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The objective of the study was to describe the complexity of diagnosis and evaluation of Zika-exposed pregnant women/fetuses and infants in a U.S. Congenital Zika Program. Pregnant women/fetuses and/or infants referred for clinical evaluation to the Congenital Zika Program at Children’s National (Washington, DC) from January 2016 to June 2018 were included. We recorded the timing of maternal Zika-virus (ZIKV) exposure and ZIKV laboratory testing results. Based on laboratory testing, cases were either confirmed, possible, or unlikely ZIKV infection. Prenatal and postnatal imaging by ultrasound and/or magnetic resonance imaging (MRI) were categorized as normal, nonspecific, or as findings of congenital Zika syndrome (CZS). Of 81 women–fetus/infant pairs evaluated, 72 (89%) had confirmed ZIKV exposure; 18% of women were symptomatic; only a minority presented for evaluation within the time frame for laboratory detection. Zika virus could only be confirmed in 29 (40%) cases, was possible in 26 (36%) cases, and was excluded in 17 (24%) cases. Five cases (7%) had prenatal ultrasound and MRI findings of CZS, but in only three was ZIKV confirmed by laboratory testing. Because of timing of exposure to presentation, ZIKV infection could not be excluded in many cases. Neuroimaging found CZS in 7% of cases, and in many patients, there were nonspecific imaging findings that warrant long-term follow-up. Overall, adherence to postnatal recommended follow-up evaluations was modest, representing a barrier to care. These challenges may be instructive to future pediatric multidisciplinary clinics for congenital infectious/noninfectious threats to pregnant women and their infants.

The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase–PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3–77.7%) risk of HC more than three SDs below the mean.

Zika virus (ZIKV) has emerged as a particularly notorious mosquito-borne flavivirus, which can lead to a devastating congenital syndrome in the fetuses of pregnant mothers (e.g., microcephaly, spasticity, craniofacial disproportion, miscarriage, and ocular abnormalities) and cause the autoimmune disorder Guillain-Barre' syndrome of adults. Due to its severity and rapid dispersal over several continents, ZIKV has been acknowledged to be a global health concern by the World Health Organization. Unfortunately, the ZIKV has recently resurged in India with the potential for devastating effects. Researchers from all around the world have worked tirelessly to develop effective detection strategies and vaccines for the prevention and control of ZIKV infection. In this review, we comprehensively summarize the most recent research into ZIKV, including the structural biology and evolution, historical overview, pathogenesis, symptoms, and transmission. We then focus on the detection strategies for ZIKV, including viral isolation, serological assays, molecular assays, sensing methods, reverse transcription loop mediated isothermal amplification, transcription-mediated amplification technology, reverse transcription strand invasion based amplification, bioplasmonic paper-based device, and reverse transcription isothermal recombinase polymerase amplification. To conclude, we examine the limitations of currently available strategies for the detection of ZIKV, and outline future opportunities and research challenges.

Zika virus (ZIKV) is an emerging pathogen associated with neurological complications, such as Guillain-Barré syndrome in adults and microcephaly in fetuses and newborns. This mosquito-borne flavivirus causes important social and sanitary problems owing to its rapid dissemination. However, the development of antivirals against ZIKV is lagging. Although various strategies have been used to study anti-ZIKV agents, approved drugs or vaccines for the treatment (or prevention) of ZIKV infections are currently unavailable. Repurposing clinically approved drugs could be an effective approach to quickly respond to an emergency outbreak of ZIKV infections. The well-established safety profiles and optimal dosage of these clinically approved drugs could provide an economical, safe, and efficacious approach to address ZIKV infections. This review focuses on the recent research and development of agents against ZIKV infection by repurposing clinical drugs. Their characteristics, targets, and potential use in anti-ZIKV therapy are presented. This review provides an update and some successful strategies in the search for anti-ZIKV agents are given.

