What is the Value of Different #Zika #Vaccination Strategies to Prevent and Mitigate Zika #Outbreaks (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

What is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks

Sarah M Bartsch, MPH, Lindsey Asti, MPH, Sarah Cox, MSPH, David P Durham, PhD, Samuel Randall, Peter J Hotez, MD, PhD, Alison P Galvani, PhD, Bruce Y Lee, MD, MBA

The Journal of Infectious Diseases, jiy688, https://doi.org/10.1093/infdis/jiy688

Published: 13 December 2018

 

Abstract

Background

While the 2015–2016 Zika epidemics prompted accelerated vaccine development, decision makers need to know the potential economic value of vaccination strategies.

Methods

We developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination (women of childbearing age, school-aged children, young adults, and everyone) and then introduced various Zika outbreaks. Sensitivity analyses varied vaccine characteristics.

Results

With a 2% attack rate ($5 vaccination), compared to no vaccination, vaccinating women of childbearing age cost $314–1664 per case averted ($790–4,221/DALY averted) in Honduras, and saved $847–1,644/case averted in Brazil, and $3,648–4,177/case averted in Puerto Rico, varying with vaccination coverage and efficacy (societal perspective). Vaccinating school-aged children cost $718–1,849/case averted ($5,002/DALY averted) in Honduras, saved $819–1,609/case averted in Brazil, and saved $3,823–4,360/case averted in Puerto Rico. Vaccinating young adults cost $310–1,666/case averted ($731–4,017/DALY averted) in Honduras, saved $953–1,703/case averted in Brazil, and saved $3,857–4,372/case averted in Puerto Rico. Vaccinating everyone averted more cases but cost more, decreasing cost-savings per case averted. Vaccination resulted in more cost-savings and better outcomes at higher attack rates.

Conclusions

When considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.

brucelee@jhu.edu, Zika, Cost-Effectiveness, Vaccine

Topic: –  cost effectiveness – brazil – cost savings – disease outbreaks – honduras – puerto rico – vaccination – vaccines – disability-adjusted life-year – attack rate – young adult – school-age child – zika virus – zika virus disease – zika vaccine

Issue Section: Major Article

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Zika Virus; Vaccines.

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#Determinants of #Zika #transmission and control (J Infect Dis., summary)

[Source: Journal of Infectious Diseases, full page: (LINK). Summary, edited.]

Determinants of Zika transmission and control

Hannah Clapham

The Journal of Infectious Diseases, jiy691, https://doi.org/10.1093/infdis/jiy691

Published: 13 December 2018

Issue Section: Editorial Commentary

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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This issue of Journal of Infectious Diseases contains two articles focusing on different aspects of Zika virus (ZIKV) transmission and control. Until 2015, Zika was little known, and little was known about ZIKV. With the 2015 – 2016 epidemics leading to large numbers of cases in multiple countries [1], and with the realization that ZIKV was causing congenital defects, understanding and mitigating virus transmission became a global health priority [2]. However, in the last two years, there has been much less ZIKV transmission identified, and Zika has slipped somewhat from public view. The World Health Organization (WHO), however, remains committed to a long-term response [2], and much research continues to be
published.

(…)

Keywords: Zika Virus.

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#Prevalence and incidence of #Zika virus #infection among #household contacts of patients with #Zika virus disease, #PuertoRico, 2016–2017 (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Prevalence and incidence of Zika virus infection among household contacts of patients with Zika virus disease, Puerto Rico, 2016–2017

Eli S Rosenberg, Kate Doyle, Jorge L Munoz-Jordan, Liore Klein, Laura Adams, Matthew Lozier, Kevin Weiss, Tyler M Sharp, Gabriela Paz-Bailey

The Journal of Infectious Diseases, jiy689, https://doi.org/10.1093/infdis/jiy689

Published: 13 December 2018

 

Abstract

Background

Little is known about the prevalence or incidence of Zika virus (ZIKV) infection in settings affected by the 2015-16 Zika pandemic, and associated risk-factors. We assessed these factors among household contacts of patients with ZIKV disease enrolled in a cohort study in Puerto Rico during 2016–2017.

Methods

Household contacts of index case-patients completed a questionnaire and gave specimens for RT-PCR and IgM ELISA testing to detect ZIKV infection. We measured the prevalence of ZIKV infection among contacts and associated individual and household factors, examined sexual transmission using a sexual-networks approach, and assessed incident infection among initially uninfected household contacts 2–4 months later.

