Free Zika by Donald G. McNeil Page B

damage would be apparent at birth. Didn’t schizophrenia usually strike young adults?
    Yes, he said, it would appear only later. But infections of the fetal brain could have a whole range of consequences. The gross ones were obvious; the subtler ones might emerge only in twenty years. “We’re looking at a large group of individuals who may not be able to function in the world.”
    And there was no way to know which outcome was most likely, he added. In 2010, his lab had infected pregnant mice with a synthetic RNA virus that replicated in fetal mouse brains. The results were wildly unpredictable.
    â€œIf you infected them halfway through gestation, the offspring got the mouse equivalent of depression—they were withdrawn; they sat in a corner of their cage and didn’t interact at all,” he said. “If you did it two-thirds of the way through, they were hyperactive, the equivalent of manic.”
    I consulted other experts on fetal brain development, and they agreed with Ian. Schizophrenia runs in families, so it is assumed to be linked to genes. It is also brought on or worsened by trauma such as sexual abuse, abandonment, or heavy drug use. But there was a growing body of evidence that infections in utero played a role. For example, adults born in late winter and early spring had schizophrenia more often than those born in summer and fall. The suspicion was that flu viruses their mothers caught shortly before their births did something harmful. The virus itself didn’t have to reach the baby’s brain, the theory went: even the “cytokine storm” that the mother’s immune system generated in response could cross the placenta.
    In 1988, Finnish researchers looked at schizophrenia rates in age cohorts and reported that it was quite high in the slice of the population born right after the 1957 Asian flu.
    And a pioneer of schizophrenia research, Dr. E. Fuller Torrey, said he believed Rosemary Kennedy, President John F. Kennedy’s older sister, had been a victim of the Spanish flu. Born at its height in 1918, she struggled to learn to read anything harder than Winnie the Pooh and in her late teens developed schizophrenia symptoms, including violent outbursts. At 23, she had one of the earliest prefontal lobotomies performed on her, and she was institutionalized until her death. Some historians had blamed it on oxygen deprivation at birth, but Dr. Torrey thought subtle damage from the flu epidemic was a more likely explanation.
    Whether psychiatric problems are in the future of babies with Zika won’t be known for years. As of now, though, doctors in Brazil and elsewhere are describing problems that confirm Ian’s basic premise: fetal death and profound microcephaly are just the most extreme end of a whole spectrum of damage suffered by Zika babies. Some have normal-looking heads, but also both small empty spots and calcifications in the brain, produced when cells die and stop filling the spaces they should. The holes appear in different parts of the brain in different children, so some may have problems with decision-making while others may have trouble running or walking. Damage to the long nerves attaching the eyes and ears to the brain has also been observed.
    Eventually, scientists from French Polynesia and France were to publish a follow-up study on the 19 pregnancies in which brain damage had been detected, usually on ultrasound. Eleven of them had been aborted. (In cases of severe malformation, French law permits termination of even a full-term pregnancy, as long as the scans have been sent to the Prenatal Multidisciplinary Diagnostic Center in East Paris and a committee there has approved.)
    Eight babies were clearly microcephalic. Six were not, but had brain lesions. Five appeared to be normal but, after birth, displayed problems that indicated brainstem damage.
    Two have since died. Six that were still alive had been flown to France or Australia to be