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Background
Following emergence of Zika virus in the Americas, a devastating new congenital syndrome has been documented, leading to significant morbidity among Zika-infected fetuses and neonates.
Case presentation
A 29-year-old pregnant woman infected with Zika virus at 9-weeks gestation in Trinidad presented with one-month of fever, headache, and...
Contexts in source publication
Context 1
... reports have described microcephaly, intra- cranial calcifications, and other abnormalities in the 2nd and 3rd trimesters (Table 1) [11][12][13][14][15][16][17][18]. The greatest risk for microcephaly has been reported to occur with ZIKV infection during the first trimester of pregnancy (Table 1), with estimated risks of possible Zika- associated birth defects in the first, second, and third trimesters of 8%, 5%, and 4%, respectively [19]. ...
Context 2
... reports have described microcephaly, intra- cranial calcifications, and other abnormalities in the 2nd and 3rd trimesters (Table 1) [11][12][13][14][15][16][17][18]. The greatest risk for microcephaly has been reported to occur with ZIKV infection during the first trimester of pregnancy (Table 1), with estimated risks of possible Zika- associated birth defects in the first, second, and third trimesters of 8%, 5%, and 4%, respectively [19]. How- ever, severely affected fetuses have been described after normal 2nd trimester ultrasounds, with subsequent ab- normalities detected in the 3rd trimester (Table 1). ...
Context 3
... greatest risk for microcephaly has been reported to occur with ZIKV infection during the first trimester of pregnancy (Table 1), with estimated risks of possible Zika- associated birth defects in the first, second, and third trimesters of 8%, 5%, and 4%, respectively [19]. How- ever, severely affected fetuses have been described after normal 2nd trimester ultrasounds, with subsequent ab- normalities detected in the 3rd trimester (Table 1). Interestingly, there have also been reports of no differ- ences in head circumference among infants born to women with possible ZIKV infection during pregnancy compared to women without infection [20]. ...
Context 4
... timing of fetal abnormalities ranges from identifica- tion at 14-weeks (this report) to post-natal diagnosis. Table 1 summarizes the spectrum of fetal ultrasound ab- normalities detected. The spectrum of severity ranges from mild ocular or auditory abnormalities, to microceph- aly, to severe brain or musculoskeletal malformations [24]. ...
Similar publications
Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review stru...
Citations
... This may be due to poor maternal virologic control allowing ZIKV to disseminate to this immune-privileged site. Also, prolonged maternal plasma viral RNA (vRNA) burden is associated with more severe fetal outcomes when compared to maternal infections lacking this feature (15)(16)(17)(18)(19). Different strains of ZIKV may also be associated with different infant outcomes: infection with low-passage African lineage ZIKV isolates result in more severe fetal pathology compared to infection with isolates of the Asian ZIKV lineage in murine models (20,21). ...
Introduction
Zika virus (ZIKV) infection during pregnancy results in a spectrum of birth defects and neurodevelopmental deficits in prenatally exposed infants, with no clear understanding of why some pregnancies are more severely affected. Differential control of maternal ZIKV infection may explain the spectrum of adverse outcomes.
Methods
Here, we investigated whether the magnitude and breadth of the maternal ZIKV-specific antibody response is associated with better virologic control using a rhesus macaque model of prenatal ZIKV infection. We inoculated 18 dams with an Asian-lineage ZIKV isolate (PRVABC59) at 30-45 gestational days. Plasma vRNA and infectious virus kinetics were determined over the course of pregnancy, as well as vRNA burden in the maternal-fetal interface (MFI) at delivery. Binding and neutralizing antibody assays were performed to determine the magnitude of the ZIKV-specific IgM and IgG antibody responses throughout pregnancy, along with peptide microarray assays to define the breadth of linear ZIKV epitopes recognized.
Results
Dams with better virologic control (n= 9) cleared detectable infectious virus and vRNA from the plasma by 7 days post-infection (DPI) and had a lower vRNA burden in the MFI at delivery. In comparison, dams with worse virologic control (n= 9) still cleared detectable infectious virus from the plasma by 7 DPI but had vRNA that persisted longer, and had higher vRNA burden in the MFI at delivery. The magnitudes of the ZIKV-specific antibody responses were significantly lower in the dams with better virologic control, suggesting that higher antibody titers are not associated with better control of ZIKV infection. Additionally, the breadth of the ZIKV linear epitopes recognized did not differ between the dams with better and worse control of ZIKV infection.