The re-emergence of Zika virus (ZIKV) and its associated neonatal microcephaly and Guillain-Barre syndrome have led the World Health Organization to declare a global health emergency. Until today, many related studies have successively reported the role of various viral proteins of ZIKV in the process of ZIKV infection and pathogenicity. These studies have provided significant insights for the treatment and prevention of ZIKV infection. Here we review the current research advances in the functional characterization of the interactions between each ZIKV viral protein and its host factors.

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.

Background: Zika Virus (ZIKV) is an emerging mosquito-transmitted flavivirus currently causing large epidemics and represents a global public health. Most ZIKV infections in humans are asymptomatic or mild with self-limiting clinical manifestations. Certainty, an available and sustainable surveillance for risk individual groups to ZIKV infection it is necessary and serological methods offer a good alternative.

BACKGROUND The Zika virus (ZIKV) epidemic that began in 2015 presented a risk for ZIKV infection among persons who traveled to ZIKV-affected countries. Latinas in North Carolina and their sexual partners may be exposed to ZIKV when traveling to these regions.METHODS We administered a cross-sectional survey, measuring ZIKV risk and knowledge, to a convenience sample of 262 reproductive-age Latinas attending a Federally Qualified Health Center in rural North Carolina. We described ZIKV risk and knowledge in the sample, and compared responses between those who were pregnant or recently pregnant, and those who were not pregnant. We further identified factors associated with 1) awareness of ZIKV and 2) high knowledge of ZIKV sequelae and prevention among those who were aware of ZIKV, using log-binomial regression.RESULTS Two-thirds of participants had ever heard of ZIKV, which was positively associated with educational attainment. Most participants aware of ZIKV had moderate/high knowledge of ZIKV transmission (92.5%) and symptoms (73.2%), but knowledge of preventing sexual and congenital transmission was limited. Travel was infrequent among pregnant or recently pregnant participants (5.4%) and their partners (7.1%). Despite low risk for ZIKV infection, participants were willing to practice ZIKV prevention.LIMITATIONS Our study is limited by a lack of generalizability to Latinas in other regions of the country, self-reporting bias, and lack of survey validation as an indicator of English language proficiency.CONCLUSIONS Providers should identify patients likely to become pregnant and travel to high-risk areas, inquire about partner travel history, and offer culturally appropriate ZIKV risk counseling.

Made available in DSpace on 2022-04-29T08:45:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Purpose: Studies show that around 80% of Zika virus (ZIKV) infections are asymptomatic. The present study tested urine samples from volunteers, unsuspected of arboviral infection, which attended an emergency care unit (ECU) in Mirassol, Brazil, from March 2018 to April 2019. Methods: The volunteers were divided into two groups. The first group was composed of outpatients who were not suspected to have an arbovirus infection. This first group was subdivided into two subgroups: outpatients with and without arbovirus-like symptoms. The second group consisted of companions of outpatients treated at the ECU. The second group was also subdivided into two subgroups: totally asymptomatic individuals and those who had arbovirus-like symptoms. RNA was extracted from urine samples, followed by RT-qPCR for ZIKV. Results: We found that 11% (79/697) of the samples tested positive for ZIKV-RNA. Among the ZIKV-RNA-positive individuals, 16.5% (13/79) were companions, of which 61.5% (8/13) were totally asymptomatic and 38.5% (5/13) reported symptoms that could be suggestive of arbovirus infection. In addition, 83.5% (66/79) of the ZIKV-RNA-positive individuals were outpatients without a clinical diagnosis of arbovirus. Of these undiagnosed ZIKV-RNA-positive outpatients, 47% (31/66) had no arbovirus-related symptoms. Conclusion: Our study shows the effectiveness of urine as a non-invasive sample to detect the incidence of ZIKV infection. We also highlight the importance of ZIKV molecular diagnosis to aid public health surveillance and prevention of congenital Zika syndrome and other ZIKV-associated diseases. Laboratório de Estudos Genômicos Universidade Estadual Paulista (Unesp) Instituto de Biociências Letras e Ciências Exatas (IBILCE), SP Department of Molecular Biology Faculdade de Medicina de São José do Rio Preto (FAMERP), SP Laboratório de Pesquisas em Virologia (LPV) Faculdade de Medicina de São José do Rio Preto (FAMERP), SP Department of Cardiology and Cardiovascular Surgery Faculdade de Medicina de São José do Rio Preto (FAMERP), SP Laboratório de Estudos Genômicos Universidade Estadual Paulista (Unesp) Instituto de Biociências Letras e Ciências Exatas (IBILCE), Rua Cristóvão Colombo, 2265, SP Laboratório de Estudos Genômicos Universidade Estadual Paulista (Unesp) Instituto de Biociências Letras e Ciências Exatas (IBILCE), SP Laboratório de Estudos Genômicos Universidade Estadual Paulista (Unesp) Instituto de Biociências Letras e Ciências Exatas (IBILCE), Rua Cristóvão Colombo, 2265, SP CAPES: 001 FAPESP: 2014/22198-0 CAPES: 2046/2016 CNPq: 440723/2016-7

