#Neurodevelopment in #Infants Exposed to #Zika Virus In #Utero (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Neurodevelopment in Infants Exposed to Zika Virus In Utero

December 13, 2018 / N Engl J Med 2018; 379:2377-2379 / DOI: 10.1056/NEJMc1800098

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To the Editor:

During the Zika virus (ZIKV) epidemic in Rio de Janeiro from September 2015 through June 2016, a prospective cohort study involving symptomatic pregnant women who had ZIKV infection confirmed by reverse-transcriptase–polymerase-chain-reaction assay was established.1 The study was approved by the institutional review boards at Fundação Oswaldo Cruz in Rio de Janeiro and the University of California, Los Angeles, and all the women provided written informed consent for themselves and their children.

(…)

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M. Elisabeth Lopes Moreira, M.D., Karin Nielsen-Saines, M.D., Patricia Brasil, M.D., Tara Kerin, Ph.D., Luana Damasceno, M.S., Marcos Pone, M.D., Liege M.A. Carvalho, M.D., Sheila M. Pone, M.D., Zilton Vasconcelos, Ph.D., Ieda P. Ribeiro, Ph.D., Andrea A. Zin, M.D., Irena Tsui, M.D., Kristina Adachi, M.D., Stephanie L. Gaw, M.D., Umme-Aiman Halai, M.D., Tania S. Salles, M.D., Denise C. da Cunha, M.D., Myrna C. Bonaldo, Ph.D., Claudia Raja Gabaglia, M.D., Leticia Guida, Ph.D., Jociele Malacarne, Ph.D., Roozemerie P. Costa, B.S., S. Clair Gomes, Jr., Ph.D., A. Beatriz Reis, M.S., Fernanda V.M. Soares, Ph.D., Renata H. Hasue, Ph.D., Carolina Y.P. Aizawa, M.S., Fernanda F. Genovesi, M.S., Mitsue Aibe, M.D., Christa Einspieler, Ph.D., Peter B. Marschik, Ph.D., J. Paulo Pereira, Jr., M.D., Elyzabeth A. Portari, M.D., Carla Janzen, M.D., James D. Cherry, M.D.

Supported by grants from the Departamento de Ciência e Tecnologia (DECIT) do Ministério da Saúde do Brasil (25000.072811/2016-17); Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) (88887.116627/2016-01); Brazilian National Council for Scientific and Technological Development (CNPq) (441098/2016-9); Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) (E_18/2015TXB); ZIKAlliance; the Thrasher Research Fund (20164370); the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH) (AI28697 and AI1259534-01); the National Eye Institute of the NIH (AI129847-01); the Wellcome Trust and the United Kingdom Department for International Development (205377-Z16-Z); and the European Union Horizon 2020 research and innovation program (ZikaPLAN grant agreement no. 734584).

Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.

Keywords: Zika Virus; Zika Congenital Syndrome.

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Descriptive #report of cases of congenital syndrome associated with #Zika virus #infection in the state of São Paulo, #Brazil, from 2015 to 2017 (Epidemiol Serv Saude, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Epidemiol Serv Saude. 2018 Oct 22;27(3):e2017382. doi: 10.5123/S1679-49742018000300012.

Descriptive report of cases of congenital syndrome associated with Zika virus infection in the state of São Paulo, Brazil, from 2015 to 2017.

[Article in English, Portuguese; Abstract available in Portuguese from the publisher]

Martins RS1, Fróes MH1, Saad LDC1, Ignácio Junior SM1, Prado WDA1, Figueiredo EM1, Sato HK1, Ciccone FH1, Guimarães TC1, Katz G1.

Author information: 1 Secretaria de Estado da Saúde, Centro de Vigilância Epidemiológica Professor Alexandre Vranjac, São Paulo, SP, Brasil.

 

Abstract in English, Portuguese, Spanish

OBJECTIVE:

to characterize cases of congenital syndrome associated with Zika virus infection (CZS) and other infectious etiologies, resident in the state of São Paulo, Brazil, from October 30, 2015, to June 30, 2017.

METHODS:

this was a descriptive study of suspected cases of CZS and other infectious etiologies notified on the Public Health Events Registry.

RESULTS:

960 cases were investigated up to epidemiological week 26/2017, and 146 were confirmed for congenital infection; of these, 59 (40.4%) were confirmed for congenital infection without etiological identification and 87 (59.6%) with laboratory confirmation, of which 55 were congenital syndrome associated with Zika virus and 32 were congenital syndrome associated with other infectious agents.

CONCLUSION:

this study enabled the detection of 23.9% CZS cases among suspected cases of infectious etiology.

PMID: 30365699 DOI: 10.5123/S1679-49742018000300012

Keywords: Zika Virus; Zika Congenital Infection; Zika Congenital Syndrome; Brazil.

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Review: #Evidence of #Neurological #Sequelae in #Children With Acquired #Zika Virus #Infection (Pediatr Neurol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Pediatr Neurol. 2018 Aug;85:16-20. doi: 10.1016/j.pediatrneurol.2018.03.001. Epub 2018 Apr 3.

