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Charniga K, Cucunubá ZM, Walteros DM, Mercado M, Prieto F, Ospina M, Nouvellet P, Donnelly CA. Estimating Zika virus attack rates and risk of Zika virus-associated neurological complications in Colombian capital cities with a Bayesian model. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220491. [PMID: 36465672 PMCID: PMC9709519 DOI: 10.1098/rsos.220491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/08/2022] [Indexed: 06/17/2023]
Abstract
Zika virus (ZIKV) is a mosquito-borne pathogen that caused a major epidemic in the Americas in 2015-2017. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with congenital birth defects and neurological complications (NC) in adults. We combined multiple data sources to improve estimates of ZIKV infection attack rates (IARs), reporting rates of Zika virus disease (ZVD) and the risk of ZIKV-associated NC for 28 capital cities in Colombia. ZVD surveillance data were combined with post-epidemic seroprevalence data and a dataset on ZIKV-associated NC in a Bayesian hierarchical model. We found substantial heterogeneity in ZIKV IARs across cities. The overall estimated ZIKV IAR across the 28 cities was 0.38 (95% CrI: 0.17-0.92). The estimated ZVD reporting rate was 0.013 (95% CrI: 0.004-0.024), and 0.51 (95% CrI: 0.17-0.92) cases of ZIKV-associated NC were estimated to be reported per 10 000 ZIKV infections. When we assumed the same ZIKV IAR across sex or age group, we found important spatial heterogeneities in ZVD reporting rates and the risk of being reported as a ZVD case with NC. Our results highlight how additional data sources can be used to overcome biases in surveillance data and estimate key epidemiological parameters.
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Affiliation(s)
- Kelly Charniga
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Zulma M. Cucunubá
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | | | | | | | | | | | - Christl A. Donnelly
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Department of Statistics, University of Oxford, Oxford, UK
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2
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Astrocyte Control of Zika Infection Is Independent of Interferon Type I and Type III Expression. BIOLOGY 2022; 11:biology11010143. [PMID: 35053142 PMCID: PMC8772967 DOI: 10.3390/biology11010143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/23/2022]
Abstract
Simple Summary Zika virus (ZIKV) is a mosquito-borne virus first isolated from the Zika forest, Uganda, in 1947, which has been spreading across continents since then. We now know ZIKV causes both microencephaly in newborns and neurological complications in adults; however, no effective treatment options have yet been found. A more complete understanding of Zika-infection-mediated pathogenesis and host responses is required to enable the development of novel treatment strategies. In this study, efforts were made to elucidate the host responses following Zika virus infection using several astrocyte cell models, as astrocytes are a major cell type within the central nervous system (CNS) with significant antiviral ability. Our data suggest that astrocytes can resist ZIKV both in an interferon type I- and III-independent manner and suggest that an early and more diverse antiviral response may be more effective in controlling Zika infection. This study also identifies astrocyte cellular models that appear to display differential abilities in the control of viral infection, which may assist in the study of alternate neurotropic virus infections. Overall, this work adds to the growing body of knowledge surrounding ZIKV-mediated cellular host interactions and will contribute to a better understanding of ZIKV-mediated pathogenesis. Abstract Zika virus (ZIKV) is a pathogenic neurotropic virus that infects the central nervous system (CNS) and results in various neurological complications. Astrocytes are the dominant CNS cell producer of the antiviral cytokine IFN-β, however little is known about the factors involved in their ability to mediate viral infection control. Recent studies have displayed differential responses in astrocytes to ZIKV infection, and this study sought to elucidate astrocyte cell-specific responses to ZIKV using a variety of cell models infected with either the African (MR766) or Asian (PRVABC59) ZIKV strains. Expression levels of pro-inflammatory (TNF-α and IL-1β) and inflammatory (IL-8) cytokines following viral infection were low and mostly comparable within the ZIKV-resistant and ZIKV-susceptible astrocyte models, with better control of proinflammatory cytokines displayed in resistant astrocyte cells, synchronising with the viral infection level at specific timepoints. Astrocyte cell lines displaying ZIKV-resistance also demonstrated early upregulation of multiple antiviral genes compared with susceptible astrocytes. Interestingly, pre-stimulation of ZIKV-susceptible astrocytes with either poly(I:C) or poly(dA:dT) showed efficient protection against ZIKV compared with pre-stimulation with either recombinant IFN-β or IFN-λ, perhaps indicating that a more diverse antiviral gene expression is necessary for astrocyte control of ZIKV, and this is driven in part through interferon-independent mechanisms.
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3
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Zoladek J, Legros V, Jeannin P, Chazal M, Pardigon N, Ceccaldi PE, Gessain A, Jouvenet N, Afonso PV. Zika Virus Requires the Expression of Claudin-7 for Optimal Replication in Human Endothelial Cells. Front Microbiol 2021; 12:746589. [PMID: 34616388 PMCID: PMC8488266 DOI: 10.3389/fmicb.2021.746589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/23/2021] [Indexed: 01/31/2023] Open
Abstract
Zika virus (ZIKV) infection has been associated with a series of neurological pathologies. In patients with ZIKV-induced neurological disorders, the virus is detectable in the central nervous system. Thus, ZIKV is capable of neuroinvasion, presumably through infection of the endothelial cells that constitute the blood-brain barrier (BBB). We demonstrate that susceptibility of BBB endothelial cells to ZIKV infection is modulated by the expression of tight-junction protein claudin-7 (CLDN7). Downregulation of CLDN7 reduced viral RNA yield, viral protein production, and release of infectious viral particles in several endothelial cell types, but not in epithelial cells, indicating that CLDN7 implication in viral infection is cell-type specific. The proviral activity of CLDN7 in endothelial cells is ZIKV-specific since related flaviviruses were not affected by CLDN7 downregulation. Together, our data suggest that CLDN7 facilitates ZIKV infection in endothelial cells at a post-internalization stage and prior to RNA production. Our work contributes to a better understanding of the mechanisms exploited by ZIKV to efficiently infect and replicate in endothelial cells and thus of its ability to cross the BBB.
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Affiliation(s)
- Jim Zoladek
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Université de Paris, Paris, France
| | - Vincent Legros
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Université de Paris, Paris, France.,VetAgro Sup, Centre International de Recherche en Infectiologie (CIRI), Lyon, France
| | - Patricia Jeannin
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Université de Paris, Paris, France
| | - Maxime Chazal
- Unité Signalisation Antivirale, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Paris, France
| | - Nathalie Pardigon
- Groupe Arbovirus, Unité Environnement et Risques Infectieux, Institut Pasteur, Paris, France
| | - Pierre-Emmanuel Ceccaldi
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Université de Paris, Paris, France
| | - Antoine Gessain
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Université de Paris, Paris, France
| | - Nolwenn Jouvenet
- Unité Signalisation Antivirale, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Paris, France
| | - Philippe V Afonso
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Centre National de la Recherche Scientifique UMR 3569, Université de Paris, Paris, France
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4
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Polonio CM, Peron JPS. ZIKV Infection and miRNA Network in Pathogenesis and Immune Response. Viruses 2021; 13:v13101992. [PMID: 34696422 PMCID: PMC8541119 DOI: 10.3390/v13101992] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/14/2021] [Accepted: 09/28/2021] [Indexed: 01/01/2023] Open
Abstract
Over the years, viral infections have caused severe illness in humans. Zika Virus (ZIKV) is a flavivirus transmitted by mosquito vectors that leads to notable neurological impairment, whose most dramatic impact is the Congenital ZIKV Syndrome (CZS). ZIKV targets neuronal precursor cells leading to apoptosis and further impairment of neuronal development, causing microcephaly, lissencephaly, ventriculomegaly, and calcifications. Several regulators of biological processes are involved in CZS development, and in this context, microRNAs (miRNAs) seem to have a fundamental role. miRNAs are important regulators of protein translation, as they form the RISC silencing complex and interact with complementary mRNA target sequences to further post-transcriptional repression. In this context, little is known about their participation in the pathogenesis of viral infections. In this review, we discuss how miRNAs could relate to ZIKV and other flavivirus infections.
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Affiliation(s)
- Carolina Manganeli Polonio
- Neuroimmune Interactions Laboratory, Department of Immunology, University of São Paulo, São Paulo 05508-000, Brazil;
- Laboratory of Neuroimmunology of Arboviruses, Scientific Platform Pasteur-USP (SPPU), University of São Paulo, São Paulo 05508-020, Brazil
| | - Jean Pierre Schatzmann Peron
- Neuroimmune Interactions Laboratory, Department of Immunology, University of São Paulo, São Paulo 05508-000, Brazil;
- Laboratory of Neuroimmunology of Arboviruses, Scientific Platform Pasteur-USP (SPPU), University of São Paulo, São Paulo 05508-020, Brazil
- Immunopathology and Allergy Post Graduate Program, School of Medicine, University of São Paulo, São Paulo 01246-000, Brazil
- Correspondence:
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5
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Enlow W, Bordeleau M, Piret J, Ibáñez FG, Uyar O, Venable MC, Goyette N, Carbonneau J, Tremblay ME, Boivin G. Microglia are involved in phagocytosis and extracellular digestion during Zika virus encephalitis in young adult immunodeficient mice. J Neuroinflammation 2021; 18:178. [PMID: 34399779 PMCID: PMC8369691 DOI: 10.1186/s12974-021-02221-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/16/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) has been associated with several neurological complications in adult patients. METHODS We used a mouse model deficient in TRIF and IPS-1 adaptor proteins, which are involved in type I interferon production, to study the role of microglia during brain infection by ZIKV. Young adult mice were infected intravenously with the contemporary ZIKV strain PRVABC59 (1 × 105 PFUs/100 µL). RESULTS Infected mice did not present overt clinical signs of the disease nor body weight loss compared with noninfected animals. However, mice exhibited a viremia and a brain viral load that were maximal (1.3 × 105 genome copies/mL and 9.8 × 107 genome copies/g of brain) on days 3 and 7 post-infection (p.i.), respectively. Immunohistochemistry analysis showed that ZIKV antigens were distributed in several regions of the brain, especially the dorsal hippocampus. The number of Iba1+/TMEM119+ microglia remained similar in infected versus noninfected mice, but their cell body and arborization areas significantly increased in the stratum radiatum and stratum lacunosum-moleculare layers of the dorsal hippocampus cornu ammoni (CA)1, indicating a reactive state. Ultrastructural analyses also revealed that microglia displayed increased phagocytic activities and extracellular digestion of degraded elements during infection. Mice pharmacologically depleted in microglia with PLX5622 presented a higher brain viral load compared to untreated group (2.8 × 1010 versus 8.5 × 108 genome copies/g of brain on day 10 p.i.) as well as an increased number of ZIKV antigens labeled with immunogold in the cytoplasm and endoplasmic reticulum of neurons and astrocytes indicating an enhanced viral replication. Furthermore, endosomes of astrocytes contained nanogold particles together with digested materials, suggesting a compensatory phagocytic activity upon microglial depletion. CONCLUSIONS These results indicate that microglia are involved in the control of ZIKV replication and/or its elimination in the brain. After depletion of microglia, the removal of ZIKV-infected cells by phagocytosis could be partly compensated by astrocytes.
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Affiliation(s)
- William Enlow
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Maude Bordeleau
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada.,Neurosciences Axis, Centre de recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Jocelyne Piret
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Fernando González Ibáñez
- Neurosciences Axis, Centre de recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada.,Department of Molecular Medicine, Université Laval, Quebec City, QC, Canada.,Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Olus Uyar
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Marie-Christine Venable
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Nathalie Goyette
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Julie Carbonneau
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Marie-Eve Tremblay
- Neurosciences Axis, Centre de recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada. .,Department of Molecular Medicine, Université Laval, Quebec City, QC, Canada. .,Division of Medical Sciences, University of Victoria, Victoria, BC, Canada. .,Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada. .,Department of Biochemistry and Molecular Biology, The University of British Columbia, Vancouver, BC, Canada.
| | - Guy Boivin
- Centre de Recherche en Infectiologie, Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada.