The Asian genotype of Zika virus (ZIKV) emerged in Brazil in 2015 and subsequently spread throughout the Americas. In July 2016, Florida experienced its first locally acquired ZIKV infection in the continental U.S. Concerns about health risks from ZIKV infection have increased the need to investigate the interactions between potential mosquito vectors and ZIKV. The time it takes for an arbovirus to propagate within a mosquito, and become transmissible, is the extrinsic incubation period (EIP). The EIP for potential mosquito vectors in Florida is unknown. To address this gap in the understanding of ZIKV epidemiology, Florida Aedes aegypti (L.) and Ae. albopictus (Skuse) were orally exposed to ZIKV infected blood meals and fully engorged mosquitoes were held at a constant temperature of 28 °C through the duration of the experiment. Saliva expectorates were collected from cohorts of mosquitoes and tested for the presence of ZIKV at three-day intervals over a period of 24 days to allow for an evaluation of the EIP of the emergent Asian lineage of ZIKV. High rates of infected bodies in Ae. albopictus (75–94%) and Ae. aegypti (68–86%) were observed throughout the incubation period, which did not differ by species. Higher rates of disseminated infection were observed later during the incubation period but did not differ between species. We calculated the 50% EIP to be shorter in Ae. albopictus than Ae. aegypti (16.2 and 18.2 days post infection, respectively). The competence for ZIKV observed in both species may contribute to high rates of ZIKV transmission in Florida populations.

Although Zika virus (ZIKV) circulates in sub-Saharan Africa, no case of ZIKV-associated microcephaly has thus far been reported. Here, we report evidence of a possible association between a 2007 outbreak of febrile illness and an increase in microcephaly and possibly ZIKV infection in Gabon.

Introduction: While death due to Zika virus (ZIKV) infection has been described, reports of fatal cases have been infrequent and no systematic reviews on the subject have been published. Methods: A systematic review of the literature in four databases was performed to assess fatal outcomes of postnatal ZIKV infection and the available evidence that links ZIKV infection to death. Results: Three hundred and eleven articles were retrieved; 20 of them were epidemiological reports from surveillance agencies and ministries of health. After screening by abstract and title, 59 articles were selected for full-text assessment. Of these, 35 were excluded (with reasons) and 24 were finally included for qualitative analysis. A total of 51 reported deaths associated with ZIKV infection in nine countries were identified. The majority of cases (56.9%) were not related to Guillain–Barré syndrome. Cases from three countries accounted for 67.6% of the deaths. ZIKV infection was laboratory-confirmed in the majority of cases (64.7%). Discussion: ZIKV was not considered to be a dangerous, and much less a lethal pathogen, until very recently. However, an increasing number of fatalities have been published in the literature since the first death was reported in 2016. Additional research is needed to elucidate factors that may mediate the pathogenesis of severe, atypical, and fatal disease. Keywords: Zika, Fatal, Complications, Severe, Epidemiology, Americas

