Figure 2. Instrumental evaluation of an infant with dysphagia and microcephaly caused by congenital Zika virus infection, Brazil, 2015. A) Videofluoroscopic swallowing study image showing a lateral view of the infant with premature spillage of liquid food (with added contrast) in the pharynx before triggering of the swallowing reflex. B) Image of the fiberoptic endoscopic evaluation of a delay in initiation of swallowing; thickened, dyed liquid is visible on the supraglottis. C) Silent aspiration, as indicated by a Rosenbek score of 8.