Results

Of 366 contacts, 34.4% had evidence of ZIKV infection at enrollment, including 11.2% by RT-PCR. Having open doors and windows that were either screened (prevalence ratio [PR]=2.1 [95% CI: 1.2–3.6]) or unscreened (PR=2.5 [95% CI: 1.5–4.1]) was associated with increased prevalence. Sexual partners were more likely to both be RT-PCR-positive relative to other relationships (OR=2.2 [95% CI: 1.1–4.5]). At follow-up, 6.1% of contacts had evidence of incident infection.

Conclusions

This study identified sexual contact as a risk factor for ZIKV infection. Persons living with ZIKV-infected individuals should be a focus of public health efforts.

Zika virus, arbovirus, household transmission, sexual transmission

Topic: polymerase chain reaction – enzyme-linked immunosorbent assay – arboviruses – follow-up – puerto rico – reverse transcriptase polymerase chain reaction – risk factors – sexual partners – immunoglobulin m – infection – public health medicine – pandemics – zika virus – zika virus disease

Issue Section: Major Article

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Zika Virus; Seroprevalence; Puerto Rico.

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A YF– #Zika #chimeric virus #vaccine candidate protects against Zika #infection and #congenital malformations in mice (npj Vaccines, abstract)

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

Article | OPEN | Published: 13 December 2018

A yellow fever–Zika chimeric virus vaccine candidate protects against Zika infection and congenital malformations in mice

Dieudonné B. Kum,  Niraj Mishra, Robbert Boudewijns, Ivan Gladwyn-Ng, Christian Alfano, Ji Ma, Michael A. Schmid, Rafael E. Marques, Dominique Schols, Suzanne Kaptein, Laurent Nguyen, Johan Neyts & Kai Dallmeier

npj Vaccines, volume 3, Article number: 56 (2018)

 

Abstract

The recent Zika virus (ZIKV) epidemic in the Americas led to an intense search for therapeutics and vaccines. Here we report the engineering of a chimeric virus vaccine candidate (YF-ZIKprM/E) by replacing the antigenic surface glycoproteins and the capsid anchor of YFV-17D with those of a prototypic Asian lineage ZIKV isolate. By intracellular passaging, a variant with adaptive mutations in the E protein was obtained. Unlike YFV-17D, YF-ZIKprM/E replicates poorly in mosquito cells. Also, YF-ZIKprM/E does not cause disease nor mortality in interferon α/β, and γ receptor KO AG129 mice nor following intracranial inoculation of BALB/c pups. A single dose as low as 1 × 102 PFU results, as early as 7 days post vaccination, in seroconversion to neutralizing antibodies and confers full protection in AG129 mice against stringent challenge with a lethal inoculum (105 LD50) of either homologous or heterologous ZIKV strains. Induction of multi-functional CD4+ and CD8+T cell responses against ZIKV structural and YFV-17D non-structural proteins indicates that cellular immunity may also contribute to protection. Vaccine immunogenicity and protection was confirmed in other mouse strains, including after temporal blockade of interferon-receptors in wild-type mice to facilitate ZIKV replication. Vaccination of wild-type NMRI dams with YF-ZIKprM/E results in complete protection of foetuses against brain infections and malformations following a stringent intraplacental challenge with an epidemic ZIKV strain. The particular characteristic of YF-ZIKprM/E in terms of efficacy and its marked attenuation in mice warrants further exploration as a vaccine candidate.

Keywords: Zika Virus; Vaccines; Animal models.

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#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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#Genome Sequences of #Zika Virus Strains Recovered from #Amniotic Fluid, #Placenta, and Fetal #Brain of a #Microcephaly Patient in #Thailand, 2017 (Microbiol Resour Announc., abstract)

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

Microbiol Resour Announc. 2018 Sep 20;7(11). pii: e01020-18. doi: 10.1128/MRA.01020-18. eCollection 2018 Sep.

Genome Sequences of Zika Virus Strains Recovered from Amniotic Fluid, Placenta, and Fetal Brain of a Microcephaly Patient in Thailand, 2017.