In 2018, the World Health Organization identified the Zika virus (ZIKV) as a pathogen that should be prioritized for public health research due to its epidemic potential. In this study, whole-genome sequencing (WGS) of travel-acquired ZIKV infections was used to examine the limitations of phylogenetic analysis. WGS and phylogenetic analysis were performed to investigate geographic clustering of samples from five Canadians with travel-acquired ZIKV infections and to assess the limitations of phylogenetic analysis of ZIKV sequences using a phylogenetic cluster approach. Genomic variability of ZIKV samples was assessed and for context, compared with hepatitis C virus (HCV) samples. Phylogenetic analysis confirmed the suspected region of ZIKV infection for one of five samples and one sample failed to cluster with sequences from its suspected country of infection. Travel-acquired ZIKV samples depicted low genomic variability relative to HCV samples. A floating patristic distance threshold classified all pre-2000 ZIKV sequences into separate clusters, while only Cambodian, Peruvian, Malaysian, and South Korean sequences were similarly classifiable. While phylogenetic analysis of ZIKV data can identify the broad geographical region of ZIKV infection, ZIKV’s low genomic variability is likely to limit precise interpretations of phylogenetic analysis of the origins of travel-related cases.

Zika virus (ZIKV) is an emerging vector-borne virus that is associated with severe congenital cerebral anomalies in fetuses and paralytic Guillain-Barre syndrome in adults. In the current global health crisis, there are no vaccines or therapeutics available for the treatment of ZIKV infection. In the present study, we evaluated the efficacy of the protoberberine alkaloid, palmatine, in inhibiting ZIKV and Japanese encephalitis virus (JEV). Palmatine was shown to bind to restricted viruses, inhibit ZIKV infection, and resist ZIKV-induced cytopathic effects. Palmatine was also shown to inhibit JEV infection in multiple cell lines. Overall, the effects of palmatine in disrupting ZIKV binding, entry, and stability indicate that this small molecule would be a good starting point for the development of treatments aimed at inhibiting ZIKV infection.

Because Zika virus (ZIKV) can cause serious birth defects and is involved in cases of Guillain-Barre syndrome, the ZIKV outbreak in the American continent in 2015 resulted in an enormous need for ZIKV diagnostic tools. We evaluated the LIAISON® XL Zika Capture IgM test on 106 samples from patients, mainly travelers, with a confirmed or probable ZIKV infection. Sensitivity between 0 and 84 days after onset of symptoms was 92.5%. Specificity was evaluated on a panel of 56 samples known to cause possible cross-reactions. Cross-reaction with DENV antibodies was limited (10.5%) but false-positive results occurred in samples from patients with malaria, CMV and EBV infections.

The circulation of Zika virus (ZIKV) in nearly 80 countries and territories poses a significant global threat to public health. ZIKV is causally linked to severe developmental defects in the brain, recognized as congenital Zika syndrome (CZS), which includes microcephaly and other serious congenital neurological complications. Since the World Health Organization declared the ZIKV outbreak a public health emergency of international concern, remarkable progress has been made in the generation of different ZIKV infection animal models to gain insight into cellular targets and pathogenesis and to explore the associated underlying mechanisms. Here we focus on summarizing our current understanding of the effects of ZIKV on mammalian brain development in different developmental stages and discuss the potential underlying mechanisms of ZIKV-induced CZS, as well as future perspectives.