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6
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Charniga K, Cucunubá ZM, Walteros DM, Mercado M, Prieto F, Ospina M, Nouvellet P, Donnelly CA. Descriptive analysis of surveillance data for Zika virus disease and Zika virus-associated neurological complications in Colombia, 2015-2017. PLoS One 2021; 16:e0252236. [PMID: 34133446 PMCID: PMC8208586 DOI: 10.1371/journal.pone.0252236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022] Open
Abstract
Zika virus (ZIKV) is a mosquito-borne pathogen that recently caused a major epidemic in the Americas. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with birth defects in fetuses and newborns of infected mothers as well as neurological complications in adults. We performed a descriptive analysis on approximately 106,000 suspected and laboratory-confirmed cases of Zika virus disease (ZVD) that were reported during the 2015-2017 epidemic in Colombia. We also analyzed a dataset containing patients with neurological complications and recent febrile illness compatible with ZVD. Females had higher cumulative incidence of ZVD than males. Compared to the general population, cases were more likely to be reported in young adults (20 to 39 years of age). We estimated the cumulative incidence of ZVD in pregnant females at 3,120 reported cases per 100,000 population (95% CI: 3,077-3,164), which was considerably higher than the incidence in both males and non-pregnant females. ZVD cases were reported in all 32 departments. Four-hundred and eighteen patients suffered from ZIKV-associated neurological complications, of which 85% were diagnosed with Guillain-Barré syndrome. The median age of ZIKV cases with neurological complications was 12 years older than that of ZVD cases. ZIKV-associated neurological complications increased with age, and the highest incidence was reported among individuals aged 75 and older. Even though neurological complications and deaths due to ZIKV were rare in this epidemic, better risk communication is needed for people living in or traveling to ZIKV-affected areas.
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Affiliation(s)
- Kelly Charniga
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Zulma M Cucunubá
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | | | | | | | | | - Pierre Nouvellet
- School of Life Sciences, University of Sussex, Brighton, United Kingdom
| | - Christl A Donnelly
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Department of Statistics, University of Oxford, Oxford, United Kingdom
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7
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Zika Virus Pathogenesis: A Battle for Immune Evasion. Vaccines (Basel) 2021; 9:vaccines9030294. [PMID: 33810028 PMCID: PMC8005041 DOI: 10.3390/vaccines9030294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 12/13/2022] Open
Abstract
Zika virus (ZIKV) infection and its associated congenital and other neurological disorders, particularly microcephaly and other fetal developmental abnormalities, constitute a World Health Organization (WHO) Zika Virus Research Agenda within the WHO’s R&D Blueprint for Action to Prevent Epidemics, and continue to be a Public Health Emergency of International Concern (PHEIC) today. ZIKV pathogenicity is initiated by viral infection and propagation across multiple placental and fetal tissue barriers, and is critically strengthened by subverting host immunity. ZIKV immune evasion involves viral non-structural proteins, genomic and non-coding RNA and microRNA (miRNA) to modulate interferon (IFN) signaling and production, interfering with intracellular signal pathways and autophagy, and promoting cellular environment changes together with secretion of cellular components to escape innate and adaptive immunity and further infect privileged immune organs/tissues such as the placenta and eyes. This review includes a description of recent advances in the understanding of the mechanisms underlying ZIKV immune modulation and evasion that strongly condition viral pathogenesis, which would certainly contribute to the development of anti-ZIKV strategies, drugs, and vaccines.
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8
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Belaunzarán-Zamudio PF, Ortega-Villa AM, Mimenza-Alvarado AJ, Guerra-De-Blas PDC, Aguilar-Navarro SG, Sepúlveda-Delgado J, Hunsberger S, Salgado RV, Ramos-Castañeda J, Rincón León HA, Rodríguez de La Rosa P, Nájera Cancino JG, Beigel J, Caballero Sosa S, Ruiz Hernández E, Powers JH, Ruiz-Palacios GM, Lane C. Comparison of the Impact of Zika and Dengue Virus Infection, and Other Acute Illnesses of Unidentified Origin on Cognitive Functions in a Prospective Cohort in Chiapas Mexico. Front Neurol 2021; 12:631801. [PMID: 33828518 PMCID: PMC8019918 DOI: 10.3389/fneur.2021.631801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/22/2021] [Indexed: 02/03/2023] Open
Abstract
Zika has been associated with a variety of severe neurologic manifestations including meningitis and encephalitis. We hypothesized that it may also cause mild to subclinical neurocognitive alterations during acute infection or over the long term. In this observational cohort study, we explored whether Zika cause subclinical or mild neurocognitive alterations, estimate its frequency and duration, and compare it to other acute illnesses in a cohort of people with suspected Zika infection, in the region of Tapachula in Chiapas, Mexico during 2016–2018. We enrolled patients who were at least 12 years old with suspected Zika virus infection and followed them up for 6 months. During each visit participants underwent a complete clinical exam, including a screening test for neurocognitive dysfunction (Montreal Cognitive Assessment score). We enrolled 406 patients [37 with Zika, 73 with dengue and 296 with other acute illnesses of unidentified origin (AIUO)]. We observed a mild and transient impact over cognitive functions in patients with Zika, dengue and with other AIUO. The probability of having an abnormal MoCA score (<26 points) was significantly higher in patients with Zika and AIUO than in those with dengue. Patients with Zika and AIUO had lower memory scores than patients with dengue (Zika vs. Dengue: −0.378, 95% CI−0.678 to −0.078; p = 0.014: Zika vs. AIUO 0.264, 95% CI 0.059, 0.469; p = 0.012). The low memory performance in patients with Zika and AIUO accounts for most of the differences in the overall MoCA score when compared with patients with dengue. Our results show a decrease in cognitive function during acute illness and provides no evidence to support the hypothesis that Zika might cause neurocognitive alterations longer than the period of acute infection or different to other infectious diseases. While effects on memory or perhaps other cognitive functions over the long term are possible, larger studies using more refined tools for neurocognitive functioning assessment are needed to identify these. Trial Registration: NCT02831699.
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Affiliation(s)
- Pablo F Belaunzarán-Zamudio
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Ana M Ortega-Villa
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Alberto J Mimenza-Alvarado
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Geriatrics & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Sara G Aguilar-Navarro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jesús Sepúlveda-Delgado
- Directorate of Research, Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula & Medical Science Research, Hospital General de Zona 1, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Sally Hunsberger
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | | | - José Ramos-Castañeda
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Departamento de Inmunidad, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | | | - José Gabriel Nájera Cancino
- Directorate of Research, Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula & Medical Science Research, Hospital General de Zona 1, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - John Beigel
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Sandra Caballero Sosa
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Mexico
| | | | - John H Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Guillermo M Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Clifford Lane
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
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9
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Ireland DDC, Manangeeswaran M, Lewkowicz AP, Engel K, Clark SM, Laniyan A, Sykes J, Lee HN, McWilliams IL, Kelley-Baker L, Tonelli LH, Verthelyi D. Long-term persistence of infectious Zika virus: Inflammation and behavioral sequela in mice. PLoS Pathog 2020; 16:e1008689. [PMID: 33301527 PMCID: PMC7728251 DOI: 10.1371/journal.ppat.1008689] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022] Open
Abstract
The neurodevelopmental defects associated with ZIKV infections early in pregnancy are well documented, however the potential defects and long-term consequences associated with milder infections in late pregnancy and perinatal period are less well understood. To model these, we challenged 1 day old (P1) immunocompetent C57BL/6 mice with ZIKV. The animals developed a transient neurological syndrome including unsteady gait, kinetic tremors, severe ataxia and seizures 10-15 days post-infection (dpi) but symptoms subsided after a week, and most animals survived. Despite apparent recovery, MRI of convalescent mice show reduced cerebellar volume that correlates with altered coordination and motor function as well as hyperactivity and impulsivity. Persistent mRNA levels of pro-inflammatory genes including Cd80, Il-1α, and Ifn-γ together with Cd3, Cd8 and perforin (PrfA), suggested persistence of low-grade inflammation. Surprisingly, the brain parenchyma of convalescent mice harbor multiple small discrete foci with viral antigen, active apoptotic processes in neurons, and cellular infiltrates, surrounded by activated astrocytes and microglia as late as 1-year post-infection. Detection of negative-sense strand viral RNA and isolation of infectious virus derived from these convalescent mice by blinded passage in Vero cells confirmed long-term persistence of replicating ZIKV in CNS of convalescent mice. Although the infection appears to persist in defined reservoirs within CNS, the resulting inflammation could increase the risk of neurodegenerative disorders. This raises concern regarding possible long-term effects in asymptomatic children exposed to the virus and suggests that long-term neurological and behavioral monitoring as well as anti-viral treatment to clear virus from the CNS may be useful in patients exposed to ZIKV at an early age.
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Affiliation(s)
- Derek D. C. Ireland
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Mohanraj Manangeeswaran
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Aaron P. Lewkowicz
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Kaliroi Engel
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Sarah M. Clark
- University of Maryland School of Medicine, Department of Psychiatry, Baltimore, Maryland, United States of America
| | - Adelle Laniyan
- University of Maryland School of Medicine, Department of Psychiatry, Baltimore, Maryland, United States of America
| | - Jacob Sykes
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Ha-Na Lee
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Ian L. McWilliams
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Logan Kelley-Baker
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
| | - Leonardo H. Tonelli
- University of Maryland School of Medicine, Department of Psychiatry, Baltimore, Maryland, United States of America
| | - Daniela Verthelyi
- US Food and Drug Administration, Office of Biotechnology Products, Silver Spring, Maryland, United States of America
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10
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Castanospermine reduces Zika virus infection-associated seizure by inhibiting both the viral load and inflammation in mouse models. Antiviral Res 2020; 183:104935. [PMID: 32949636 PMCID: PMC7492813 DOI: 10.1016/j.antiviral.2020.104935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/02/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
Zika virus (ZIKV) outbreaks have been reported worldwide, including a recent occurrence in Brazil where it spread rapidly, and an association with increased cases of microcephaly was observed in addition to neurological issues such as GBS that were reported during previous outbreaks. Following infection of neuronal tissues, ZIKV can cause inflammation, which may lead to neuronal abnormalities, including seizures and paralysis. Therefore, a drug containing both anti-viral and immunosuppressive properties would be of great importance in combating ZIKV related neurological abnormalities. Castanospermine (CST) is potentially a right candidate drug as it reduced viral load and brain inflammation with the resulting appearance of delayed neuronal disorders, including seizures and paralysis in an Ifnar1−/− mouse. Anti-ZIKV activity of castanospermine (CST) In vivo and in vitro. CST reduces ZIKV induced inflammation of brain. CST delays the ZIKV induced seizure and improves neuronal disorders such as motor function. CST gives marginal improvement in survivability in Ifnar1−/− mice.
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11
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Serrano-Collazo C, Pérez-Guzmán EX, Pantoja P, Hassert MA, Rodríguez IV, Giavedoni L, Hodara V, Parodi L, Cruz L, Arana T, Martínez MI, White L, Brien JD, de Silva A, Pinto AK, Sariol CA. Effective control of early Zika virus replication by Dengue immunity is associated to the length of time between the 2 infections but not mediated by antibodies. PLoS Negl Trop Dis 2020; 14:e0008285. [PMID: 32463814 PMCID: PMC7255596 DOI: 10.1371/journal.pntd.0008285] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 04/10/2020] [Indexed: 12/18/2022] Open
Abstract
Little is known about the contribution of virus-specific and cross-reacting antibodies (Abs) or the cellular immune response generated by a primary dengue (DENV) infection on the course of a secondary zika (ZIKV) infection in vivo. Here we show that the length of time between DENV/ZIKV infections has a qualitative impact on controlling early ZIKV replication. Depletion of DENV2-specific Abs in sera confirmed that those type-specific Abs do not contribute to ZIKV control. We show that the magnitude and durability of the neutralizing antibodies (nAbs) induced by a secondary ZIKV infection is modest compared to the response induced after a secondary heterologous DENV infection. Our in vivo results are showing a complex interplay between the cellular and innate immune responses characterized by a high frequency of plasmacytoid dendritic cells (pDC) correlating with an increase in the frequency of DENV antigen specific T cells and a significant control of ZIKV replication which is time dependent. Taken together, our results suggest that early after ZIKV infection other mechanisms such as the innate and cellular immune responses may play a predominant role in controlling ZIKV replication. Regardless of the time elapsed between infections there was no evidence of in vivo antibody-dependent enhancement (ADE) of ZIKV by DENV immunity. These findings have pivotal implications while interpreting ZIKV pathogenesis in flavivirus-experimented populations, diagnostic results interpretation and vaccine designs and schedules among others. From our previous work in non-human primates and others using humans, we believe that previous DENV immunity confers some degree of protection against ZIKV infection. However, at least two highly relevant questions remain unanswered. One is precisely if the time between primary DENV and a subsequent ZIKV infections may play a role in the degree of protection conferred by DENV immunity. The second question is related to the mechanisms of cross-protection. In this work we provide evidences that a period of 12 months between DENV and ZIKV infections has a significant impact controlling ZIKV replication compared to a shorter period of 3 months. We also provide evidences that the pre-existing DENV Abs play no role controlling early ZIKV replication. Our results strongly suggest that the mechanisms controlling ZIKV replication are related to the complex interaction between the innate and the cellular immune responses. Our results have significant implications for vaccine design and schedules.
