promising," they wrote.

"Until a vaccine is available, mosquito control and education of at-risk populations to reduce contact with the vector are the only short-term approaches available. These methods have had limited success for dengue and chikungunya viruses."

See more on the spread of the Zika virus:

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Zika, health agents trying to eradicate Zika mosquitoes in South America, Central America
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Zika might cause worse birth defects than feared
RECIFE, BRAZIL - FEBRUARY 01: David Henrique Ferreira, 5 months, who was born with microcephaly, is examined by a doctor on February 1, 2016 in Recife, Pernambuco state, Brazil. Ferreira's mother says she spends up to eight hours per day in transit on buses, three days per week, to visit a litany of doctors with David. In the last four months, authorities have recorded thousands of cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. The World Health Organization (WHO) declared the Zika virus a 'public health emergency of international concern' today. (Photo by Mario Tama/Getty Images)
Health ministry personnel fumigate a classroom against the Aedes aegypti mosquito, vector of the dengue, Chikungunya and Zika viruses in Tegucigalpa, , on February 1, 2016. Honduran President Juan Orlando Hernandez on Friday declared the country on a preventive state of alert due to the Zika virus which in the last 44 days killed a person and infected some 1000. AFP PHOTO/Orlando SIERRA. / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
Members of the Migente foundation check mosquito traps in the Paris neighborhood, Bello municipality, Antioquia department, Colombia on January 26, 2016. The Study and Control of Tropical Diseases Program (PECET) of Antioquia's University released one year ago Aedes aegypti mosquitos carrying the Wolbachia pipientis bacteria, which prevents them from transmitting the Zika and dengue viruses, as part of project to fight dengue. The Zika virus, a mosquito-borne disease suspected of causing serious birth defects, is expected to spread to all countries in the Americas except Canada and Chile, the World Health Organization said. AFP PHOTO /Raul ARBOLEDA / AFP / -- / RAUL ARBOLEDA (Photo credit should read RAUL ARBOLEDA/AFP/Getty Images)
A photographer walks through the fumes as Health Ministry employee fumigate against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
Army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
Army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
Army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
A health agent from the Sao Paulo secretariat of public health and army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
TOPSHOT - A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
Health ministry employees spray to eliminate breeding sites of the Aedes Aegypti mosquito, which transmits diseases such as the dengue, chicunguna and Zica viruses, in a Tegucigalpa cemetery on January 21, 2016. The medical school at the National Autonomous University of Honduras (UNAH) recommended that women in the country avoid getting pregnant for the time being due to the presence of the Zika virus. If a pregnant woman is infected by the virus, the baby could be born with microcephaly. AFP PHOTO/Orlando SIERRA / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
A specialist fumigates the Nueva Esperanza graveyard in the outskirts of Lima on January 15, 2016. Health officials fumigated the largest cementery in Peru and second largest in the world to prevent Chikunguya and Zika virus, which affect several South American countries. AFP PHOTO/ERNESTO BENAVIDES / AFP / ERNESTO BENAVIDES (Photo credit should read ERNESTO BENAVIDES/AFP/Getty Images)
View of the Nueva Esperanza graveyard as it is fumigated in the outskirts of Lima on January 15, 2016. Health officials fumigated the largest cemetery in Peru and second largest in the world to prevent Chikunguya and Zika virus, which affect several South American countries. AFP PHOTO/ERNESTO BENAVIDES / AFP / ERNESTO BENAVIDES (Photo credit should read ERNESTO BENAVIDES/AFP/Getty Images)
A pregnant woman is attended at the Maternal and Children's Hospital in Tegucigalpa on January 21, 2016. The medical school at the National Autonomous University of Honduras (UNAH) recommended that women in the country avoid getting pregnant for the time being due to the presence of the Zika virus. If a pregnant woman is infected by the virus, the baby could be born with microcephaly. AFP PHOTO/Orlando SIERRA / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
A pregnant woman waits to be attended at the Maternal and Children's Hospital in Tegucigalpa on January 21, 2016. The medical school at the National Autonomous University of Honduras (UNAH) recommended that women in the country avoid getting pregnant for the time being due to the presence of the Zika virus. If a pregnant woman is infected by the virus, the baby could be born with microcephaly. AFP PHOTO/Orlando SIERRA / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
Aedes aegypti mosquitos are seen in containers at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January 8, 2016 in Sao Paulo, Brazil. Researchers at the Pasteur Institute in Dakar, Senegal are in Brazil to train local researchers to combat the Zika virus epidemic. / AFP / NELSON ALMEIDA (Photo credit should read NELSON ALMEIDA/AFP/Getty Images)
Aedes aegypti mosquitos are seen in containers at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January 8, 2016 in Sao Paulo, Brazil. Researchers at the Pasteur Institute in Dakar, Senegal are in Brazil to train local researchers to combat the Zika virus epidemic. / AFP / NELSON ALMEIDA (Photo credit should read NELSON ALMEIDA/AFP/Getty Images)
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