Review: Evidence of Neurological Sequelae in Children With Acquired Zika Virus Infection.

Lebov JF1, Brown LM2, MacDonald PDM3, Robertson K4, Bowman NM5, Hooper SR6, Becker-Dreps S7.

Author information: 1 RTI International, Center for Applied Public Health Research, Durham, North Carolina. Electronic address: jlebov@rti.org. 2 RTI International, Center for Applied Public Health Research, Rockville, Maryland. 3 RTI International, Center for Applied Public Health Research, Berkeley, California. 4 Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. 5 Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina. 6 Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina. 7 Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

 

Abstract

Limited information is available on health outcomes related to Zika virus infection acquired during childhood. Zika virus can cause severe central nervous system malformations in congenitally exposed fetuses and neonates. In vitro studies show the capacity of Zika virus to infect neural progenitor cells, induce central and peripheral neuronal cell deaths, and target different brain cells over the course of brain development. Studies of postnatally infected mice and nonhuman primates have detected degradation of neural cells and morphologic brain cell changes consistent with a broad neuroinflammatory response. In addition, case reports of central nervous system disease in adults and in adolescents secondary to Zika virus infection suggest that Zika virus may have a broader impact on neurological health beyond that observed in congenitally exposed newborns. Long-term neurological complications have been observed with other acquired flaviviral infections, with clinical symptoms manifesting for years after primary infection. The extent to which postnatal Zika virus infection in humans negatively affects the central and peripheral nervous systems and causes long-term neurological damage or cognitive effects is currently unknown. To better understand the potential for neurological sequelae associated with acquired Zika virus infection in children, we reviewed the biological, clinical, and epidemiologic literature and summarized the evidence for this link. First, we review biological mechanisms for neurological manifestations of Zika virus infection in experimental studies. Second, we review observational studies of congenital Zika virus infection and case studies and surveillance reports of neurological sequelae of Zika virus infection in adults and in children. Lastly, we discuss the challenges of conducting Zika virus-neurological sequela studies and future directions for pediatric Zika virus research.

KEYWORDS: Child development; Flavivirus infections; Malformations of cortical development; Neurological sequelae; Zika virus infection

PMID: 30343688 DOI: 10.1016/j.pediatrneurol.2018.03.001

Keywords: Zika Virus; Zika Congenital Syndrome; Neurology.

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#Congenital #Zika Virus #Infection with Normal Neurodevelopmental Outcome, #Brazil (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 24, Number 11—November 2018 / Research Letter

Congenital Zika Virus Infection with Normal Neurodevelopmental Outcome, Brazil

Alessandra Lemos de Carvalho  , Carlos Brites, Tânia Barreto Taguchi, Suely Fernandes Pinho, Gúbio Campos, and Rita Lucena

Author affiliations: SARAH Network of Rehabilitation Hospitals, Salvador, Brazil (A.L. de Carvalho, T.B. Taguchi, S.F. Pinho); Federal University of Bahia, Salvador (C. Brites, G. Campos, R. Lucena)

 

Abstract

We describe a case of a 20-month-old girl with probable congenital Zika virus infection and normal neurodevelopment, despite microcephaly and abnormal neuroimaging. This case raises questions about early prognostic markers and draws attention to the need for investigation in suspected Zika cases, even if the child’s early neurodevelopment is normal.

Keywords: Zika Virus; Zika Congenital Syndrome; Microcephaly.

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The emergence of #Zika virus and its new #clinical #syndromes (Nature, abstract)

[Source: Nature, full page: (LINK). Abstract, edited.]

The emergence of Zika virus and its new clinical syndromes

Theodore C. Pierson &  Michael S. Diamond

Nature, volume 560, pages573–581 (2018)

 

Abstract

Zika virus (ZIKV) is a mosquito-transmitted flavivirus that has emerged as a global health threat because of its potential to generate explosive epidemics and ability to cause congenital disease in the context of infection during pregnancy. Whereas much is known about the biology of related flaviviruses, the unique features of ZIKV pathogenesis, including infection of the fetus, persistence in immune-privileged sites and sexual transmission, have presented new challenges. The rapid development of cell culture and animal models has facilitated a new appreciation of ZIKV biology. This knowledge has created opportunities for the development of countermeasures, including multiple ZIKV vaccine candidates, which are advancing through clinical trials. Here we describe the recent advances that have led to a new understanding of the causes and consequences of the ZIKV epidemic.

Keywords: Zika Virus; Zika Congenital Syndrome.

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Why is #congenital #Zika #syndrome asymmetrically distributed among #human populations? (PLoS Biol., abstract)

[Source: PLoS Biology, full page: (LINK). Abstract, edited.]

OPEN ACCESS / UNSOLVED MYSTERY

Why is congenital Zika syndrome asymmetrically distributed among human populations?

Jimena Barbeito-Andrés, Lavínia Schuler-Faccini, Patricia Pestana Garcez

Published: August 24, 2018 / DOI: https://doi.org/10.1371/journal.pbio.2006592 / This is an uncorrected proof.