Zika virus (ZIKV) serological diagnostics are compromised in areas where dengue viruses (DENV) co-circulate because of their high levels of protein sequence homology. Here, we describe the characterization of a Zika blockade-of-binding ELISA (Zika BOB) and a Zika microneutralization assay (Zika MN) for the detection of ZIKV nonstructural protein 1 (NS1)–specific antibodies and ZIKV neutralizing antibodies, respectively. Zika BOB and Zika MN cutoffs were established as 10 and 100 endpoint titers, respectively, using samples collected pre- and post-virologically confirmed ZIKV infection from subjects living in DENV-endemic areas. Specificity of the assays was equally high, whereas sensitivity of Zika BOB was lower than that of Zika MN, especially in samples collected > 6 months post-infection. Immunosurveillance analysis, using combined results from both Zika BOB and Zika MN, carried out also in DENV-endemic regions in Colombia, Honduras, Mexico, and Puerto Rico before (2013–2014) and after (2017–2018) ZIKV introduction in the Americas suggests unapparent ZIKV seroprevalence rates ranged from 25% to 80% over the specified period of time in the regions investigated.

Zika virus (ZIKV) and dengue virus (DENV) are co-endemic in many parts of the world, but the impact of ZIKV infection on subsequent DENV infection is not well understood. Here we show in rhesus macaques that the time elapsed after ZIKV infection affects the immune response to DENV infection. We show that previous ZIKV exposure increases the magnitude of the antibody and T cell responses against DENV. The time interval between ZIKV and subsequent DENV infection further affects the immune response. A mid-convalescent period of 10 months after ZIKV infection results in higher and more durable antibody and T cell responses to DENV infection than a short period of 2 months. In contrast, previous ZIKV infection does not affect DENV viremia or pro-inflammatory status. Collectively, we find no evidence of a detrimental effect of ZIKV immunity in a subsequent DENV infection. This supports the implementation of ZIKV vaccines that could also boost immunity against future DENV epidemics., Here, the authors show that the time elapsed between Zika infection and subsequent dengue virus infection affects the magnitude and durability of the antibody and cell-mediated immune responses against dengue virus, but not viremia. This research in non-human primates has implications for co-endemic regions and vaccination.