Discussion
Thus, the magnitude and breadth of the maternal antibody responses do not seem to impact maternal virologic control. This may be because control of maternal infection is determined in the first 7 DPI, when detectable infectious virus is present and before robust antibody responses are generated. However, the presence of higher ZIKV-specific antibody titers in dams with worse virologic control suggests that these could be used as a biomarker of poor maternal control of infection and should be explored further.
... It is estimated that about 584-1786 exportations of Zika from Brazil occurred in 2016, predominantly to the USA [6]. Since then, Zika virus has been documented in returning febrile travelers from tropical and sub-tropical Americas to countries all around the world, including Canada, China, France, Japan, and the Republic of Korea with concerns of autochthonous transmission in areas with compatible mosquito vectors [11,[29][30][31][32]. ...
... Arboviruses were documented in over 3% of malaria-negative specimens from returning Canadian travelers to the Americas using highly sensitive real-time and end-point PCR assays. A positivity rate of 1.3% for dengue and 0.9% for Zika virus and other flaviviruses reflects previously reported rates in Canadian travelers [29,[45][46][47]. Notably, two travelers with travel history to Colombia were positive for Zika virus and an untypeable flavivirus, respectively. ...
Purpose of Review
The Zika virus outbreak in the Americas prompted enhanced global surveillance due to the recognition of adverse neurological outcomes, including Guillain-Barré Syndrome, a novel but devastating congenital syndrome. Symptomatic Zika virus infection is clinically indistinguishable from other arboviral infections of the Americas such as chikungunya, dengue, and the more recently emerging Mayaro virus.
Recent Findings
We conducted laboratory surveillance for such arboviruses in ill returned travelers to the Americas between November 2015 and May 2016 by examining whole blood, malaria-negative specimens with noted travel history to the Americas by real-time and end-point PCR for the following targets: chikungunya (CHIKV), flaviviruses (Pan-Flavi), dengue virus types 1–4 (DEN1, DEN2, DEN3, DEN4), and Zika virus (ZIKV). End-point PCR was performed to detect Mayaro virus (MAYV).
1294 malaria-negative specimens were evaluated for compatible travel history. Of 224 enrolled specimens, 124 (55%) were from returned travelers to the Caribbean, while 66 (29.5%) were from Central America, and 34 (15.2%) from South America. Arboviral pathogens detected included: dengue (n = 3, 1.3%), Zika virus (n = 2, 0.9%), and unspecified flavivirus (n = 2, 0.9%). No cases of chikungunya or Mayaro were detected in the cohort.
Summary
Common arboviruses circulating in the Americas were detected in over 3% of whole-blood malaria-free specimens from ill returned travelers, supporting the notion that during this time period, Zika virus was as commonly imported as dengue from this geographic region. Surveillance for other flaviviruses and alphaviruses including Mayaro virus is warranted to detect sentinel events, and inform priorities for diagnostic testing capacity.
... Driggers et al. (6) detected ZIKV RNA in maternal serum samples 8 weeks after onset of clinical symptoms; they suggested that prolonged viremia might occur as a consequence of viral replication in the fetus or placenta and might be correlated with CZS. In other reports, however, prolonged maternal viremia has been described in pregnant women with both normal and adverse fetal outcomes (6)(7)(8)(9)(10). ...
Whether prolonged maternal viremia after Zika virus infection represents a risk factor for maternal–fetal transmission and subsequent adverse outcomes remains unclear. In this prospective cohort study in French Guiana, we enrolled Zika virus–infected pregnant women with a positive PCR result at inclusion and noninfected pregnant women; both groups underwent serologic testing in each trimester and at delivery during January–July 2016. Prolonged viremia was defined as ongoing virus detection >30 days postinfection. Adverse outcomes (fetal loss or neurologic anomalies) were more common in fetuses and neonates from mothers with prolonged viremia (40.0%) compared with those from infected mothers without prolonged viremia (5.3%, adjusted relative risk [aRR] 7.2 [95% CI 0.9–57.6]) or those from noninfected mothers (6.6%, aRR 6.7 [95% CI 3.0–15.1]). Congenital infections were confirmed more often in fetuses and neonates from mothers with prolonged viremia compared with the other 2 groups (60.0% vs. 26.3% vs. 0.0%, aRR 2.3 [95% CI 0.9–5.5]).
... Major neurological anomalies consistently observed with CZS in fetuses and neonates include decreased brain matter, cerebral atrophy, diffuse cortical and subcortical calcifications, varying degrees of ventriculomegaly, signs of abnormal gyration, cortical development, and ocular anomalies that might lead to severe mental retardation and substantial motor disabilities, and visual and auditory impairments [41,47]. Other serious sequelae of ZIKV include IUGR [70], abnormal umbilical artery flow, placental insufficiency, hydrops fetalis, and fetal demise [71,72]. In addition to neuronal abnormalities, reactive gliosis, microglial hyperplasia, corpus callosum hypoplasia, and delayed myelination have also been subsequently reported [19]. ...