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Affiliation(s)
- Crisanta Serrano-Collazo
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Erick X. Pérez-Guzmán
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Petraleigh Pantoja
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Mariah A. Hassert
- Department of Molecular Microbiology & Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, United States of America
| | - Idia V. Rodríguez
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Luis Giavedoni
- Host Pathogen Interactions Program, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Vida Hodara
- Host Pathogen Interactions Program, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Laura Parodi
- University of North Carolina Chapel Hill, North Carolina, United States of America
| | - Lorna Cruz
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Teresa Arana
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Melween I. Martínez
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
| | - Laura White
- University of North Carolina Chapel Hill, North Carolina, United States of America
| | - James D. Brien
- Department of Molecular Microbiology & Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, United States of America
| | - Aravinda de Silva
- University of North Carolina Chapel Hill, North Carolina, United States of America
| | - Amelia K. Pinto
- Department of Molecular Microbiology & Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, United States of America
| | - Carlos A. Sariol
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- Department of Internal Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, United States of America
- * E-mail:
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Kim J, Alejandro B, Hetman M, Hattab EM, Joiner J, Schroten H, Ishikawa H, Chung DH. Zika virus infects pericytes in the choroid plexus and enters the central nervous system through the blood-cerebrospinal fluid barrier. PLoS Pathog 2020; 16:e1008204. [PMID: 32357162 PMCID: PMC7194358 DOI: 10.1371/journal.ppat.1008204] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/07/2020] [Indexed: 12/21/2022] Open
Abstract
Zika virus (ZIKV) can infect and cause microcephaly and Zika-associated neurological complications in the developing fetal and adult brains. In terms of pathogenesis, a critical question is how ZIKV overcomes the barriers separating the brain from the circulation and gains access to the central nervous system (CNS). Despite the importance of ZIKV pathogenesis, the route ZIKV utilizes to cross CNS barriers remains unclear. Here we show that in mouse models, ZIKV-infected cells initially appeared in the periventricular regions of the brain, including the choroid plexus and the meninges, prior to infection of the cortex. The appearance of ZIKV in cerebrospinal fluid (CSF) preceded infection of the brain parenchyma. Further the brain infection was significantly attenuated by neutralization of the virus in the CSF, indicating that ZIKV in the CSF at the early stage of infection might be responsible for establishing a lethal infection of the brain. We show that cells infected by ZIKV in the choroid plexus were pericytes. Using in vitro systems, we highlight the possibility that ZIKV crosses the blood-CSF barrier by disrupting the choroid plexus epithelial layer. Taken together, our results suggest that ZIKV might exploit the blood-CSF barrier rather than the blood-brain barrier to invade the CNS.
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Affiliation(s)
- Jihye Kim
- Department of Microbiology and Immunology, School of Medicine, University of Louisville, Kentucky, United States of America
| | - Brian Alejandro
- Department of Microbiology and Immunology, School of Medicine, University of Louisville, Kentucky, United States of America
| | - Michal Hetman
- Department of Neurological Surgery, School of Medicine, University of Louisville, Kentucky, United States of America
| | - Eyas M. Hattab
- Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, Kentucky, United States of America
| | - Joshua Joiner
- Centre College, Danville, Kentucky, United States of America
| | - Horst Schroten
- Department of Pediatrics, Pediatric Infectious Diseases, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Dong-Hoon Chung
- Department of Microbiology and Immunology, School of Medicine, University of Louisville, Kentucky, United States of America
- Center for Predictive Medicine, School of Medicine, University of Louisville, Kentucky, United States of America
- * E-mail:
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13
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Autophagy Contributes to Host Immunity and Protection against Zika Virus Infection via Type I IFN Signaling. Mediators Inflamm 2020; 2020:9527147. [PMID: 32410874 PMCID: PMC7204160 DOI: 10.1155/2020/9527147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/20/2020] [Accepted: 04/08/2020] [Indexed: 11/17/2022] Open
Abstract
Recent studies have indicated that the Zika virus (ZIKV) has a significant impact on the fetal brain, and autophagy is contributing to host immune response and defense against virus infection. Here, we demonstrate that ZIKV infection triggered increased LC3 punctuation in mouse monocyte-macrophage cell line (RAW264.7), mouse microglial cell line (BV2), and hindbrain tissues, proving the occurrence of autophagy both in vitro and in vivo. Interestingly, manual intervention of autophagy, like deficiency inhibited by 3-MA, can reduce viral clearance in RAW264.7 cells upon ZIKV infection. Besides, specific siRNA strategy confirmed that autophagy can be activated through Atg7-Atg5 and type I IFN signaling pathway upon ZIKV infection, while knocking down of Atg7 and Atg5 effectively decreased the ZIKV clearance in phagocytes. Furthermore, we analyzed that type I IFN signaling could contribute to autophagic clearance of invaded ZIKV in phagocytes. Taken together, our findings demonstrate that ZIKV-induced autophagy is favorable to activate host immunity, particularly through type I IFN signaling, which participates in host protection and defense against ZIKV infection.
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Gupta N, Yadav PD, Patil DY, Sapkal G. Preparedness of public health-care system for Zika virus outbreak: An Indian perspective. J Infect Public Health 2020; 13:949-955. [PMID: 32340832 DOI: 10.1016/j.jiph.2020.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/18/2020] [Accepted: 03/26/2020] [Indexed: 11/20/2022] Open
Abstract
Zika virus is a mosquito-borne flavivirus that has emerged recently and affected in many countries. Since its discovery in Uganda in 1947, two major outbreaks were reported from Yap Islands in 2007 and French Polynesia in 2013. In 2015, the first case of ZIKV infection was confirmed from Brazil followed by a report of cases from American and Caribbean countries. In February 2016, the World Health Organization declared ZIKV infection a Public Health Emergency of International Concern. India reported the first Zika case in 2017. Subsequently, 157 laboratory-confirmed cases of ZIKV including 63 pregnant women were reported from Rajasthan, India in 2018. Since 2014, many countries took initiatives to boost their public health system to combat ZIKV. However, there is still scope for the improvement. This review describes ZIKV outbreaks, diagnostic challenges, surveillance and control measures in India and the future perspective to deal with the ZIKV outbreak in India.
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Affiliation(s)
- Nivedita Gupta
- Epidemiology and Communicable Diseases, Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi 110029, India.
| | - Pragya D Yadav
- ICMR-National Institute of Virology, Sus-Pashan Road, Pune, Maharashtra 411021, India
| | - Deepak Y Patil
- ICMR-National Institute of Virology, Sus-Pashan Road, Pune, Maharashtra 411021, India
| | - Gajanan Sapkal
- ICMR-National Institute of Virology, Sus-Pashan Road, Pune, Maharashtra 411021, India
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15
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Rieder CA, Rieder J, Sannajust S, Goode D, Geguchadze R, Relich RF, Molliver DC, King TE, Vaughn J, May M. A Novel Mechanism for Zika Virus Host-Cell Binding. Viruses 2019; 11:v11121101. [PMID: 31795144 PMCID: PMC6949893 DOI: 10.3390/v11121101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022] Open
Abstract
Zika virus (ZIKV) recently emerged in the Western Hemisphere with previously unrecognized or unreported clinical presentations. Here, we identify two putative binding mechanisms of ancestral and emergent ZIKV strains featuring the envelope (E) protein residue asparagine 154 (ASN154) and viral phosphatidylserine (PS). Synthetic peptides representing the region containing ASN154 from strains PRVABC59 (Puerto Rico 2015) and MR_766 (Uganda 1947) were exposed to neuronal cells and fibroblasts to model ZIKV E protein/cell interactions and bound MDCK or Vero cells and primary neurons significantly. Peptides significantly inhibited Vero cell infectivity by ZIKV strains MR_766 and PRVABC59, indicating that this region represents a putative binding mechanism of ancestral African ZIKV strains and emergent Western Hemisphere strains. Pretreatment of ZIKV strains MR_766 and PRVABC59 with the PS-binding protein annexin V significantly inhibited replication of PRVABC59 but not MR_766, suggesting that Western hemisphere strains may additionally be capable of utilizing PS-mediated entry to infect host cells. These data indicate that the region surrounding E protein ASN154 is capable of binding fibroblasts and primary neuronal cells and that PS-mediated entry may be a secondary mechanism for infectivity utilized by Western Hemisphere strains.
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Affiliation(s)
- Courtney A. Rieder
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
| | - Jonathan Rieder
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
| | - Sebastién Sannajust
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME 04005, USA
| | - Diana Goode
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME 04005, USA
| | - Ramaz Geguchadze
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME 04005, USA
| | - Ryan F. Relich
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Derek C. Molliver
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME 04005, USA
| | - Tamara E. King
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME 04005, USA
| | - James Vaughn
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
| | - Meghan May
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA; (C.A.R.); (J.R.); (S.S.); (D.G.); (R.G.); (D.C.M.); (T.E.K.); (J.V.)
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME 04005, USA
- Correspondence:
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16
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Salgado DM, Vega R, Rodríguez JA, Niño Á, Rodríguez R, Ortiz Á, DeLaura I, Bosch I, Narváez CF. Clinical, laboratory and immune aspects of Zika virus-associated encephalitis in children. Int J Infect Dis 2019; 90:104-110. [PMID: 31678190 DOI: 10.1016/j.ijid.2019.10.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To evaluate the clinical, laboratory, and immune characteristics of Zika virus (ZIKV)-associated encephalitis in pediatric patients after the epidemic in Huila, southern Colombia. METHODS A pediatric neuro-surveillance hospital study was conducted in a referral health center in southern Colombia, from October 2016 to October 2017. Cases of encephalitis were confirmed by nucleic acid amplification tests and serological methods in cerebrospinal fluid (CSF), plasma, and/or urine. Levels of six cytokines were evaluated by flow cytometry. Patients underwent daily clinical and laboratory follow-up. RESULTS Twenty children with probable encephalitis were included for further studies and 16 of them were confirmed. Four cases of bacterial meningoencephalitis (Streptococcus pneumoniae, group B Streptococcus, Staphylococcus epidermidis, and Escherichia coli) and 12 cases of viral encephalitis were identified, six of them associated with ZIKV infection. Other viral encephalitis cases were caused by herpes viruses (n=3), enterovirus (n=2), and dengue virus type 2 (DENV-2; n=1) infections. ZIKV-associated encephalitis symptoms subsided faster than those of patients with encephalitis caused by other agents. CSF analysis revealed lymphocytic pleocytosis. Compared to healthy controls, children with ZIKV-associated encephalitis presented modest plasma interleukin (IL)-10 but not IL-2, IL-4, IL-6, interferon gamma (IFN-γ), or tumor necrosis factor alpha (TNF-α). Cytokine expression was differentially regulated, as dramatically elevated IL-6, IL-10, and IFN-γ levels were observed in CSF but not in paired plasma samples in one of the patients with ZIKV detectable in CSF. CONCLUSIONS This study provides evidence that ZIKV is responsible for pediatric encephalitis in endemic areas, and the local presence of the virus may induce cephalic but not systemic expression of cytokines.
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Affiliation(s)
- Doris M Salgado
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia.
| | - Rocío Vega
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Jairo Antonio Rodríguez
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Ángela Niño
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Rocío Rodríguez
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Ángela Ortiz
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Departamento de Pediatría, Hospital Universitario de Neiva, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
| | - Isabel DeLaura
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Harvard College, Cambridge, MA 02138, USA
| | - Irene Bosch
- E25Bio Inc., The Engine of MIT, 501 Massachusetts Ave., Cambridge, MA 02139, USA; Mount Sinai School of Medicine, Department of Medicine, New York, NY 10029-6500, USA
| | - Carlos F Narváez
- Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia; Especialización Médica en Pediatría, Postgrados Clínicos, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia.
