Journal Article


Chantal Nelson

in Paediatrics & Child Health

Published on behalf of Canadian Paediatric Society

Volume 23, issue suppl_1 Published in print May 2018 | ISSN: 1205-7088
Published online May 2018 | e-ISSN: 1918-1485 | DOI:

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  • Neonatology
  • Primary Care
  • Child and Adolescent Psychiatry
  • Clinical Child and Adolescent Psychology
  • Developmental Psychology


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Microcephaly is a congenital anomaly of the central nervous system. It is a condition in which an infant’s head is significantly smaller than the heads of other children of the same age and sex. Sometimes detected at birth, microcephaly usually results from the brain developing abnormally in the womb or not growing normally after birth. At the present time there is an increase of microcephaly cases which have are linked to an ongoing Zika virus outbreak. While the increase was mostly seen in Brazil, due to the possible modes of transmission of the Zika virus and the increased travel of Canadians to warmer climates, conducting this study was highly responsive, timely and relevant to an emerging public health issue that has received significant international concern.


This study aims to address two specific objectives: 1) define the minimum incidence of severe microcephaly in Canada, and 2) describe Canadian -specific epidemiology (including etiology, when known) of severe microcephaly.


Data is collected by questionnaire through the Canadian Paediatric Surveillance Program. Each paediatrician who is registered with the network is asked to report every month any new cases of infants, < 1 year of age, with a head circumference < 3 standard deviations below the mean for gestational age and sex, based on the sex-specific WHO growth parameters. Any infant with confirmed microcephaly will have additional information completed by questionnaire by his/her paediatrician.


As of October 2017, a total of 44 questionnaires have been completed and submitted (n=1 duplicate case, n=2 did not meet case definition) yielding a total of 41 questionnaires for analysis. To date, one case of severe microcephaly has been confirmed due to Zika virus. The other leading suspected causes (when reported) include: 3.4% infection, 34.5% genetic, 13.8% ischemic, 34.5% unknown, and 13.8% other. The average head circumference at birth is 28.3 cm for all cases. Most of the cases are males (64%) and the majority are singleton births (94%). Data is less complete for diagnostic testing information, including test results, and parental travel history.


An increase in prevalence of the Zika virus and the emergence of its association with microcephaly warrants heightened awareness and targeted surveillance to better understand this issue in the Canadian context. Data collection is still ongoing, but once analysis is complete it will provide valuable baseline incidence and etiologic information on severe microcephaly in Canada.

Journal Article.  0 words. 

Subjects: Neonatology ; Primary Care ; Child and Adolescent Psychiatry ; Clinical Child and Adolescent Psychology ; Developmental Psychology

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