Certain viruses can have a significant impact on an infant’s brain development, leading to various neurological and cognitive impairments. Some of these viruses include cytomegalovirus (CMV), herpes simplex virus (HSV), rubella virus, and Zika virus. CMV is the most common cause of congenital infections and can cause severe neurological disabilities such as hearing loss, developmental delays, and intellectual disabilities. HSV can cause encephalitis and brain damage in newborns if the mother is infected during pregnancy or delivery. Rubella virus can cause congenital rubella syndrome, which can lead to deafness, blindness, and intellectual disabilities. Zika virus can cause microcephaly, a condition where the baby’s head and brain are smaller than usual, leading to developmental delays and intellectual disabilities. Early detection and management are crucial for preventing long-term complications.
Dr Sandip Badgujar, Associate Consultant, Paediatrics, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, says, “If you have a child you’re likely to have experienced a fever or infection in them atleast once. Viral infections are almost two times more common than bacterial. While most can be trivial, some are of notable importance specially the ones that infect the nervous system. It is of paramount importance to identify neurological infections in infants because of the impact to developing brain. Depending on the part of the brain involved – infection can be classified as meningitis (inflammation of the layer covering the brain), encephalitis (involvement of entire brain) and abscess (infection localised to a part of brain). Such a viral infection to developing brain has critical neurological sequelae.”
There are two possible routes through which a neonatal brain can become infected by a virus. Dr. Sandeep Patil, Consultant Paediatric Neurologist, Ruby Hall Clinic, Pune, “One transplacentally that is from mother to baby in utero and other while during process of the birth. In first case there are multiple viruses can affect developing brain for example cytomegalovirus, Herpes Virus, Rubella viruses, Zika virus and Toxoplasma. These viruses affect the developing brain usually in first trimester. These viruses affect overall development of brain and it manifest as Microcephaly, seizures and developmental delays.”
The other viruses which affects usually during the process of delivery cause acute infarction after the birth. For example, par echo virus, parvovirus etc. “These viruses affect brain which is already mature and affect white matter more. They manifest with neonatal seizures initially and developmental delay, difficulty in walking in later life. For diagnosis of this condition one require specialised investigation such as MRI, EEG, CSF study to do viral markers,” adds Dr Patil.
Viruses which are known to cause CNS infection are:
Enterovirus, Herpes simplex virus, Varicella zoster virus, Cytomegalovirus, Influenza, Measles, Rubella, Japanese encephalitis.
Symptoms of viral encephalitis/meningitis:
Dr Badgujar adds, “Possible symptoms which raise the suspicion of viral encephalitis in your baby could be running a high temperature, headache, increased irritability, sensitivity to light, vomiting, confusion, stiff neck, seizures and coma.”
Mode of transmission
Such viruses spread by different means. “Some of them spread by cough or sneezes from an infected person that release airborne viruses (influenza and measles virus); while others are transmitted via eating contaminated food/drinks(enterovirus) or bite by infected insects such as mosquitoes and ticks can transfer viruses directly in bloodstream (Japanese encephalitis etc),” opines Dr Badgujar.
Diagnosis
Cerebrospinal fluid examination via lumbar puncture, blood tests (Viral PCR), CT scan, EEG, MRI and physical examination.
Complications
Low BP and low oxygen levels, bleeding inside the brain, permanent brain damage or death.
Treatment:
Viruses are difficult to treat. Antiviral medication only work on limited number of viruses. Treatment includes hospitalization, pain relieving medication, medication to prevent vomiting, seizures, fever; medications to reduce brain swelling. IV antiviral medications like Acyclovir and valacyclovir for susceptible viruses like HSV.
“As most of the viral infection doesn’t have definitive treatment, prevention is the best defence against this viral condition. During acute infection one needs supportive care and management of symptoms under observation of experts. Early diagnosis and treatment also can modify long term outcome. Taking expert opinion early in to condition is helpful,” states Dr Patil.
Long term complications:
Generally acute phase of illness lasts for 1-2 weeks and symptoms subside slowly. In most cases child makes full recovery while some with neurological sequelae may require long term supportive care.
When and where to get help:
Dr Badgujar believes one should reach the emergency department of nearest hospital in case of above-mentioned symptoms.
Timely vaccination against vaccine-preventable diseases like Japanese encephalitis, measles, varicella and influenza are recommended.
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