Wongsurawat T1, Jenjaroenpun P1, Athipanyasilp N2, Kaewnapan B2, Leelahakorn N2, Angkasekwinai N3, Kantakamalakul W2, Sutthent R2, Ussery DW1,4, Horthongkham N2, Nookaew I1,4.

Author information: 1 Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. 2 Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand. 3 Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand. 4 Department of Physiology and Biophysics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

 

Abstract

We present here the complete genome sequences of Zika virus strains isolated from aborted fetal tissue (brain and placenta) and amniotic fluid of a microcephaly patient in Thailand in 2017. The virus genomes that were sequenced have an average length of 10,807 nucleotides.

PMID: 30533643 PMCID: PMC6256666 DOI: 10.1128/MRA.01020-18

Keywords: Zika Virus; Microcephaly; Thailand.

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#Seroprevalence of #Zika virus among asymptomatic #pregnant mothers and their #newborns in the #Najran region of southwest #Saudi Arabia (Ann Saudi Med., abstract)

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

Ann Saudi Med. 2018 Nov-Dec;38(6):408-412. doi: 10.5144/0256-4947.2018.408.

Seroprevalence of Zika virus among asymptomatic pregnant mothers and their newborns in the Najran region of southwest Saudi Arabia.

Alayed MS, Qureshi MA, Ahmed S, Alqahtani AS, Al-Qahtani AM, Alshaybari K, Alshahrani M, Asaad AM.

 

Abstract

BACKGROUND:

Zika virus (ZIKV) is a teratogenic flavivirus that can cause microcephaly. Its main vector, Aedes aegypti, has been previ.ously identified in Saudi Arabia, but no ZIKV infection has yet been reported. Nevertheless, the country is at risk from ZIKV because it receives many travelers throughout the year, including pilgrims from ZIKV-endemic countries.

OBJECTIVES:

Screen asymptomatic pregnant mothers and their newborns attending a major hospital in the Najran region for subclinical or past infections with ZIKV, using ELISA and RT-PCR.

DESIGN:

Cross-sectional.

SETTING:

Najran Maternity and Children Hospital (NMCH).

SUBJECTS AND METHODS:

All pregnant women admitted to NMCH in labor between November 2016 and July 2017 were included in the study. Clinical and demographic data were collected by pre-validated physician-administered questionnaires. Paired umbilical and maternal serum samples were collected and frozen at -60°C, using ELISA to measure anti-ZIKA IgG and IgM antibodies and RT-PCR to further investigate positive samples.

MAIN OUTCOME MEASURES:

Maternal and newborn serum anti-ZIKV IgM and IgG and ZIKV RT-PCR.

SAMPLE SIZE:

410 mother-newborn pairs.

RESULTS:

The median gestational age was 38.5 weeks (range 33-42). Most (n=342, 83.41%) of the women were from Najran city. All of the newborns had normal growth parameters with no congenital malformations. None of the mothers had symptoms suggestive of ZIKV infection; 3 (0.7%) exhibited a low-grade fever (38°C), but did not test positive for anti-ZIKV antibodies. Thirty-five (8.53%) of mothers had travelled inside Saudi Arabia, but none outside the country. Twenty-four (5.85%) mothers tested positive for anti-ZIKV IgM and 52 (12.68%) tested positive for anti-ZIKV IgG, but all infant samples were negative. All seropositive ZIKV IgM were also ZIKV IgG positive, but RT-PCR test.ing of all seropositive samples was negative.

CONCLUSION:

Although previous (resolved) ZIKV infection and cross-reactivity of the ELISA method with other flaviviruses cannot be ex.cluded, the study found no confirmed cases of acute ZIKV infection. However, given the presence of the vector in Saudi Arabia, the presence of presumptive positive serology and the ongoing risk of ZIKV entry via a regular influx of travelers from endemic areas, we propose that continuous surveillance be conducted for ZIKV as well for other flaviviruses. Larger-scale nationwide studies are strongly recommended to gain a broader view of the potential threat from ZIKV in the country.

LIMITATIONS:

Small sample size, unavailability of plaque reduction neutralization tests to confirm serology results, and RT-PCR was only conducted on ELISA-positive serum samples, due to resource constraints.

CONFLICT OF INTEREST: None.

PMID: 30531174 DOI: 10.5144/0256-4947.2018.408

Keywords: Saudi Arabia; Zika Virus; Zika Congenital Infection; Seroprevalence; Pregnancy.

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