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Zika Outcomes and Development in Infants and Children Investigation

Hispanic mom sitting in a chair holding her toddler

The Zika Outcomes and Development in Infants and Children (ZODIAC) investigation will describe the developmental challenges faced by Brazilian children exposed to the Zika virus infection before birth. The investigation studies children born during the 2015 to 2016 Zika virus outbreak who had evidence of Zika virus infection.

Investigation Overview

The ZODIAC investigation studies children who

  • Live in northeastern Brazil,
  • Are up to 2 years of age, and
  • Have confirmed exposure to Zika virus infection before birth.

Children affected by Zika virus infection before birth may have birth defects and other challenges that make it difficult to do activities that other children their age can do. Some common challenges that Zika infected children may face include

  • Intellectual disabilities,
  • Movement or balance problems,
  • Vision and hearing loss,
  • Speech and mental delays, and
  • Seizures.

A child’s infection with Zika virus before birth may not be recognized. This may happen if the mother’s infection during pregnancy was mild, she did not get tested for Zika virus infection, and/or the child is born without noticeable birth defects. The ZODIAC investigation was designed to look carefully at these children to pick up problems that are less obvious at birth, or that progress over time.

Brazil with two states highlighted

ZODIAC Research in Brazil

CDC’s National Center on Birth Defects and Developmental Disabilities and Center for Global Health partnered with Brazil’s Ministry of Health to compile a list of the health and development of babies, aged 12-24 months, infected with Zika virus before birth. Researchers conducted the study in Paraíba and Ceará, which are two Brazilian states heavily affected by the Zika virus outbreak in 2015 to 2016. Furthermore, ZODIAC scientists directly observed the babies in clinic, interviewed caregivers, and reviewed medical records to gather information on the following long-term health and developmental challenges:

  • Physical growth,
  • Birth defects,
  • Vision and hearing loss, and
  • Cognitive, social, language, and motor development.

ZODIAC completed its data collection in October 2017.

How will CDC use the Data?

Boy sitting with a juice box with a woman handing him a book

ZODIAC’s data collection will be useful to

  • Understand the full range of potential health problems.
  • Educate parents and healthcare providers to watch for these problems early.
  • Get children the care and the support to develop to their full potential.

Families and healthcare providers in Brazil, the United States, and other countries affected by Zika virus will find the research results most helpful.

ZODIAC: Collaboration and Support

The research from the ZODIAC investigation is possible from the support and collaboration of the Ministério da Saúde do Brasil (Ministry of Health of Brazil), CDC’s National Center on Birth Defects and Developmental Disabilities, CDC’s Center for Global Health, CDC’s country office in Brazil, and CDC’s National Center for Emerging and Zoonotic Infectious Disease.

ZODIAC Publications and Resources

  • Health and Development at Age 19–24 Months of 19 Children Who Were Born with Microcephaly and Laboratory Evidence of Congenital Zika Virus Infection During the 2015 Zika Virus Outbreak — Brazil, 2017 – Read the MMWR
  • Zika Care Connect is a healthcare organization established in collaboration with March of Dimes. Zika Care Connect supports family care coordination and helps to improve access to needed services. Learn more at zikacareconnect.org.
  • Visit cdc.gov/zika for the latest Zika-related updates.
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