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17
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Nem de Oliveira Souza I, Frost PS, França JV, Nascimento-Viana JB, Neris RLS, Freitas L, Pinheiro DJLL, Nogueira CO, Neves G, Chimelli L, De Felice FG, Cavalheiro ÉA, Ferreira ST, Assunção-Miranda I, Figueiredo CP, Da Poian AT, Clarke JR. Acute and chronic neurological consequences of early-life Zika virus infection in mice. Sci Transl Med 2019; 10:10/444/eaar2749. [PMID: 29875203 DOI: 10.1126/scitranslmed.aar2749] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/17/2018] [Indexed: 12/13/2022]
Abstract
Although congenital Zika virus (ZIKV) exposure has been associated with microcephaly and other neurodevelopmental disorders, long-term consequences of perinatal infection are largely unknown. We evaluated short- and long-term neuropathological and behavioral consequences of neonatal ZIKV infection in mice. ZIKV showed brain tropism, causing postnatal-onset microcephaly and several behavioral deficits in adulthood. During the acute phase of infection, mice developed frequent seizures, which were reduced by tumor necrosis factor-α (TNF-α) inhibition. During adulthood, ZIKV replication persisted in neonatally infected mice, and the animals showed increased susceptibility to chemically induced seizures, neurodegeneration, and brain calcifications. Altogether, the results show that neonatal ZIKV infection has long-term neuropathological and behavioral complications in mice and suggest that early inhibition of TNF-α-mediated neuroinflammation might be an effective therapeutic strategy to prevent the development of chronic neurological abnormalities.
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Affiliation(s)
| | - Paula S Frost
- School of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.,Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil
| | - Julia V França
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil
| | | | - Rômulo L S Neris
- Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil
| | - Leandro Freitas
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP 04023-062, Brazil
| | - Daniel J L L Pinheiro
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP 04023-062, Brazil
| | - Clara O Nogueira
- School of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil
| | - Gilda Neves
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil
| | - Leila Chimelli
- Laboratory of Neuropathology, State Institute of Brain Paulo Niemeyer, Rio de Janeiro, Brazil
| | - Fernanda G De Felice
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.,Centre for Neuroscience Studies, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Ésper A Cavalheiro
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP 04023-062, Brazil
| | - Sergio T Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.,Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil
| | - Iranaia Assunção-Miranda
- Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.
| | - Claudia P Figueiredo
- School of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.
| | - Andrea T Da Poian
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.
| | - Julia R Clarke
- School of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21944-590, Brazil.
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18
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Zika virus replicates in adult human brain tissue and impairs synapses and memory in mice. Nat Commun 2019; 10:3890. [PMID: 31488835 PMCID: PMC6728367 DOI: 10.1038/s41467-019-11866-7] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/31/2019] [Indexed: 12/22/2022] Open
Abstract
Neurological complications affecting the central nervous system have been reported in adult patients infected by Zika virus (ZIKV) but the underlying mechanisms remain unknown. Here, we report that ZIKV replicates in human and mouse adult brain tissue, targeting mature neurons. ZIKV preferentially targets memory-related brain regions, inhibits hippocampal long-term potentiation and induces memory impairment in adult mice. TNF-α upregulation, microgliosis and upregulation of complement system proteins, C1q and C3, are induced by ZIKV infection. Microglia are found to engulf hippocampal presynaptic terminals during acute infection. Neutralization of TNF-α signaling, blockage of microglial activation or of C1q/C3 prevent synapse and memory impairment in ZIKV-infected mice. Results suggest that ZIKV induces synapse and memory dysfunction via aberrant activation of TNF-α, microglia and complement. Our findings establish a mechanism by which ZIKV affects the adult brain, and point to the need of evaluating cognitive deficits as a potential comorbidity in ZIKV-infected adults. Here, using ex-vivo human adult cortical tissue and a mouse model, the authors investigate the functional consequences of Zika virus (ZIKV) infection in the adult brain, and show that ZIKV causes synapse damage and altered brain function that impacts cognition via activation of innate and inflammatory factors.
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Abstract
Zika virus (ZIKV) is an arthropod-borne virus that belongs to the Flaviviridae family. Although most cases are mild or go undetected, rare severe neurologic effects, including congenital ZIKV syndrome (CZS) and Guillain-Barré syndrome, have been identified. The serious neurologic complications associated with ZIKV prompted the declaration of the public health emergency of international concern by the World Health Organization. Overall, transmission occurred throughout South and Central America as well as the Caribbean, affecting 48 countries and territories from March 2015 to March 2017. Long-term management of CZS requires a comprehensive combination of supportive services throughout early development.
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Affiliation(s)
- Savina Reid
- Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA
| | - Kathryn Rimmer
- Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA
| | - Kiran Thakur
- Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA.
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Sanyaolu A, Ayodele O, Likaj L, Marinkovic A, Locke J, Ahmed M, Akanbi O, Orish V, Okorie C, Badaru O. Changing Epidemiology, Treatment, and Vaccine Update on Chikungunya, Dengue, and Zika Viruses. CURRENT TROPICAL MEDICINE REPORTS 2019. [DOI: 10.1007/s40475-019-00181-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
PURPOSE OF REVIEW We review the range of dermatological signs seen in Zika infection and the possible relationship between the rash and viremia. We also hoped to explore the utility of mucocutaneous manifestations in narrowing the differential diagnosis from other similar flaviviruses. RECENT FINDINGS Clinical manifestations of Zika infection share many similarities with other mosquito-borne viruses such as dengue. These include non-specific symptoms such as a fever, rash, arthralgia, myalgia, and conjunctivitis. The morphology of the rash in Zika infection is not very specific and commonly described as maculopapular and centrifugal that usually extends to become diffuse. We reviewed 123 publications, encompassing a total of 368 Zika cases. One hundred seven cases with rash had sufficient data for detailed analysis. 8.4% of cases with rash had hemorrhagic manifestations such as palatal petechiae and bleeding ulcers. Only 20 reported cases were tested for viremia during presence of rash, and 70.6% of these cases were positive. While mucocutaneous complications are common in Zika infection, more research is necessary to determine the impact of rash on diagnosis, prognosis, and transmissibility in Zika infection.
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Affiliation(s)
- Xuan Qi Koh
- National University Health System, NUHS Residency Program, Medical Affairs (Education)/Internal Medicine, 1E Kent Ridge Road, NUHS Tower Block, Level 10, Singapore, 119228, Singapore.
| | | | - Paul Anantharajah Tambyah
- Department of Medicine (Infectious Disease), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Lannuzel A, Fergé JL, Lobjois Q, Signate A, Rozé B, Tressières B, Madec Y, Poullain P, Herrmann C, Najioullah F, McGovern E, Savidan AC, Valentino R, Breurec S, Césaire R, Hirsch E, Lledo PM, Thiery G, Cabié A, Lazarini F, Roze E. Long-term outcome in neuroZika. Neurology 2019; 92:e2406-e2420. [DOI: 10.1212/wnl.0000000000007536] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/22/2019] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo characterize the full spectrum, relative frequency, and prognosis of the neurologic manifestations in Zika virus (ZIKV) postnatal infection.MethodsWe conducted an observational study in consecutive ZIKV-infected patients presenting with neurologic manifestations during the French West Indies 2016 outbreak.ResultsEighty-seven patients, including 6 children, were enrolled. Ninety-five percent of all cases required hospitalization. Guillain-Barré syndrome was the most frequent manifestation (46.0%) followed by encephalitis or encephalomyelitis (20.7%), isolated single or multiple cranial nerve palsies (9.2%), other peripheral manifestations (6.9%), and stroke (1.1%). Fourteen patients (16.1%), including one child, developed a mixed disorder involving both the central and peripheral nervous system. Mechanical ventilation was required in 21 cases, all of whom had ZIKV RNA in at least one biological fluid. Two adult patients died due to neuroZika. Clinical follow-up (median 14 months; interquartile range, 13–17 months) was available for 76 patients. Residual disability (modified Rankin Scale score ≥2) was identified in 19 (25.0%) patients; in 6 cases (7.9%), disability was severe (modified Rankin Scale score ≥4). Among patients with ZIKV RNA detected in one biological fluid, the risk of residual disability or death was higher (odds ratio 9.19; confidence interval 1.12–75.22; p = 0.039).ConclusionsNeuroZika spectrum represents a heterogeneous group of clinical neurologic manifestations. During an outbreak, clinicians should consider neuroZika in patients presenting with cranial nerve palsies and a mixed neurologic disorder. Long-term sequelae are frequent in NeuroZika. ZIKV reverse-transcription PCR status at admission can inform prognosis and should therefore be taken into consideration in the management of hospitalized patients.
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Muñoz LS, Parra B, Pardo CA. Neurological Implications of Zika Virus Infection in Adults. J Infect Dis 2019; 216:S897-S905. [PMID: 29267923 DOI: 10.1093/infdis/jix511] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The 2015-2016 epidemic of Zika virus (ZIKV) in the Americas and the Caribbean was associated with an unprecedented burden of neurological disease among adults. Clinically, Guillain-Barre syndrome (GBS) predominated among regions affected by the ZIKV epidemic, but the spectrum of neurological disease in the adults appears broader as cases of encephalopathy, encephalitis, meningitis, myelitis, and seizures have also been reported. A para-infectious temporal profile of ZIKV-associated GBS (ZIKV-GBS) has been described in clinical studies, which may suggest a direct viral neuropathic effect. However, ZIKV neuropathogenesis has not yet been fully understood. Mechanisms for ZIKV-GBS and other neurological syndromes have been hypothesized, such as adaptive viral genetic changes, immunological interactions with other circulating flaviviruses, and host and factors. This review summarizes the current evidence on ZIKV-associated neurological complications in the adults.
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Affiliation(s)
- Laura S Muñoz
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Beatriz Parra
- Department of Microbiology, Universidad del Valle School of Medicine, Cali, Colombia
| | - Carlos A Pardo
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Du S, Liu Y, Liu J, Zhao J, Champagne C, Tong L, Zhang R, Zhang F, Qin CF, Ma P, Chen CH, Liang G, Liu Q, Shi PY, Cazelles B, Wang P, Tian H, Cheng G. Aedes mosquitoes acquire and transmit Zika virus by breeding in contaminated aquatic environments. Nat Commun 2019; 10:1324. [PMID: 30902991 PMCID: PMC6430813 DOI: 10.1038/s41467-019-09256-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 03/01/2019] [Indexed: 01/26/2023] Open
Abstract
Zika virus (ZIKV) is a mosquito-borne flavivirus that predominantly circulates between humans and Aedes mosquitoes. Clinical studies have shown that Zika viruria in patients persists for an extended period, and results in infectious virions being excreted. Here, we demonstrate that Aedes mosquitoes are permissive to ZIKV infection when breeding in urine or sewage containing low concentrations of ZIKV. Mosquito larvae and pupae, including from field Aedes aegypti can acquire ZIKV from contaminated aquatic systems, resulting in ZIKV infection of adult females. Adult mosquitoes can transmit infectious virions to susceptible type I/II interferon receptor-deficient (ifnagr-/-) C57BL/6 (AG6) mice. Furthermore, ZIKV viruria from infected AG6 mice can causes mosquito infection during the aquatic life stages. Our studies suggest that infectious urine could be a natural ZIKV source, which is potentially transmissible to mosquitoes when breeding in an aquatic environment.
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Affiliation(s)
- Senyan Du
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China
- Beijing Advanced Innovation Center for Structural Biology, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China
- Institute of Pathogenic Organisms, Shenzhen Center for Disease Control and Prevention, 518055, Shenzhen, Guangdong, People's Republic of China
| | - Yang Liu
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China
- School of Life Science, Tsinghua University, 100084, Beijing, People's Republic of China
| | - Jianying Liu
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China
| | - Jie Zhao
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China
| | - Clara Champagne
- IBENS, UMR 8197 CNRS-ENS Ecole Normale Supérieure, 75005, Paris, France
| | - Liangqin Tong
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China
| | - Renli Zhang
- Institute of Pathogenic Organisms, Shenzhen Center for Disease Control and Prevention, 518055, Shenzhen, Guangdong, People's Republic of China
| | - Fuchun Zhang
- Institute of infectious diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510060, Guangzhou, People's Republic of China
| | - Cheng-Feng Qin
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 100071, Beijing, People's Republic of China
| | - Ping Ma
- Department of Clinical Laboratory, Tsinghua University Hospital, 100084, Beijing, People's Republic of China
| | - Chun-Hong Chen
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, 35053, Taiwan, Republic of China
| | - Guodong Liang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Viral Disease Control and Prevention, China CDC, 102206, Beijing, People's Republic of China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, China CDC, 102206, Beijing, People's Republic of China
| | - Pei-Yong Shi
- Department of Biochemistry and Molecular Biology, Department of Pharmacology and Toxicology, and Sealy Center for Structural Biology and Molecular Biophysics, University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Bernard Cazelles
- IBENS, UMR 8197 CNRS-ENS Ecole Normale Supérieure, 75005, Paris, France
- International Center for Mathematical and Computational Modeling of Complex Systems (UMMISCO), IRD-Sorbone Université, Bondy, 93143, France
| | - Penghua Wang
- Department of Immunology, School of Medicine, the University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Huaiyu Tian
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, 100875, Beijing, People's Republic of China.
| | - Gong Cheng
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China.
