New insights into the recombinant proteins and monoclonal antibodies employed to immunodiagnosis and control of Zika virus infection: A review

An emergent positive-stranded RNA virus, transmitted by mosquitoes with its first case of vertical transmission confirmed in 2015 in Brazil. The Zika virus (ZIKV) fever has received particular attention, mainly related to neurological diseases such as microcephaly in newborns. However, the laboratory diagnosis for ZIKV still faces some challenges due to its cross-reactivity with other flaviviruses, requiring a correct and differential diagnosis, contributing to the good prognosis of patients, especially in pregnant women. Among these, for early diagnosis, the CDC considers the RT-PCR the gold standard, more sensitive and specific, but expensive. Serological tests for the diagnosis of ZIKV can also be found beyond the period when the viral components are detectable in the serum. Inputs to produce more sensitive and specific diagnostic kits and the possibility of viral detection in less invasive samples are among the objectives of recent research on ZIKV. This review outlines recent advances in developing recombinant antigen and antibody-based diagnostic tools for the main flaviviruses in Northeast Brazil, such as ZIKV and Dengue virus (DENV).

SARS-CoV-2, Zika viruses and mycoplasma: Structure, pathogenesis and some treatment options in these emerging viral and bacterial infectious diseases

The molecular evolution of life on earth along with changing environmental, conditions has rendered mankind susceptible to endemic and pandemic emerging infectious diseases. The effects of certain systemic viral and bacterial infections on morbidity and mortality are considered as examples of recent emerging infections. Here we will focus on three examples of infections that are important in pregnancy and early childhood: SARS-CoV-2 virus, Zika virus, and Mycoplasma species. The basic structural characteristics of these infectious agents will be examined, along with their general pathogenic mechanisms. Coronavirus infections, such as caused by the SARS-CoV-2 virus, likely evolved from zoonotic bat viruses to infect humans and cause a pandemic that has been the biggest challenge for humanity since the Spanish Flu pandemic of the early 20th century. In contrast, Zika Virus infections represent an expanding infectious threat in the context of global climate change. The relationship of these infections to pregnancy, the vertical transmission and neurological sequels make these viruses highly relevant to the topics of this special issue. Finally, mycoplasmal infections have been present before mankind evolved, but they were rarely identified as human pathogens until recently, and they are now recognized as important coinfections that are able to modify the course and prognosis of various infectious diseases and other chronic illnesses. The infectious processes caused by these intracellular microorganisms are examined as well as some general aspects of their pathogeneses, clinical presentations, and diagnoses. We will finally consider examples of treatments that have been used to reduce morbidity and mortality of these infections and discuss briefly the current status of vaccines, in particular, against the SARS-CoV-2 virus. It is important to understand some of the basic features of these emerging infectious diseases and the pathogens involved in order to better appreciate the contributions of this special issue on how infectious diseases can affect human pregnancy, fetuses and neonates.

Proof of concept study of the development of a survey protocol for adults with ASD participating in community-based programs

There is limited research regarding the effectiveness of community-based services for young adults with autism spectrum disorder (ASD) as they transition out of school and enter a more autonomous life stage. This study utilized a two-phase, mixed methods design to determine the feasibility and participant acceptability of a protocol developed to standardize an assessment of program effectiveness for young adults with ASD at a community-based center. Field notes, participant interviews, and clinical observations were combined with descriptive analysis of participant survey responses. This study offers insights into the process of effective outcomes measurement for young adults with ASD participating in community-based programs. Administration of the study's protocol is feasible; however, alternative methods of data collection should continue to be explored. Furthermore, research in the form of a pilot study is needed to further determine the protocol's facility for assessing program outcomes in young adults with ASD.

Perception of the Zika virus infection and its influence on Zika prevention practices by pregnant women at the Region 5 Health Promotion Center in Thailand

Background: The Zika virus (ZIKA) infection in pregnant women causes microcephaly, a brain disorder resulting in severe birth defects. The objective of this study was to identify the factors that influence Zika prevention practices by pregnant women at the Region 5 Health Promotion Center in Thailand.Methods: A cross-sectional study applied a survey method to collect data from pregnant women between 18 and 45 years of age. The sampling method used multistage random sampling. The data were analyzed using descriptive statistics and multiple linear regression analysis.Results: The findings indicated that 5 of 12 factors could significantly predict Zika prevention practices of pregnant women at the Health Promotion Center Region 5 in Thailand: education, smoking behavior, check-up status during pregnancy, perception of susceptibility, and perception of benefit.Conclusion: The results show a direct correlation between the perception of susceptibility and benefit and Zika prevention practices. Policies for promoting Zika knowledge and preventive behavior by providing information about Zika should focus on changing the thoughts, attitudes, and beliefs of pregnant women and their families.

