Microcephaly has been in the news lately related to the Zika virus outbreak spreading in many South American countries, especially Brazil. It seems that there is a correlation between prenatal exposure to the Zika virus in women who then give birth to children with microcephaly.

Scientists don't know if the Zika virus is actually causing microcephaly in newborns; more research is necessary to determine cause and effect. But for now, pregnant women and women planning to become pregnant are encouraged to avoid areas where they may come in contact with the mosquito that spreads the virus.


Unfortunately, the Zika virus is rapidly spreading beyond Brazil and has already been identified in Florida and other warm climate territories in the Americas and Caribbean. It is important to note that the virus itself is not a killer. In fact, the vast majority of people infected with the Zika virus do not have any symptoms. Those that become sick have only minor flu-like symptoms. It is the possible link to children born with significant disabilities, like microcephaly, that makes avoiding Zika carrying mosquitos important.

According to the Center for Disease Control, microcephaly is "a condition where a baby's head is much smaller than expected. During pregnancy, a baby's head grows because the baby's brain grows. Microcephaly can occur because a baby's brain has not developed properly during pregnancy or has stopped growing after birth, which results in a smaller head size."

According to the National Institute of Neurological Disorders and Strokes, "Microcephaly can be present at birth or it may develop in the first few years of life" if the baby's brain stops growing. When not related to the Zika or other viruses, microcephaly "is most often caused by genetic abnormalities that interfere with the growth of the cerebral cortex during the early months of fetal development" according to the NINDS.

In my 40-year career in special education I have worked with many children with microcephaly. These children have a range of developmental disabilities and other related physical challenges. They may have seizures and physical limitations in mobility, speech and eating. Anything that the brain controls, such as vision and hearing, may also be impacted by poor brain growth and development.

The important thing to remember about any disability, including microcephaly, is that there is no one-size-fits-all diagnosis. Children with microcephaly have a large range of intellectual and developmental development. I have worked mostly with children with severe disabilities who need a lifetime of support and care.

The CDC reports that microcephaly is normally a rare condition, affecting about 2 to 12 babies per 10,000 live births in the United States. In Brazil, just 150 cases of microcephaly are reported in a normal year compared to thousands of new cases in recent months in Zika infected areas.

The exact cause of microcephaly is unknown, but like its potential relationship with the Zika virus, it is correlated, although not as strongly, with other infections such as rubella, toxoplasmosis and cytomegalovirus. Prenatal exposure to alcohol, drugs, and other toxic chemicals is also related to the birth of children with microcephaly.

Microcephaly may be diagnosed prenatally by measuring the baby's head using ultrasound. Results may then be confirmed using a CT scan or an MRI. After-birth diagnoses is completed by also measuring the baby's head circumference and comparing it to expected measurements given the baby's overall size and age.

Microcephaly cannot be reversed and is a lifelong condition. Depending upon the severity of any disabilities related to the condition, a variety of special education services will likely be necessary.

If these reports are true and thousands of cases of microcephaly are being diagnosed because of the Zika virus, the world's health organizations need to respond quickly to stop this epidemic. Family hardships and the economic costs of caring for these children will be significant. It reminds me of the importance and economic benefit of prevention programs.

Tom Zirpoli writes from Westminster. He is the Laurence J. Adams Endowed Chair in special education and coordinator of the human services management graduate program at McDaniel College. His column appears Wednesdays. Email him at tzirpoli@mcdaniel.edu.