 

Abstract

Zika virus (ZIKV) is a health burden due to the severe neurological abnormalities that arise after congenital infection. Although multiple experimental studies have linked ZIKV with neural birth defects, the scientific community has not been able to fully explain why Congenital Zika Syndrome (CZS) was only apparent after the virus entered the Americas and why these occurrences have an asymmetric geographic distribution. Here, we review the impact of ZIKV infection on human populations by exploring evolutionary changes in the virus’ genome as well as examining the diverse genetic and environmental cofactors of the human hosts.

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Citation: Barbeito-Andrés J, Schuler-Faccini L, Garcez PP (2018) Why is congenital Zika syndrome asymmetrically distributed among human populations? PLoS Biol 16(8): e2006592. https://doi.org/10.1371/journal.pbio.2006592

Academic Editor: Steven Riley, Imperial College London, United Kingdom of Great Britain and Northern Ireland

Published: August 24, 2018

Copyright: © 2018 Barbeito-Andrés et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: FAPERJ (grant number 203.291/2017). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Brazilian Ministry of Health-DECIT (grant number CNPq grant 440763/2016-9). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. INAGEMP – National Institute of Population Medical Genetics (grant number CNPq 465549/2014-4). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: CNS, central nervous system; CZS, Congenital Zika Syndrome; DENV, dengue virus; HDI, Human Development Index; HPV, human papillomavirus; IUGR, intrauterine growth restriction; STORCH, Syphilis, Toxoplasmosis, others, Rubella, Cytomegalovirus, and Herpes virus; ZIKV, Zika virus

Provenance: Not commissioned; externally peer reviewed

Keywords: Zika Virus; Zika Congenital Syndrome.

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Persistent #detection of #Zika virus #RNA from an #infant with severe #microcephaly – a case report (BMC Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMC Infect Dis. 2018 Aug 10;18(1):388. doi: 10.1186/s12879-018-3313-4.

Persistent detection of Zika virus RNA from an infant with severe microcephaly – a case report.

Brito CAA1, Henriques-Souza A2, Soares CRP3, Castanha PMS3, Machado LC4, Pereira MR5, Sobral MCM4, Lucena-Araujo AR6, Wallau GL4, Franca RFO7.

Author information: 1 Department of Clinical Medicine, Federal University of Pernambuco – UFPE, Recife, 50670-901, Brazil. 2 Department of Pediatrics, Hospital da Restauração, Recife, 50110-900, Brazil. 3 Department of Virology and Experimental Therapy, Aggeu Magalhães Institute, Oswaldo Cruz Foundation – FIOCRUZ, Avenida Professor Moraes Rego s/n, Recife, PE, 50740-465, Brazil. 4 Department of Entomology, Oswaldo Cruz Foundation – FIOCRUZ, Aggeu Magalhães Institute, Recife, 50740-465, Brazil. 5 Department Veterinary Medicine, Federal Rural University of Pernambuco – UFRPE, Recife, 52171-900, Brazil. 6 Department of Biophysics, Federal University of Pernambuco – UFPE, Recife, 50670-901, Brazil. 7 Department of Virology and Experimental Therapy, Aggeu Magalhães Institute, Oswaldo Cruz Foundation – FIOCRUZ, Avenida Professor Moraes Rego s/n, Recife, PE, 50740-465, Brazil. rafael.franca@cpqam.fiocruz.br.

 

Abstract

BACKGROUND:

Zika virus (ZIKV) is a recently emerged arbovirus, which infection during pregnancy is associated with a series of congenital malformations, collectively denominated Congenital Zika Syndrome (CZS). Following infection, ZIKV RNA has a median duration period of 10 days in plasma and up to 6 months in semen in immunocompetent adult individuals. Moreover, ZIKV is able to replicate and persist in fetal brains and placentas, consequently, infection is associated with pregnancy loss, albeit the pathogenic mechanisms are still unknown.

CASE PRESENTATION:

Here we report a CZS case of an infant born during the ZIKV outbreak in northeast Brazil, the child presented recurrent episodes of seizures with prolonged presence of ZIKV RNA on the central nervous system (CNS) and blood. ZIKV RNA was identified and partially sequenced from a sample of cerebrospinal fluid (CSF) obtained from the infant with 6 months of life, and later from another sample after the infant completed 17 months of life. Commonly congenital infections were discarded based on STORCH (syphilis, toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus) negative laboratory results. Presence of specific ZIKV antibodies on both mother and children confirmed the association of severe microcephaly and ZIKV infection, diagnosed after birth.

CONCLUSIONS:

Altogether, our data raise the possibility that CZS cases may result in prolonged viral presence, these findings could be useful for therapy and diagnostic recommendations.

KEYWORDS: Microcephaly; Neurological disease; Virus persistence; Zika virus

PMID: 30097025 DOI: 10.1186/s12879-018-3313-4

Keywords: Zika Virus; Zika Congenital Syndrome; Microcephaly.

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