Zika virus infection (ZIKV) has caused major outbreaks in tropic and sub-tropic areas. No case from ZIKV has yet been reported in the countries of the Eastern Mediterranean Region (EMR) despite the presence of competent vector Aedes mosquitoes in many of these countries.This study addresses appropriate surveillance strategies for early detection of ZIKV infection, which is important for EMR countries with established Aedes populations, but with no known or documented autochthonous transmission of ZIKV.The WHO Regional Office for the Eastern Mediterranean developed a strategic framework for enhancing surveillance for ZIKV infection in EMR countries with established Aedes populations through a consultative process and review of available evidence.The framework calls for enhancing surveillance for early detection of ZIKV infection using a combination of both syndromic and event-based surveillance approaches.Enhancing surveillance for ZIKAV would require no shift in the existing system. A number of considerations would be required to integrate this syndromic and event-based surveillance approaches within the existing system.تعزيز الترصُّد للكشف المبكر عن عدوى فيروس زيكا: استراتيجيات لبلدان إقليم شرق المتوسط.مجدولين أوبطيل، مأمون مالك، تران نهو نجويين، إيفانس بوليفا، أحمد الخوبي، سالم عبد الرحمن سالم، ندى غصن، بيمان همتي، فو توان، بيتر مالا.سببت عدوى فيروس زيكا أوبئة كبرى في المناطق المدارية وشبه المدارية. ولم يتم الإبلاغ بعد عن أي حالات لعدوى فيروس زيكا في بلدان إقليم شرق المتوسط، رغم وجود الناقلات المختصة للبعوض الزاعج في العديد من هذه البلدان.تتناول هذه الدراسة استراتيجيات الترصُّد المناسبة للكشف المبكر عن عدوى فيروس زيكا، والتي تُعَد مهمة لبلدان إقليم شرق المتوسط التي يوجد فيها البعوض الزاعج، ولكن دون أي حالات انتقال محلية الأصل معروفة أو موثقة للعدوى.وضع المكتب الإقليمي لشرق المتوسط لمنظمة الصحة العالمية إطار عمل استراتيجي لتعزيز ترصُّد عدوى فيروس زيكا في بلدان الإقليم التي يوجد فيها البعوض الزاعج، وذلك من خلال عملية تشاورية واستعراض للبيّنات المتاحة.يدعو إطار العمل إلى تعزيز الترصُّد بهدف الكشف المبكر عن عدوى فيروس زيكا، باستخدام مجموعة من نُُوج الترصُّد القائم على الأحداث والمتلازمات.لا يتطلب تعزيز ترصُّد عدوى فيروس زيكا أي تغيير في النظام الحالي. ومن المطلوب أخذ عدة اعتبارات في الحسبان من أجل دمج نُُوج الترصُّد القائم على الأحداث والمتلازمات في النظام الحالي.Renforcement de la surveillance pour le dépistage précoce de l’infection par le virus Zika : stratégies destinées aux pays de la Région de la Méditerranée orientale.L’infection par le virus Zika est à l’origine d’importantes flambées épidémiques dans les régions tropicales et subtropicales. Aucun cas d’infection par le virus Zika n’a encore été signalé dans les pays de la Région de la Méditerranée orientale malgré la présence, dans nombre d’entre eux, de moustiques compétents du genre Aedes, vecteurs du virus.La présente étude porte sur les stratégies de surveillance à mettre en oeuvre pour le dépistage précoce de l’infection par le virus Zika, particulièrement important dans les pays de la Région de Méditerranée orientale où des populations d’Aedes sont établies mais dans lesquels aucune transmission autochtone de ce virus n’est connue ou documentée à ce jour.Par l’intermédiaire d’un processus consultatif et d’examen des données disponibles, le Bureau régional de l’OMS pour la Méditerranée orientale a développé un cadre stratégique en vue d’améliorer la surveillance de l’infection par le virus Zika dans les pays de la Région de Méditerranée orientale où sont établies des populations d’Aedes.Afin de dépister de façon précoce l’infection par le virus Zika, ce cadre préconise une meilleure surveillance en recourant à la fois à la surveillance syndromique et basée sur les événements.Le renforcement de la surveillance du virus Zika n’impliquerait pas le changement du système actuel. Un certain nombre d’aspects devraient être pris en compte afin d’intégrer ces approches de surveillance syndromique et basée sur les événements dans le système existant.

Zika virus (ZIKV) was an emergent flavivirus transmitted by Aedes genus mosquitoes and made an explosive outbreak in Latin America in 2015. A few months later, an obvious increase in the number of microcephaly neonates has been observed, which might be related to ZIKV infection during the mothers’ pregnancy. Since then, researchers in many countries and territories have been working on the causal link between ZIKV and microcephaly and have made a number of achievements. To summarize the most recent evidence and the contribution of Chinese researchers on this issue, and to provide perspectives and challenges for future studies, we reviewed the literature of both microcephaly and ZIKV. Based on previous research results, ZIKV has been preliminarily proved to be the direct cause of microcephaly in newborns and Chinese researchers have made many important discoveries in the pathogenesis of microcephaly. Even so, future researches should also further investigate the mechanism of ZIKV-related microcephaly to advance the development of therapeutic and preventive strategies.

Zika virus (ZIKV) belongs to the group of viruses called arboviruses. Congenital Zika syndrome is a new disease with infectious teratogenic aetiology. The clinical symptoms are divided into morphological and functional. Most severe complication is the foetal brain disruption sequence that includes severe microcephaly, anomalies of the eyes and congenital contractions of joints. The aim of this paper was to review available facts about Zika virus infection from a newborn point of view in a form of the summary of all important information. Zika virus infection is a problem of past, present and future. Epidemics may occur because of global climate changes, also in countries where natural conditions for life of mosquitos are not present. This clearly indicates the need to continue developing of vaccines and specific antiviral drugs. Until this happens, we must adhere individual preventive measures. Zika virus has proven to us how it can affect the health of adults and neonates but also thinking of healthy people. Newborns with microcephaly on the front pages of the media caused in 2015 panic and fear around the world – for this reason education of people is necessary. Due to serious congenital disorders associated with ZIKV infection and global impact of virus we suggest modifying old acronym TORCH for new TORZiCH to accent the position of Zika virus.

