NPC1 and microcephaly: In ZF2 and ZF3 with histopathological evidence of loss of NPCs throughout the cerebrum, this finding coincided with reduced brain mass, which is consistent with hypotheses that NPC degeneration may be partly responsible for the characteristic microcephaly seen in severe CZS cases [25, 72]; however, we note that ZF2 was affected by acute septicemia, and NPC loss in this infant cannot conclusively be attributed to ZIKV infection.