- Beijing Advanced Innovation Center for Structural Biology, School of Medicine, Tsinghua University, 100084, Beijing, People's Republic of China.
- Institute of Pathogenic Organisms, Shenzhen Center for Disease Control and Prevention, 518055, Shenzhen, Guangdong, People's Republic of China.
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Wright JK, Castellani L, Lecce C, Khatib A, Bonta M, Boggild AK. Zika Virus-Associated Aseptic Meningitis and Guillain-Barre Syndrome in a Traveler Returning from Latin America: a Case Report and Mini-Review. Curr Infect Dis Rep 2019; 21:3. [PMID: 30767073 DOI: 10.1007/s11908-019-0661-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ZIKV-associated Guillain-Barré syndrome presents with an accelerated clinical course compared to classic post-infectious Guillain-Barré syndrome. Clinicians should anticipate and screen patients with ZIKV infection for neurologic complications bearing in mind that these may manifest during the acute viremic phase or during early convalescence.
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Affiliation(s)
| | - Lucas Castellani
- Department of Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, Canada
| | - Christian Lecce
- Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, Toronto, 13EN-218, Canada
| | - Aisha Khatib
- Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, Toronto, 13EN-218, Canada
| | - Mark Bonta
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Andrea K Boggild
- Department of Medicine, University of Toronto, Toronto, Canada. .,Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, Toronto, 13EN-218, Canada. .,Public Health Ontario Laboratories, Toronto, Canada.
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Niedrig M, Patel P, El Wahed AA, Schädler R, Yactayo S. Find the right sample: A study on the versatility of saliva and urine samples for the diagnosis of emerging viruses. BMC Infect Dis 2018; 18:707. [PMID: 30594124 PMCID: PMC6311079 DOI: 10.1186/s12879-018-3611-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/10/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The emergence of different viral infections during the last decades like dengue, West Nile, SARS, chikungunya, MERS-CoV, Ebola, Zika and Yellow Fever raised some questions on quickness and reliability of laboratory diagnostic tests for verification of suspected cases. Since sampling of blood requires medically trained personal and comprises some risks for the patient as well as for the health care personal, the sampling by non-invasive methods (e.g. saliva and/ or urine) might be a very valuable alternative for investigating a diseased patient. MAIN BODY To analyse the usefulness of alternative non-invasive samples for the diagnosis of emerging infectious viral diseases, a literature search was performed on PubMed for alternative sampling for these viral infections. In total, 711 papers of potential relevance were found, of which we have included 128 in this review. CONCLUSIONS Considering the experience using non-invasive sampling for the diagnostic of emerging viral diseases, it seems important to perform an investigation using alternative samples for routine diagnostics. Moreover, during an outbreak situation, evaluation of appropriate sampling and further processing for laboratory analysis on various diagnostic platforms are very crucial. This will help to achieve optimal diagnostic results for a good and reliable case identification.
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Affiliation(s)
| | | | - Ahmed Abd El Wahed
- Division of Microbiology and Animal Hygiene, University of Goettingen, Goettingen, Germany
| | | | - Sergio Yactayo
- Control of Epidemic Diseases (CED), World Health Organization, Geneva, Switzerland
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Paz-Bailey G, Rosenberg ES, Doyle K, Munoz-Jordan J, Santiago GA, Klein L, Perez-Padilla J, Medina FA, Waterman SH, Gubern CG, Alvarado LI, Sharp TM. Persistence of Zika Virus in Body Fluids - Final Report. N Engl J Med 2018; 379:1234-1243. [PMID: 28195756 PMCID: PMC5831142 DOI: 10.1056/nejmoa1613108] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND To estimate the frequency and duration of detectable Zika virus (ZIKV) RNA in human body fluids, we prospectively assessed a cohort of newly infected participants in Puerto Rico. METHODS We evaluated samples obtained from 150 participants (including 55 men) in whom ZIKV RNA was detected on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay in urine or blood in an enhanced arboviral clinical surveillance site. We collected serum, urine, saliva, semen, and vaginal secretions weekly for the first month and then at 2, 4, and 6 months. All specimens were tested by means of RT-PCR, and serum was tested with the use of anti-ZIKV IgM enzyme-linked immunosorbent assay. Among the participants with ZIKV RNA in any specimen at week 4, biweekly collection continued until all specimens tested negative. We used parametric Weibull regression models to estimate the time until the loss of ZIKV RNA detection in each body fluid and reported the findings in medians and 95th percentiles. RESULTS The medians and 95th percentiles for the time until the loss of ZIKV RNA detection were 14 days (95% confidence interval [CI], 11 to 17) and 54 days (95% CI, 43 to 64), respectively, in serum; 8 days (95% CI, 6 to 10) and 39 days (95% CI, 31 to 47) in urine; and 34 days (95% CI, 28 to 41) and 81 days (95% CI, 64 to 98) in semen. Few participants had detectable ZIKV RNA in saliva or vaginal secretions. CONCLUSIONS The prolonged time until ZIKV RNA clearance in serum in this study may have implications for the diagnosis and prevention of ZIKV infection. Current sexual-prevention guidelines recommend that men use condoms or abstain from sex for 6 months after ZIKV exposure; in 95% of the men in this study, ZIKV RNA was cleared from semen after about 3 months. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Gabriela Paz-Bailey
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Eli S Rosenberg
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Kate Doyle
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Jorge Munoz-Jordan
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Gilberto A Santiago
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Liore Klein
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Janice Perez-Padilla
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Freddy A Medina
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Stephen H Waterman
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Carlos Garcia Gubern
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Luisa I Alvarado
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
| | - Tyler M Sharp
- From the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (G.P.-B., K.D.), and the Department of Epidemiology, Emory University (E.S.R.), Atlanta; and the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (J.M.-J., G.A.S., J.P.-P., F.A.M., S.H.W., T.M.S.), and Caduceus Healthcare (L.K.), San Juan, and Ponce University School of Medicine-Saint Luke's Episcopal Hospital Consortium, Ponce (C.G.G., L.I.A.) - all in Puerto Rico
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Andrade DV, Harris E. Recent advances in understanding the adaptive immune response to Zika virus and the effect of previous flavivirus exposure. Virus Res 2018; 254:27-33. [PMID: 28655548 PMCID: PMC5743770 DOI: 10.1016/j.virusres.2017.06.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Abstract
Zika virus (ZIKV) caused explosive epidemics across the Americas, starting in Brazil in 2015, and has been associated with severe manifestations such as microcephaly in babies born to infected mothers and Guillain-Barré syndrome in adults. As the underlying mechanisms of pathogenesis remain largely unknown, diverse investigations have focused on a potential role for flavivirus cross-reactive antibodies in enhancing ZIKV infection. Antibody-dependent enhancement is especially concerning due to structural similarities between ZIKV and other flaviviruses, especially dengue virus (DENV), that co-circulate in areas affected by ZIKV. Conversely, investigating cross-neutralizing antibodies is important for understanding protection among flaviviruses, including ZIKV. In this review, we discuss the latest findings regarding ZIKV-induced adaptive immunity, such as monoclonal and polyclonal antibody responses, structural immunology, and T cell-mediated responses. Much progress has been made in a short amount of time, but many questions remain. Fully understanding the specificity, magnitude, and kinetics of B cell/antibody and T cell responses in ZIKV-infected individuals with or without prior exposure to flaviviruses is of great relevance for diagnostics and vaccine development.
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Affiliation(s)
- Daniela V Andrade
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, United States.
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Saá P, Proctor M, Foster G, Krysztof D, Winton C, Linnen JM, Gao K, Brodsky JP, Limberger RJ, Dodd RY, Stramer SL. Investigational Testing for Zika Virus among U.S. Blood Donors. N Engl J Med 2018; 378:1778-1788. [PMID: 29742375 DOI: 10.1056/nejmoa1714977] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Because of the potential severe clinical consequences of Zika virus (ZIKV) infection, the large numbers of asymptomatic travelers returning from ZIKV-active areas, the detection of ZIKV nucleic acid in blood, and reports of transmission of ZIKV through transfusion, in 2016 the Food and Drug Administration released recommendations for individual-unit nucleic acid testing to minimize the risk of transmission of ZIKV through blood transfusions. METHODS The American Red Cross implemented investigational screening of donated blood for ZIKV RNA by means of transcription-mediated amplification (TMA). Confirmatory testing of reactive donations involved repeat TMA, TMA testing in exploratory minipools, real-time reverse-transcriptase polymerase chain reaction, IgM serologic testing, and red-cell TMA. Viral loads in plasma and red cells were estimated by means of end-point TMA. The costs of interdicting a donation that was confirmed to be positive were calculated for the 15-month period between June 2016 and September 2017. RESULTS Of the 4,325,889 donations that were screened, 393,713 (9%) were initially tested in 24,611 minipools, and no reactive donations were found. Of the 3,932,176 donations that were subsequently tested individually, 160 were initially reactive and 9 were confirmed positive (a 1:480,654 confirmed-positive rate overall; positive predictive value, 5.6%; specificity, 99.997%). Six (67%) of the confirmed-positive donations were reactive on repeat TMA, of which 4 were IgM-negative; of these 4, all 3 that could be tested were reactive on minipool TMA. Two confirmed-positive donors had infections that had been transmitted locally (in Florida), 6 had traveled to ZIKV-active areas, and 1 had received an experimental ZIKV vaccine. ZIKV RNA levels in red cells ranged from 40 to 800,000 copies per milliliter and were detected up to 154 days after donation, as compared with 80 days of detection in plasma at levels of 12 to 20,000 copies per milliliter. On the basis of industry-reported costs of testing and the yield of the tests in our study, the cost of identifying 8 mosquito-borne ZIKV infections through individual-unit nucleic acid testing was $5.3 million per ZIKV RNA-positive donation. CONCLUSIONS Screening of U.S. blood donations for ZIKV by individual-donation TMA was costly and had a low yield. Among the 9 confirmed ZIKV-positive donations, only 4 were IgM-negative; of these donations, all 3 that were tested were reactive on minipool TMA. (Funded by the American Red Cross and Grifols Diagnostic Solutions.).
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Affiliation(s)
- Paula Saá
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Melanie Proctor
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Gregory Foster
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - David Krysztof
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Colleen Winton
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Jeffrey M Linnen
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Kui Gao
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Jaye P Brodsky
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Ronald J Limberger
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Roger Y Dodd
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Susan L Stramer
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
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Gaburro J, Bhatti A, Harper J, Jeanne I, Dearnley M, Green D, Nahavandi S, Paradkar PN, Duchemin JB. Neurotropism and behavioral changes associated with Zika infection in the vector Aedes aegypti. Emerg Microbes Infect 2018; 7:68. [PMID: 29691362 PMCID: PMC5915379 DOI: 10.1038/s41426-018-0069-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/23/2018] [Accepted: 03/20/2018] [Indexed: 12/31/2022]
Abstract
Understanding Zika virus infection dynamics is essential, as its recent emergence revealed possible devastating neuropathologies in humans, thus causing a major threat to public health worldwide. Recent research allowed breakthrough in our understanding of the virus and host pathogenesis; however, little is known on its impact on its main vector, Aedes aegypti. Here we show how Zika virus targets Aedes aegypti’s neurons and induces changes in its behavior. Results are compared to dengue virus, another flavivirus, which triggers a different pattern of behavioral changes. We used microelectrode array technology to record electrical spiking activity of mosquito primary neurons post infections and discovered that only Zika virus causes an increase in spiking activity of the neuronal network. Confocal microscopy also revealed an increase in synapse connections for Zika virus-infected neuronal networks. Interestingly, the results also showed that mosquito responds to infection by overexpressing glutamate regulatory genes while maintaining virus levels. This neuro-excitation, possibly via glutamate, could contribute to the observed behavioral changes in Zika virus-infected Aedes aegypti females. This study reveals the importance of virus-vector interaction in arbovirus neurotropism, in humans and vector. However, it appears that the consequences differ in the two hosts, with neuropathology in human host, while behavioral changes in the mosquito vector that may be advantageous to the virus.