Despite being discovered approximately 70 years ago, Zika virus (ZIKV) has received little attention, until the occurrence of alarming epidemics in the Pacific Islands and Latin America between 2013 and 2016. These series of outbreaks resulted in crippling neurological complications in adults, and congenital deformities in new-borns. The dire outcomes marked ZIKV as a re-emerging pathogen of public health concern. Over a period of two years, extensive studies have been conducted to understand different aspects of ZIKV from pathogen biology to infection, including the immune response during virus-host interplay in established animal models, as well as potential therapeutics against ZIKV infection. The vast diversity of novel findings has added value to ZIKV research, and a strategic consolidation is crucial to encompass the latest advances and developments, as well as missing pieces of the puzzle. This review thus aims to provide a concise yet extensive update on current ZIKV studies.

International audience; Zika virus (ZIKV) is a Flavivirus transmitted by Aedes mosquitoes, and was responsible for a worldwide outbreak between 2013 and 2016. However, no ZIKV outbreak has been described in Southeast Asia since 2017. In this study, we report the first microcephaly case with probable ZIKV infection during pregnancy in Lao People's Democratic Republic.

OBJECTIVE To analyze published scientific evidence about the most common orofacial disorders in children with microcephaly associated with ZIKV infection. METHODS Through a scoping review, we respond to the search question was formulated: "What are the orofacial alterations in children with microcephaly associated with ZIKV?" It was performed a search in PubMed, EMBASE, Scopus, and Health Virtual Library. It was selected papers wrote in English, Portuguese, or Spanish. An evidence quality analysis was performed using the Agency for Healthcare Research and Quality classification. RESULTS It was included 11 studies performed in the Brazilian Northeast region. The studies were carried out between 2018 and 2020. The main related alterations were delay in the tooth-eruption and deformation in the oral structures. CONCLUSION The results observed in our work show moderate scientific evidence regarding the association of ZIKV with orofacial alterations in children with microcephaly due to the classifications of the quality of evidence of each one of the included studies. The main changes reported were in the chronology of tooth eruption, alteration in teeth, and oral structures.