Structural and Practical Identifiability Analysis of Zika Epidemiological Models

The Zika virus (ZIKV) epidemic has caused an ongoing threat to global health security and spurred new investigations of the virus. Use of epidemiological models for arbovirus diseases can be a powerful tool to assist in prevention and control of the emerging disease. In this article, we introduce six models of ZIKV, beginning with a general vector-borne model and gradually including different transmission routes of ZIKV. These epidemiological models use various combinations of disease transmission (vector and direct) and infectious classes (asymptomatic and pregnant), with addition to loss of immunity being included. The disease-induced death rate is omitted from the models. We test the structural and practical identifiability of the models to find whether unknown model parameters can uniquely be determined. The models were fit to obtain time-series data of cumulative incidences and pregnant infections from the Florida Department of Health Daily Zika Update Reports. The average relative estimation errors (AREs) were computed from the Monte Carlo simulations to further analyze the identifiability of the models. We show that direct transmission rates are not practically identifiable; however, fixed recovery rates improve identifiability overall. We found ARE is low for each model (only slightly higher for those that account for a pregnant class) and help to confirm a reproduction number greater than one at the start of the Florida epidemic. Basic reproduction number, [Formula: see text], is an epidemiologically important threshold value which gives the number of secondary cases generated by one infected individual in a totally susceptible population in duration of infectiousness. Elasticity of the reproduction numbers suggests that the mosquito-to-human ratio, mosquito life span and biting rate have the greatest potential for reducing the reproduction number of Zika, and therefore, corresponding control measures need to be focused on.

Demographic and Travel Characteristics of Travel-Associated Zika Virus Infection Case-Patients in San Diego County, California (January 1, 2016-March 31, 2017)

Most Zika disease cases diagnosed in the continental US have been associated with travel to areas with risk of Zika transmission, mainly the Caribbean and Latin America. Limited information has been published about the demographic and travel characteristics of Zika case-patients in the United States, besides their age and gender. During 2016-2017 the County of San Diego Health and Human Services Agency, California, expanded the scope and completeness of demographic and travel information collected from Zika case-patients for public health surveillance purposes. The majority (53.8%) of travel-related Zika virus infection case-patients (n = 78) in the county were Hispanic, significantly higher (p ≤ 0.05) than the 33.0% of Hispanics in the county. Foreign-born residents, mainly from Mexico, were also overrepresented among cases compared to their share in the county population (33.3 vs. 23.0%; p ≤ 0.05). Seventeen (21.8%) patients reported a primary language other than English (14 Spanish). Most case-patients traveled for tourism (54%) or to visit friends and relatives (36%). This surveillance information helps identify higher-risk populations and implement culturally targeted interventions for Zika prevention and control.

Rapid Detection Strategies for the Global Threat of Zika Virus: Current State, New Hypotheses, and Limitations

The current scenario regarding the widespread Zika virus (ZIKV) has resulted in numerous diagnostic studies, specifically in South America and in locations where there is frequent entry of travelers returning from ZIKV-affected areas, including pregnant women with or without clinical symptoms of ZIKV infection. The World Health Organization, WHO, announced that millions of cases of ZIKV are likely to occur in the USA in the near future. This situation has created an alarming public health emergency of international concern requiring the detection of this life-threatening viral candidate due to increased cases of newborn microcephaly associated with ZIKV infection. Hence, this review reports possible methods and strategies for the fast and reliable detection of ZIKV with particular emphasis on current updates, knowledge, and new hypotheses that might be helpful for medical professionals in poor and developing countries that urgently need to address this problem. In particular, we emphasize liposome-based biosensors. Although these biosensors are currently among the less popular tools for human disease detection, they have become useful tools for the screening and detection of pathogenic bacteria, fungi, and viruses because of their versatile advantageous features compared to other sensing devices. This review summarizes the currently available methods employed for the rapid detection of ZIKV and suggests an innovative approach involving the application of a liposome-based hypothesis for the development of new strategies for ZIKV detection and their use as effective biomedicinal tools.

Vertical transmission of Zika virus (ZIKV) in early pregnancy: two cases, two different courses

Background:

Vertical Zika virus (ZIKV) transmission is actively being studied. Prior cases of ZIKV in pregnancy have suggested an association with infection and adverse fetal outcomes. We describe two cases of maternal illness and their respective pregnancy courses.

Case 1: A 30-year-old Hispanic female presented with rash, fatigue, and chills after noticing mosquito bites in Honduras. Fetal anatomy appeared normal on ultrasound at 16 and 17 weeks. ZIKV RNA reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was identified in her serum and amniotic fluid. She opted for pregnancy termination. Fetal serum and tissue analysis confirmed ZIKV infection.

Case 2: A 28-year-old Hispanic female presented with rash, fever, and fatigue after sexual intercourse. Her ZIKV serum RNA RT-PCR was positive and amniotic fluid was negative. Fetal anatomy appeared normal at 20 and 22 weeks and her pregnancy remains ongoing.

Conclusion:

The effects of maternal ZIKV infection in early pregnancy can vary.

Zika Virus: Critical Information for Emergency Providers

Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers.

Rapid Spread of Zika Virus in The Americas--Implications for Public Health Preparedness for Mass Gatherings at the 2016 Brazil Olympic Games

Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a 'Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for public health preparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the public health implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events.