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Affiliation(s)
- Julie Gaburro
- CSIRO Health and Biosecurity, Australian Animal Health Laboratory, Geelong, Australia.,Deakin University, Institute for Intelligent Systems Research and Innovation (IISRI), Geelong, Australia
| | - Asim Bhatti
- Deakin University, Institute for Intelligent Systems Research and Innovation (IISRI), Geelong, Australia
| | - Jenni Harper
- CSIRO Health and Biosecurity, Australian Animal Health Laboratory, Geelong, Australia
| | | | - Megan Dearnley
- CSIRO Health and Biosecurity, Australian Animal Health Laboratory, Geelong, Australia
| | - Diane Green
- CSIRO Health and Biosecurity, Australian Animal Health Laboratory, Geelong, Australia
| | - Saeid Nahavandi
- Deakin University, Institute for Intelligent Systems Research and Innovation (IISRI), Geelong, Australia
| | - Prasad N Paradkar
- CSIRO Health and Biosecurity, Australian Animal Health Laboratory, Geelong, Australia
| | - Jean-Bernard Duchemin
- CSIRO Health and Biosecurity, Australian Animal Health Laboratory, Geelong, Australia.
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Araújo PSRD, Silva Júnior MLDM, Tenório M, Santos FGTD. Co-infection ZIKV and HSV-1 associated with meningoencephalitis: Case report and literature review. J Infect Public Health 2018; 12:97-100. [PMID: 29703710 DOI: 10.1016/j.jiph.2018.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/15/2018] [Accepted: 04/08/2018] [Indexed: 10/17/2022] Open
Abstract
A man, 26years-old, presented fever, mental confusion and a progressively worsening headache 6days prior to admission. The CSF study was suggestive of meningoencephalitis, the PCR study revealed presence of HSV-1 and ZIKV, while other immunology tests were negative. ZIKV was also identified in serum. The MRI showed temporal lobe hyper-intensity in FLAIR-weight sequence with areas of contrast enhancement and the electroencephalogram showed slow wave activity in such region. Patient was treated with acyclovir and supportive measures and had good clinical outcome at evaluation after 6 months. Neurological spectrum of ZIKV manifestations is wide, but meningoencephalitis is not frequent. Co-infection HSV-1 plus ZIKV was not yet related in humans, but there is increased cellular damage caused by association of ZIKV and herpes virus family infection. ZIKV may facilitate infection or recrudescence by other viruses or cause concurrently neuronal injury by direct or indirect mechanisms. We suggest that clinicians attempt new manifestations related to ZIKV and include this agent in differential diagnosis of neurological diseases even when other agents were identified.
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Affiliation(s)
- Paulo S Ramos de Araújo
- Instituto Aggeu Magalhaes, Fiocruz, Recife, Pernambuco, Brazil; Universidade Federal de Pernambuco, Departamento de Medicina Tropical, Recife, Pernambuco, Brazil
| | | | - Marli Tenório
- Instituto Aggeu Magalhaes, Fiocruz, Recife, Pernambuco, Brazil
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Acosta-Ampudia Y, Monsalve DM, Castillo-Medina LF, Rodríguez Y, Pacheco Y, Halstead S, Willison HJ, Anaya JM, Ramírez-Santana C. Autoimmune Neurological Conditions Associated With Zika Virus Infection. Front Mol Neurosci 2018; 11:116. [PMID: 29695953 PMCID: PMC5904274 DOI: 10.3389/fnmol.2018.00116] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/26/2018] [Indexed: 12/20/2022] Open
Abstract
Zika virus (ZIKV) is an emerging flavivirus rapidly spreading throughout the tropical Americas. Aedes mosquitoes is the principal way of transmission of the virus to humans. ZIKV can be spread by transplacental, perinatal, and body fluids. ZIKV infection is often asymptomatic and those with symptoms present minor illness after 3 to 12 days of incubation, characterized by a mild and self-limiting disease with low-grade fever, conjunctivitis, widespread pruritic maculopapular rash, arthralgia and myalgia. ZIKV has been linked to a number of central and peripheral nervous system injuries such as Guillain-Barré syndrome (GBS), transverse myelitis (TM), meningoencephalitis, ophthalmological manifestations, and other neurological complications. Nevertheless, mechanisms of host-pathogen neuro-immune interactions remain incompletely elucidated. This review provides a critical discussion about the possible mechanisms underlying the development of autoimmune neurological conditions associated with Zika virus infection.
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Affiliation(s)
- Yeny Acosta-Ampudia
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Diana M Monsalve
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Luis F Castillo-Medina
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Yhojan Rodríguez
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Yovana Pacheco
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Susan Halstead
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Hugh J Willison
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Carolina Ramírez-Santana
- Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
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Kuszpit K, Hollidge BS, Zeng X, Stafford RG, Daye S, Zhang X, Basuli F, Golden JW, Swenson RE, Smith DR, Bocan TM. [ 18F]DPA-714 PET Imaging Reveals Global Neuroinflammation in Zika Virus-Infected Mice. Mol Imaging Biol 2018; 20:275-283. [PMID: 28900831 PMCID: PMC5862915 DOI: 10.1007/s11307-017-1118-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE The association of Zika virus (ZIKV) infection and development of neurological sequelae require a better understanding of the pathogenic mechanisms causing severe disease. The purpose of this study was to evaluate the ability and sensitivity of positron emission tomography (PET) imaging using [18F]DPA-714, a translocator protein (TSPO) 18 kDa radioligand, to detect and quantify neuroinflammation in ZIKV-infected mice. PROCEDURES We assessed ZIKV-induced pathogenesis in wild-type C57BL/6 mice administered an antibody to inhibit type I interferon (IFN) signaling. [18F]DPA-714 PET imaging was performed on days 3, 6, and 10 post-infection (PI), and tissues were subsequently processed for histological evaluation, quantification of microgliosis, and detection of viral RNA by in situ hybridization (ISH). RESULTS In susceptible ZIKV-infected mice, viral titers in the brain increased from days 3 to 10 PI. Over this span, these mice showed a two- to sixfold increase in global brain neuroinflammation using [18F]DPA-714 PET imaging despite limited, regional detection of viral RNA. No measurable increase in ionized calcium binding adaptor molecule 1 (Iba-1) expression was noted at day 3 PI; however, there was a modest increase at day 6 PI and an approximately significant fourfold increase in Iba-1 expression at day 10 PI in the susceptible ZIKV-infected group relative to controls. CONCLUSIONS The results of the current study demonstrate that global neuroinflammation plays a significant role in the progression of ZIKV infection and that [18F]DPA-714 PET imaging is a sensitive tool relative to histology for the detection of neuroinflammation. [18F]DPA-714 PET imaging may be useful in dynamically characterizing the pathology associated with neurotropic viruses and the evaluation of therapeutics being developed for treatment of infectious diseases.
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Affiliation(s)
- Kyle Kuszpit
- Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA
| | - Bradley S Hollidge
- Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA
| | - Xiankun Zeng
- Pathology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA
| | - Robert G Stafford
- Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA
| | - Sharon Daye
- Pathology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA
| | - Xiang Zhang
- Imaging Probe Development Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 9800 Medical Center Drive, Bldg. B., #2034, Bethesda, MD, 20892, USA
| | - Falguni Basuli
- Imaging Probe Development Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 9800 Medical Center Drive, Bldg. B., #2034, Bethesda, MD, 20892, USA
| | - Joseph W Golden
- Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA
| | - Rolf E Swenson
- Imaging Probe Development Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 9800 Medical Center Drive, Bldg. B., #2034, Bethesda, MD, 20892, USA
| | - Darci R Smith
- Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA.
| | - Thomas M Bocan
- Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425, Porter St., Ft. Detrick, Frederick, MD, 21702, USA.
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Pastula DM, Durrant JC, Smith DE, Beckham JD, Tyler KL. Zika Virus Disease for the Neurointensivist. Neurocrit Care 2018; 26:457-463. [PMID: 27995511 DOI: 10.1007/s12028-016-0333-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Zika virus (ZIKV) is a mosquito-borne and sexually transmitted flavivirus currently spreading throughout the Pacific and Western Hemisphere. ZIKV infection is often either asymptomatic or causes a self-limiting illness with symptoms such as rash, fever, myalgia, arthralgia, headache, or conjunctivitis. Rarely, ZIKV infection has been associated with conditions such as severe thrombocytopenia, microcephaly and other developmental abnormalities, acute polyneuropathy/Guillain-Barré syndrome, myelitis, meningoencephalitis, transient encephalopathy, provoked seizures, and various ophthalmologic conditions. Optimal treatment of these ZIKV-associated conditions is currently unclear and is largely guided by expert opinion or case reports/series. Further studies are needed to establish best treatment practices. This review concentrates on caring by neurointensivists for the patient affected with Zika virus-expected to flare up again in the summer.
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Affiliation(s)
- Daniel M Pastula
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado Denver, 12401 East 17th Avenue, Mailstop L950, Room 486, Aurora, CO, 80045, USA.
| | - Julia C Durrant
- Department of Neurology, Oregon Health and Sciences University, Portland, OR, USA
| | - Daniel E Smith
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado Denver, 12401 East 17th Avenue, Mailstop L950, Room 486, Aurora, CO, 80045, USA
| | - J David Beckham
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado Denver, 12401 East 17th Avenue, Mailstop L950, Room 486, Aurora, CO, 80045, USA
| | - Kenneth L Tyler
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado Denver, 12401 East 17th Avenue, Mailstop L950, Room 486, Aurora, CO, 80045, USA
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Abstract
PURPOSE OF REVIEW Zika virus (ZIKV), a mosquito-borne flavivirus, has gained recognition over the past few years as an important new cause of congenital infection. As a result, it is critical that pediatricians understand its epidemiology, clinical presentation, clinical sequelae, and management. RECENT FINDINGS The recent ZIKV epidemiology, clinical presentation of acute infection in children and complications, perinatal infection, and congenital infection will be summarized in this ZIKV review. This will be followed by a brief summary on ZIKV diagnosis, management, treatment, and prevention. SUMMARY The field of clinical research in ZIKV has rapidly evolved over recent months. It is critical that pediatricians continue to stay up-to-date with the continuously evolving understanding of the clinical aspects of ZIKV to ensure optimal identification and management of affected infants and children. Given the recent changes in Centers for Disease Control and Prevention guidelines to limit screening of asymptomatic pregnant women in the United States with possible ZIKV exposure, comprehensive ZIKV clinical knowledge becomes even more crucial.
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Affiliation(s)
- Kristina Adachi
- David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S
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Mehta R, Soares CN, Medialdea-Carrera R, Ellul M, da Silva MTT, Rosala-Hallas A, Jardim MR, Burnside G, Pamplona L, Bhojak M, Manohar R, da Silva GAM, Adriano MV, Brasil P, Nogueira RMR, Dos Santos CC, Turtle L, de Sequeira PC, Brown DW, Griffiths MJ, de Filippis AMB, Solomon T. The spectrum of neurological disease associated with Zika and chikungunya viruses in adults in Rio de Janeiro, Brazil: A case series. PLoS Negl Trop Dis 2018; 12:e0006212. [PMID: 29432457 PMCID: PMC5837186 DOI: 10.1371/journal.pntd.0006212] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/05/2018] [Accepted: 01/04/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND During 2015-16 Brazil experienced the largest epidemic of Zika virus ever reported. This arthropod-borne virus (arbovirus) has been linked to Guillain-Barré syndrome (GBS) in adults but other neurological associations are uncertain. Chikungunya virus has caused outbreaks in Brazil since 2014 but associated neurological disease has rarely been reported here. We investigated adults with acute neurological disorders for Zika, chikungunya and dengue, another arbovirus circulating in Brazil. METHODS We studied adults who had developed a new neurological condition following suspected Zika virus infection between 1st November 2015 and 1st June 2016. Cerebrospinal fluid (CSF), serum, and urine were tested for evidence of Zika, chikungunya, and dengue viruses. RESULTS Of 35 patients studied, 22 had evidence of recent arboviral infection. Twelve had positive PCR or IgM for Zika, five of whom also had evidence for chikungunya, three for dengue, and one for all three viruses. Five of them presented with GBS; seven had presentations other than GBS, including meningoencephalitis, myelitis, radiculitis or combinations of these syndromes. Additionally, ten patients positive for chikungunya virus, two of whom also had evidence for dengue virus, presented with a similar range of neurological conditions. CONCLUSIONS Zika virus is associated with a wide range of neurological manifestations, including central nervous system disease. Chikungunya virus appears to have an equally important association with neurological disease in Brazil, and many patients had dual infection. To understand fully the burden of Zika we must look beyond GBS, and also investigate for other co-circulating arboviruses, particularly chikungunya.
