Perinatal Outcomes in Vertically Infected Neonates During a Chikungunya Outbreak on the Island of Curaçao

Abstract

Recent outbreaks of Chikungunya virus (CHIKV) infection confirm the vulnerability of neonates after vertical transmission. In 2014, CHIKV was reported for the first time in the Americas, including the island of Curaçao. We describe the outcomes of symptomatic neonates with vertically transmitted CHIKV infection during the CHIKV epidemic, who were admitted in the Saint Elisabeth Hospital, Willemstad, Curaçao. There were three symptomatic neonates with serologically confirmed infection. Two neonates developed neurological complications, including convulsions and intracerebral bleeding. One newborn, in whom maternal infection occurred 7 weeks before delivery, had a fatal outcome after birth. Maternal-fetal transmission of CHIKV may cause severe neonatal complications. There is a need to share experiences and to implement protocols toward the management of perinatal CHIKV infection.

Figure 1.

Computed tomography scan in a newborn (case 1) with intracerebral hemorrhage and vertically transmitted Chikungunya infection, Curaçao 2014–2015. Extensive intracerebral hemorrhage with midline shift to the left with an enlarged ventricular system and hemorrhagic choroid plexus cyst.

Figure 2.

Magnetic resonance imaging in a newborn (case 2) with convulsions and vertically transmitted Chikungunya infection, Curaçao 2014–2015. *Diffusion-weighted imaging and apparent diffusion coefficient map show diffuse excessive high signal intensity. **White matter involvement is extensive (A and B) with abnormalities extending into the subcortical white matter, entire fiber tracts, corpus callosum and ***optic radiation (C).