Zika virus (ZIKV) is a reemerging arthropod-borne Flavivirus and it has become a major international public health problem following the large outbreaks during 2013–16. ZIKV poses a serious threat to human beings because of its rapid spread and association with adverse pregnancy and neonatal outcomes, including miscarriage, microcephaly, Guillain–Barre syndrome, and other serious brain abnormalities and birth defects indicative of a Congenital Zika Syndrome. Aedes spp. mosquitoes are the primary vectors of ZIKV transmission in humans and it can also be transmitted through maternal–fetal route, blood transfusion, and sexual practices. To date, there is no vaccine and antiviral drug available to prevent or treat ZIKV infection due to the poor understanding of ZIKV–host interactions and the mechanisms associated with the disease manifestations. In the present report, we summarize the recent progress that has been made to define the ZIKV-mediated cellular apoptotic and immune response evasion pathways and the plausible molecular mechanisms underlying ZIKV-associated neurological disorders and birth defects in the developing fetuses and newborn babies, respectively, using several independent in vitro and in vivo animal studies. Knowledge on these mechanisms may contribute to the development of early diagnostics and preventive/therapeutic interventions for the control of ZIKV.
COVID-19 is an emerging pandemic that has affected millions of individuals for the past few months by causing severe damage to lives, health, and economy globally. Even with concentrated research efforts globally, a properly approved vaccine or antiviral therapy is yet unavailable. With the advent of innovative high-throughput technologies including genomics, transcriptomics, and proteomics, novel insights into the SARS-CoV-2 replication cycle and its interaction of the host cell and systems have been obtained. This information can shed light on the intimate relationship between the virus and its host, serving as the basis to develop optimal prophylactic and therapeutic treatment options. In this chapter we provide a comprehensive outline of the current status of the SARS-CoV-2 research, encompassing every step of the viral replication cycle with a specific focus on virus–host cell interaction. We also review specific chemical inhibitors targeting cellular factors and processes of relevance for the SARS-CoV-2 replication cycle and their possible exploitation for the development of next-generation antivirals.
Aedes aegypti mosquitoes are vectors of diseases such as dengue, chikungunya, zika and yellow fever. With the increase in the incidence of these diseases the population has resorted to the use of repellents searching to protect themselves from mosquito attack. The Brazilian market offers a wide variety of products with different active principles in varying levels of concentration, times of action and different prices, where DEET (N, N-diethyl-3-methylbenzamide) and IR3535 (ethyl-butyl-acetylaminopropionate) based repellents are suitable for use around adults and children, respectively. The action time of these repellents depends, among other factors, on the concentration of their active ingredients. Chromatographic methods are recommended to quantify these compounds in different samples. However, these methods require long analysis time, and use reagents that are expensive and generate toxic waste. Near Infrared Spectroscopy (NIRS) has been applied in several areas of research on this subject and is characterized by its rapid, low cost, non-destructive characteristics no sample treatment is required. The present work proposes the development of a methodology based on NIR spectroscopy and multivariate calibration for determination of DEET and IR 3535 in samples from commercial repellents. A PerkinElmer FT-NIR spectrometer equipped with a 0.1 cm quartz cell was used to obtain the NIR spectra in the range of 750–2500 nm, with a resolution of 0.1 nm and an average of 16 scans. The reference analysis for the determination of DEET and IR3535 was performed using high performance liquid chromatography with diode array ultraviolet detection (HPLC-DAD). Calibration models based on partial least squares (PLS) regression across spectral bands, the same algorithm using intervals (iPLS), and multiple linear regression (MLR) with previous selected of variables by successive projections algorithm (SPA), stepwise (SW) and genetic algorithm (GA) were developed and compared. Satisfactory prediction results were obtained for all models with RMSEP values ranging from 0.70 to 1.18% (m m⁻¹) and 0.64 to 1.12% (m m⁻¹) for DEET and IR3535, respectively. In addition, no systematic error was observed and no significant differences were found between predicted and reference values obtained by HPLC analysis for 178 samples, according to a t-paired test at the 95% confidence level.
Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review.
Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019.
Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I ² =19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I ² =0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I ² =0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I ² =0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I ² =74.6%). In case-control studies, selection of controls from hospitals could have biased results.
Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.