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Affiliation(s)
- Ravi Mehta
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | | | - Raquel Medialdea-Carrera
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Mark Ellul
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Marcus Tulius Texeira da Silva
- Laboratório de Pesquisa em Neuroinfecção, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
- Department of Neurology, Hospital de Clínicas de Niterói, Niterói, Brazil
| | - Anna Rosala-Hallas
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | | | - Girvan Burnside
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Luciana Pamplona
- Department of Neurology, Hospital Geral de Bonsucesso, Rio de Janeiro, Brazil
| | - Maneesh Bhojak
- Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Radhika Manohar
- Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | | | | | - Patricia Brasil
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | | | | | - Lance Turtle
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | | | - David W. Brown
- Influenza Reference Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
- Virus Reference Department, National Infection Service, Public Health England, London, United Kingdom
| | - Michael J. Griffiths
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- Department of Neurology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | | | - Tom Solomon
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
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Abstract
Long known to be endemic in Africa and Southeast Asia and a rare cause of acute febrile illness, Zika virus (ZIKAV) arose from obscurity when an Asian genotype ZIKAV caused an outbreak of mild febrile illness in 2007 in Yap State, Federated States of Micronesia. Subsequent viral spread in the Pacific led to a large outbreak in French Polynesia commencing in 2013. After its recognition in the Americas through March 2017, the Pan American Health Organization has received reports of >750000 suspected and laboratory-confirmed cases of autochthonous ZIKAV transmission. Outbreaks in most countries in the Americas peaked in early to mid-2016. Increased surveillance in several Southeast Asian counties has led to increased case recognition, including an outbreak in Singapore, and the first reports of birth defects linked to ZIKAV in the region. As of April 2017, the World Health Organization reported 84 countries or territories with current or previous ZIKAV transmission.
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Affiliation(s)
- Susan L Hills
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Marc Fischer
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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Mittal R, Nguyen D, Debs LH, Patel AP, Liu G, Jhaveri VM, S. Kay SI, Mittal J, Bandstra ES, Younis RT, Chapagain P, Jayaweera DT, Liu XZ. Zika Virus: An Emerging Global Health Threat. Front Cell Infect Microbiol 2017; 7:486. [PMID: 29276699 PMCID: PMC5727043 DOI: 10.3389/fcimb.2017.00486] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/13/2017] [Indexed: 01/07/2023] Open
Abstract
Zika virus (ZIKV) is an emerging healthcare threat. The presence of the mosquito Aedes species across South and Central America in combination with complementary climates have incited an epidemic of locally transmitted cases of ZIKV infection in Brazil. As one of the most significant current public health concerns in the Americas, ZIKV epidemic has been a cause of alarm due to its known and unknown complications. At this point, there has been a clear association between ZIKV infection and severe clinical manifestations in both adults and neonates, including but not limited to neurological deficits such as Guillain-Barré syndrome (GBS) and microcephaly, respectively. The gravity of the fetal anomalies linked to ZIKV vertical transmission from the mother has prompted a discussion on whether to include ZIKV as a formal member of the TORCH [Toxoplasma gondii, other, rubella virus, cytomegalovirus (CMV), and herpes] family of pathogens known to breach placental barriers and cause congenital disease in the fetus. The mechanisms of these complex phenotypes have yet to be fully described. As such, diagnostic tools are limited and no effective modalities are available to treat ZIKV. This article will review the recent advancements in understanding the pathogenesis of ZIKV infection as well as diagnostic tests available to detect the infection. Due to the increase in incidence of ZIKV infections, there is an immediate need to develop new diagnostic tools and novel preventive as well as therapeutic modalities based on understanding the molecular mechanisms underlying the disease.
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Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States,*Correspondence: Rahul Mittal
| | - Desiree Nguyen
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Luca H. Debs
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Amit P. Patel
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - George Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Vasanti M. Jhaveri
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Sae-In S. Kay
- Department of Surgery, Division of Otorhinolaryngology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Jeenu Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Emmalee S. Bandstra
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ramzi T. Younis
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States,Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States,Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Prem Chapagain
- Department of Physics and Biomolecular Sciences Institute, Florida International University, Miami, FL, United States
| | - Dushyantha T. Jayaweera
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Xue Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States,Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States,Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States,Xue Zhong Liu
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Sariol CA, Nogueira ML, Vasilakis N. A Tale of Two Viruses: Does Heterologous Flavivirus Immunity Enhance Zika Disease? Trends Microbiol 2017; 26:186-190. [PMID: 29122447 PMCID: PMC6530781 DOI: 10.1016/j.tim.2017.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/05/2017] [Accepted: 10/17/2017] [Indexed: 01/01/2023]
Abstract
The rise of Zika virus (ZIKV) and its unusual clinical manifestations provided ground for speculative debate. The clinical severity of secondary dengue virus (DENV) infections is associated with antibody-dependent enhancement (ADE), and it was recently suggested that previous exposure to DENV may worsen ZIKV clinical outcomes. In this Opinion article we analyze the relationship among different flaviviruses and ADE. We discuss new evidence obtained in non-human primates and human cohorts demonstrating that there is no correlation to ADE when ZIKV infection occurs in the presence of pre-existing DENV immunity. We propose a redefinition of ADE in the context of complex immunological flavivirus interactions to provide a more objective perspective when translating in vitro or in vivo observations into the clinical setting. Zika virus (ZIKV) caused atypical clinical manifestations in areas with previous exposure to other flaviruses. Different dengue–ZIKV cross-reacting antibodies neutralize or enhance ZIKV in vitro, but the percentage of dengue immune serum neutralizing ZIKV is very low. Antibody-dependent enhancement (ADE) of ZIKV by dengue and West Nile immune sera has been shown in vitro and induced in immunosuppressed mice by dengue and West Nile immune sera. No ADE of ZIKV by previous dengue immunity was detected in non-human primates. No ADE of ZIKV was documented in a human cohort previously exposed to dengue. ADE needs to be redefined in the context of clinical outcomes. In vitro and experimental results in small animals need to be carefully weighed when translating results to humans. Prospective epidemiological and clinical studies are needed to reassure that previous exposure to dengue or other flaviviruses does not increase the pathogenesis of ZIKV.
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Affiliation(s)
- Carlos A Sariol
- Unit of Comparative Medicine, Caribbean Primate Research Center, University of Puerto Rico - Medical Sciences Campus, San Juan, PR, USA; Department of Microbiology and Medical Zoology, University of Puerto Rico - Medical Sciences Campus, San Juan, PR, USA; Department of Internal Medicine, University of Puerto Rico - Medical Sciences Campus, San Juan, PR, USA.
| | | | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA; Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, TX, USA; Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, USA; Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.
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40
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da Silva IRF, Frontera JA, Bispo de Filippis AM, Nascimento OJMD. Neurologic Complications Associated With the Zika Virus in Brazilian Adults. JAMA Neurol 2017; 74:1190-1198. [PMID: 28806453 DOI: 10.1001/jamaneurol.2017.1703] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Importance There are no prospective cohort studies assessing the incidence and spectrum of neurologic manifestations secondary to Zika virus (ZIKV) infection in adults. Objective To evaluate the rates of acute ZIKV infection among patients hospitalized with Guillain-Barré syndrome (GBS), meningoencephalitis, or transverse myelitis. Design, Setting, and Participants A prospective, observational cohort study was conducted at a tertiary referral center for neurological diseases in Rio de Janeiro, Brazil, between December 5, 2015, and May 10, 2016, among consecutive hospitalized adults (>18 years of age) with new-onset acute parainfectious or neuroinflammatory disease. All participants were tested for a series of arbovirosis. Three-month functional outcome was assessed. Interventions Samples of serum and cerebrospinal fluid were tested for ZIKV using real-time reverse-transcriptase-polymerase chain reaction and an IgM antibody-capture enzyme-linked immunosorbent assay. Clinical, radiographic (magnetic resonance imaging), electrophysiological, and 3-month functional outcome data were collected. Main Outcomes and Measures The detection of neurologic complications secondary to ZIKV infection. Results Forty patients (15 women and 25 men; median age, 44 years [range, 22-72 years]) were enrolled, including 29 patients (73%) with GBS (90% Brighton level 1 certainty), 7 (18%) with encephalitis, 3 (8%) with transverse myelitis, and 1 (3%) with newly diagnosed chronic inflammatory demyelinating polyneuropathy. Of these, 35 patients (88%) had molecular and/or serologic evidence of recent ZIKV infection in the serum and/or cerebrospinal fluid. Of the patients positive for ZIKV infection, 27 had GBS (18 demyelinating, 8 axonal, and 1 Miller Fisher syndrome), 5 had encephalitis (3 with concomitant acute neuromuscular disease), 2 had transverse myelitis, and 1 had chronic inflammatory demyelinating polyneuropathy. Admission to the intensive care unit was required for 9 patients positive for ZIKV infection (26%), and 5 (14%) required mechanical ventilation. Compared with admission during the period from December 5, 2013, to May 10, 2014 (before the Brazilian outbreak of ZIKV), admissions for GBS increased from a mean of 1.0 per month to 5.6 per month, admissions for encephalitis increased from 0.4 per month to 1.4 per month, and admissions for transverse myelitis remained constant at 0.6 per month. At 3 months, 2 patients positive for ZIKV infection (6%) died (1 with GBS and 1 with encephalitis), 18 (51%) had chronic pain, and the median modified Rankin score among survivors was 2 (range, 0-5). Conclusions and Relevance In this single-center Brazilian cohort, ZIKV infection was associated with an increase in the incidence of a diverse spectrum of serious neurologic syndromes. The data also suggest that serologic and molecular testing using blood and cerebrospinal fluid samples can serve as a less expensive, alternative diagnostic strategy in developing countries, where plaque reduction neutralization testing is impractical.
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Affiliation(s)
- Ivan Rocha Ferreira da Silva
- Neurology Department, Universidade Federal Fluminense, Niteroi, Brazil.,Neurocritical Care Department, Americas Medical City, Rio de Janeiro, Brazil
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41
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Abrams RPM, Solis J, Nath A. Therapeutic Approaches for Zika Virus Infection of the Nervous System. Neurotherapeutics 2017; 14:1027-1048. [PMID: 28952036 PMCID: PMC5722777 DOI: 10.1007/s13311-017-0575-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Zika virus has spread rapidly in the Americas and has caused devastation of human populations affected in these regions. The virus causes teratogenic effects involving the nervous system, and in adults and children can cause a neuropathy similar to Guillain-Barré syndrome, an anterior myelitis, or, rarely, an encephalitis. While major efforts have been undertaken to control mosquito populations that spread the virus and to develop a vaccine, drug development that directly targets the virus in an infected individual to prevent or treat the neurological manifestations is necessary. Rational and targeted drug development is possible since the viral life cycle and the structure of the key viral proteins are now well understood. While several groups have identified therapeutic candidates, their approaches differ in the types of screening processes and viral assays used. Animal studies are available for only a few compounds. Here we provide an exhaustive review and compare each of the classes of drugs discovered, the methods used for drug discovery, and their potential use in humans for the prevention or treatment of neurological complications of Zika virus infection.
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Affiliation(s)
- Rachel P M Abrams
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jamie Solis
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Avindra Nath
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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42
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Saiz JC, Martín-Acebes MA, Bueno-Marí R, Salomón OD, Villamil-Jiménez LC, Heukelbach J, Alencar CH, Armstrong PK, Ortiga-Carvalho TM, Mendez-Otero R, Rosado-de-Castro PH, Pimentel-Coelho PM. Zika Virus: What Have We Learnt Since the Start of the Recent Epidemic? Front Microbiol 2017; 8:1554. [PMID: 28878742 PMCID: PMC5572254 DOI: 10.3389/fmicb.2017.01554] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/31/2017] [Indexed: 01/03/2023] Open
Abstract
Zika is a viral disease transmitted mainly by mosquitoes of the genus Aedes. In recent years, it has expanded geographically, changing from an endemic mosquito-borne disease across equatorial Asia and Africa, to an epidemic disease causing large outbreaks in several areas of the world. With the recent Zika virus (ZIKV) outbreaks in the Americas, the disease has become a focus of attention of public health agencies and of the international research community, especially due to an association with neurological disorders in adults and to the severe neurological and ophthalmological abnormalities found in fetuses and newborns of mothers exposed to ZIKV during pregnancy. A large number of studies have been published in the last 3 years, revealing the structure of the virus, how it is transmitted and how it affects human cells. Many different animal models have been developed, which recapitulate several features of ZIKV disease and its neurological consequences. Moreover, several vaccine candidates are now in active preclinical development, and three of them have already entered phase I clinical trials. Likewise, many different compounds targeting viral and cellular components are being tested in in vitro and in experimental animal models. This review aims to discuss the current state of this rapidly growing literature from a multidisciplinary perspective, as well as to present an overview of the public health response to Zika and of the perspectives for the prevention and treatment of this disease.
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Affiliation(s)
- Juan-Carlos Saiz
- Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y AlimentariaMadrid, Spain
| | - Miguel A. Martín-Acebes
- Department of Biotechnology, Instituto Nacional de Investigación y Tecnología Agraria y AlimentariaMadrid, Spain
| | - Rubén Bueno-Marí
- Departamento de Investigación y Desarrollo (I+D), Laboratorios LokímicaValencia, Spain
| | | | | | - Jorg Heukelbach
- Department of Community Health, School of Medicine, Federal University of CearáFortaleza, Brazil
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, TownsvilleQLD, Australia
| | - Carlos H. Alencar
- Department of Community Health, School of Medicine, Federal University of CearáFortaleza, Brazil
| | - Paul K. Armstrong
- Communicable Disease Control Directorate, Western Australia Department of Health, PerthWA, Australia
| | - Tania M. Ortiga-Carvalho
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
| | - Rosalia Mendez-Otero
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
| | - Paulo H. Rosado-de-Castro
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
- Instituto D’Or de Pesquisa e EnsinoRio de Janeiro, Brazil
| | - Pedro M. Pimentel-Coelho
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de JaneiroRio de Janeiro, Brazil
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43
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De Broucker T, Mailles A, Stahl JP. Neurological Presentation of Zika Virus Infection Beyond the Perinatal Period. Curr Infect Dis Rep 2017; 19:35. [PMID: 28815404 DOI: 10.1007/s11908-017-0590-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Our purpose was to summarize the current knowledge about the neurological presentation of Zika virus infection after the perinatal period. Other Flaviviruses infections, such as West Nile virus (WNV) or Japanese encephalitis virus (JEV), can result in neuro-invasive disease such as myelitis, encephalitis, or meningitis. We aimed at describing the specificities of ZV neurological infection. RECENT FINDINGS The recent outbreaks demonstrated clearly the neurotropism of ZV. However, by contrast with other Flaviviruses, the most frequent neurological presentation of ZV infection beyond the perinatal period was Guillain-Barré syndrome, especially the demyelination form of GBS. Encephalitis and myelitis seem to occur less frequently after ZV infection than after WNV or JEV infection. The pathophysiology of neurological ZV infections is still poorly understood and no specific treatment is available. Moreover, no data is available about long-term persisting symptoms and possible impairment of patients after the acute clinical episode.
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Affiliation(s)
- Thomas De Broucker
- Neurology, Centre Hospitalier de Saint-Denis, 93200, Saint-Denis, France
| | | | - Jean-Paul Stahl
- Infectious Diseases and Tropical Medicine, University hospital, 38700, Grenoble, France
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44
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Doughty CT, Yawetz S, Lyons J. Emerging Causes of Arbovirus Encephalitis in North America: Powassan, Chikungunya, and Zika Viruses. Curr Neurol Neurosci Rep 2017; 17:12. [PMID: 28229397 DOI: 10.1007/s11910-017-0724-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Arboviruses are arthropod-borne viruses transmitted by the bite of mosquitoes, ticks, or other arthropods. Arboviruses are a common and an increasing cause of human illness in North America. Powassan virus, Chikungunya virus, and Zika virus are arboviruses that have all recently emerged as increasing causes of neurologic illness. Powassan virus almost exclusively causes encephalitis, but cases are rare, sporadic, and restricted to portions of North America and Russia. Chikungunya virus has spread widely across the world, causing millions of infections. Encephalitis is a rare manifestation of illness but is more common and severe in neonates and older adults. Zika virus has recently spread through much of the Americas and has been associated mostly with microcephaly and other congenital neurologic complications. Encephalitis occurring in infected adults has also been recently reported. This review will discuss the neuropathogenesis of these viruses, their transmission and geographic distribution, the spectrum of their neurologic manifestations, and the appropriate method of diagnosis.
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Affiliation(s)
- Christopher T Doughty
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Division of Neurological Infections and Inflammatory Diseases, Department of Neurology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, USA
| | - Sigal Yawetz
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Disease, Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Jennifer Lyons
- Division of Neurological Infections and Inflammatory Diseases, Department of Neurology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA, 02115, USA. .,Harvard Medical School, Boston, MA, USA.
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45
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[Zika virus infection: A review]. Ann Dermatol Venereol 2017; 144:518-524. [PMID: 28673675 DOI: 10.1016/j.annder.2017.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 02/07/2017] [Accepted: 05/12/2017] [Indexed: 11/23/2022]
Abstract
Zika Virus (ZIKV), originally identified in 1947, is a re-emerging Flavivirus transmitted mainly through bites by Aedes mosquitos. Until the recent outbreaks in the Pacific islands and Central and South America, it was known to cause benign disease, in most cases asymptomatic or with mild and nonspecific symptoms (fever, rash, conjunctivitis, arthralgia, etc.). The unprecedented current epidemic has highlighted new modes of transmission (through blood, perinatally and sexually) as well as serious neurological complications such as congenital defects in the fetuses of infected mothers and Guillain-Barre syndrome in adults. This situation, coupled with the threat of worldwide spread, prompted the WHO to declare the ZIKV a public health emergency of international concern in February 2016.
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46
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Abstract
Zika virus was considered an innocent pathogen while restricted to the African and Asian population; however, after reaching the Americas in March 2015, it became a global threat. Despite usually causing mild or no symptoms in infected adults, Zika virus displays a different behavior toward fetuses. When infected during gestation, fetuses have their immature neural cells killed by the virus and consequently have devastating findings at birth. In the past year the drastic effects of Zika virus infection in newborns include neurological, ophthalmological, audiological, and skeletal abnormalities. These findings represent a new entity called congenital Zika syndrome. We summarize the ocular findings of congenital Zika Syndrome, as well as the current understanding of the illness, systemic manifestations, laboratory investigation, differential diagnosis, prophylaxis, and treatment for this disorder.
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47
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Puccioni-Sohler M, Roveroni N, Rosadas C, Ferry F, Peralta JM, Tanuri A. Dengue infection in the nervous system: lessons learned for Zika and Chikungunya. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:123-126. [PMID: 28226083 DOI: 10.1590/0004-282x20160189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 10/10/2016] [Indexed: 01/08/2023]
Abstract
Dengue, Zika and Chikungunya are emerging arboviruses and important causes of acute febrile disease in tropical areas. Although dengue does not represent a new condition, a geographic expansion over time has occurred with the appearance of severe neurological complications. Neglect has allowed the propagation of the vector (Aedes spp), which is also responsible for the transmission of other infections such as Zika and Chikungunya throughout the world. The increased number of infected individuals has contributed to the rise of neurological manifestations including encephalitis, myelitis, meningitis, Guillain-Barré syndrome and congenital malformations such as microcephaly. In this narrative review, we characterize the impact of the geographic expansion of the vector on the appearance of neurological complications, and highlight the lack of highly accurate laboratory tests for nervous system infections. This represents a challenge for public health in the world, considering the high number of travelers and people living in endemic areas.
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Affiliation(s)
- Marzia Puccioni-Sohler
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Escola de Medicina e Cirurgia, Hospital Universitário Gaffree e Guinle, Rio de Janeiro RJ, Brasil.,Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Pós-graduação em Doenças Infecciosas e Parasitárias, Rio de Janeiro RJ, Brasil
| | - Natalia Roveroni
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Escola de Medicina e Cirurgia, Hospital Universitário Gaffree e Guinle, Rio de Janeiro RJ, Brasil
| | - Carolina Rosadas
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Pós-graduação em Doenças Infecciosas e Parasitárias, Rio de Janeiro RJ, Brasil
| | - Fernando Ferry
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Escola de Medicina e Cirurgia, Hospital Universitário Gaffree e Guinle, Rio de Janeiro RJ, Brasil
| | - Jose Mauro Peralta
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Microbiologia Professor Paulo de Góes, Rio de Janeiro RJ, Brasil
| | - Amilcar Tanuri
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Biologia, Rio de Janeiro RJ, Brasil
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48
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Mailles A, Stahl JP, Bloch KC. Update and new insights in encephalitis. Clin Microbiol Infect 2017; 23:607-613. [PMID: 28501667 DOI: 10.1016/j.cmi.2017.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/30/2017] [Accepted: 05/01/2017] [Indexed: 01/17/2023]
Abstract
Infectious encephalitis is a rare but severe medical condition resulting from direct invasion of the brain by viruses, bacteria, fungi or parasites, or indirect post-infectious immune or inflammatory disorders when the infectious agent does not cross the blood-brain barrier. Infectious encephalitis cases represent an interesting and accurate sentinel to follow up on trends in infectious diseases or to detect emerging infections. Using Pubmed and Embase, we searched the most relevant publications over the last years. We present here an update on the important findings and new data recently published about infectious encephalitis.
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Affiliation(s)
- A Mailles
- Santé publique France, Saint-Maurice, France; ESCMID Study Group on infections of the Brain.
| | - J-P Stahl
- ESCMID Study Group on infections of the Brain; Joseph Fourier University, University Hospital, Grenoble, France
| | - K C Bloch
- Vanderbilt University Medical Center, Nashville, TN, USA
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49
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Kawiecki AB, Mayton EH, Dutuze MF, Goupil BA, Langohr IM, Del Piero F, Christofferson RC. Tissue tropisms, infection kinetics, histologic lesions, and antibody response of the MR766 strain of Zika virus in a murine model. Virol J 2017; 14:82. [PMID: 28420392 PMCID: PMC5395720 DOI: 10.1186/s12985-017-0749-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/07/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The appearance of severe Zika virus (ZIKV) disease in the most recent outbreak has prompted researchers to respond through the development of tools to quickly characterize transmission and pathology. We describe here another such tool, a mouse model of ZIKV infection and pathogenesis using the MR766 strain of virus that adds to the growing body of knowledge regarding ZIKV kinetics in small animal models. METHODS We infected mice with the MR766 strain of ZIKV to determine infection kinetics via serum viremia. We further evaluated infection-induced lesions via histopathology and visualized viral antigen via immunohistochemical labeling. We also investigated the antibody response of recovered animals to both the MR766 and a strain from the current outbreak (PRVABC59). RESULTS We demonstrate that the IRF3/7 DKO mouse is a susceptible, mostly non-lethal model well suited for the study of infection kinetics, pathological progression, and antibody response. Infected mice presented lesions in tissues that have been associated with ZIKV infection in the human population, such as the eyes, male gonads, and central nervous system. In addition, we demonstrate that infection with the MR766 strain produces cross-neutralizing antibodies to the PRVABC59 strain of the Asian lineage. CONCLUSIONS This model provides an additional tool for future studies into the transmission routes of ZIKV, as well as for the development of antivirals and other therapeutics, and should be included in the growing list of available tools for investigations of ZIKV infection and pathogenesis.
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Affiliation(s)
- Anna B Kawiecki
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - E Handly Mayton
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - M Fausta Dutuze
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Brad A Goupil
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Ingeborg M Langohr
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Fabio Del Piero
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Rebecca C Christofferson
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
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50
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Boyer Chammard T, Schepers K, Breurec S, Messiaen T, Destrem AL, Mahevas M, Soulillou A, Janaud L, Curlier E, Herrmann-Storck C, Hoen B. Severe Thrombocytopenia after Zika Virus Infection, Guadeloupe, 2016. Emerg Infect Dis 2017; 23:696-698. [PMID: 27997330 PMCID: PMC5367410 DOI: 10.3201/eid2304.161967] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Severe thrombocytopenia during or after the course of Zika virus infection has been rarely reported. We report 7 cases of severe thrombocytopenia and hemorrhagic signs and symptoms in Guadeloupe after infection with this virus. Clinical course and laboratory findings strongly suggest a causal link between Zika virus infection and immune-mediated thrombocytopenia.
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