In 2015, in Northeast Brazil, cases of microcephaly associated with the outbreak of zika virus in South America were identified. This virus is transmitted by the biological vector Aedes aegypti, which also transmits dengue, yellow fever, and chikungunya viruses. The congenital Zika syndrome affected newborns with head circumference smaller than 32 cm, compromising their central nervous system. Besides ocular lesions, hyperexcitability, and hypertonia, newborns also showed intracranial calcifications in imaging exams. If children with congenital Zika syndrome suffer maxillofacial alterations during embryonic development, they could have delayed tooth eruption and malformations. This study aims to perform an integrative review of the current literature about the health conditions of children with congenital Zika virus infection and the possible alterations of their oral cavity. This integrative literature review was performed by searching scientific articles in the PubMed, SciELO, and MEDLINE electronic databases with the descriptors “Zika Virus Infection”, “Zika Virus”, and “Microcephaly”, which deal with clinical case reports and were indexed between 2016 and 2021. About 26 articles published entirely in English were analyzed after meeting the eligibility criteria. The studies contributed to better treatment conducts by showing the neurological, functional, and oral alterations in children with congenital Zika syndrome, including periodontal diseases, malocclusions, dental caries, bruxism, micrognathia, ankyloglossia, short labial frenum, dental trauma, and dysphagia. No nordeste brasileiro, no ano de 2015, foram identificados casos de microcefalia associados ao surto de Zika vírus no continente sul-americano, transmitido pelo vetor biológico Aedes Aegypti, também transmissor dos vírus da dengue, febre amarela, Chikungunya. A síndrome congênita de Zika manifestou-se em recém-nascidos com perímetro cefálico menor de 32 cm, comprometendo o sistema nervoso central, apresentando em exames de imagem calcificações cerebrais, além de lesões oculares, hiperexcitabilidade e hipertonia. As crianças portadoras de síndrome congênita de Zika apresentam possíveis alterações maxilofaciais durante o desenvolvimento embrionário, ocasionando atraso na cronologia de erupção dentária e possíveis malformações. Este estudo busca realizar uma revisão integrativa da literatura atual sobre as condições de saúde e possíveis alterações na cavidade oral das crianças portadoras de infecção congênita por Zika vírus. A revisão integrativa da literatura foi realizada por meio de uma busca de artigos científicos na base de dados eletrônica PubMed, SciELO e MEDLINE, utilizando os descritores “Zika Virus Infection”, “Zika Virus” e “Microcephaly”, indexados no período de 2016 a 2021, que tratavam de relato de caso clínico. Após os critérios de elegibilidade, foram analisados integralmente 26 artigos publicados em língua inglesa. Os estudos mostraram as principais alterações bucais presentes nas crianças portadoras da síndrome congênita de Zika, como doenças periodontais, maloclusões, cárie dentária, bruxismo, micrognatia, anquiloglossia, encurtamento do freio labial, traumatismos dentários e disfagia, assim como as neurológicas e funcionais dos indivíduos, contribuindo para melhores condutas de tratamento.

Dengue virus (DENV) and Zika virus (ZIKV) are both circulating in the same endemic areas and causing clinically similar disease. The diagnostic challenge is to discriminate these viruses from each other. The most reliable diagnosis of ZIKV infection is based on nucleic acid amplification tests (NAATs). With these NAATs, both DENV and ZIKV can be identified from the original patient sample, and conclusive diagnosis can be made. The window for nucleic acid detection, however, is narrow in ZIKV infection. This has to be taken into account when interpreting negative NAAT results. Serological methods for ZIKV IgM and IgG detection should be used in parallel with NAATs.

Zika virus is a global public health emergency due to its association with microcephaly, Guillain-Barré syndrome, neuropathy, and myelitis in children and adults. A total of 87 countries have had evidence of autochthonous mosquito-borne transmission of Zika virus, distributed across four continents, and no antivirus therapy or vaccines are available. Therefore, several strategies have been developed to target the main mosquito vector, Aedes aegypti, to reduce the burden of different arboviruses. Among such strategies, the use of the maternally-inherited endosymbiont Wolbachia pipientis has been applied successfully to reduce virus susceptibility and decrease transmission. However, the mechanisms by which Wolbachia orchestrate resistance to ZIKV infection remain to be elucidated. In this study, we apply isobaric labeling quantitative mass spectrometry-based proteomics to quantify proteins and identify pathways altered during ZIKV infection; Wolbachia infection; co-infection with Wolbachia/ZIKV in the Ae. aegypti heads and salivary glands. We show that Wolbachia regulates proteins involved in ROS production, regulates humoral immune response, and antioxidant production. The reduction of ZIKV polyprotein in the presence of Wolbachia in mosquitoes was determined by mass spectrometry and corroborates the idea that Wolbachia helps to block ZIKV infections in Ae. aegypti. The present study offers a rich resource of data that may help to elucidate mechanisms by which Wolbachia orchestrate resistance to ZIKV infection in Ae. aegypti, and represents a step further on the development of new targeted methods to detect and quantify ZIKV and Wolbachia directly in complex tissues.HighlightsThe abundance of ZIKV polyprotein is reduced in the presence of WolbachiaShotgun proteomics quantifies ZIKV and Wolbachia proteins directly in tissuesWolbachia regulates proteins involved in ROS productionWolbachia regulates humoral immune response and antioxidant productionMetabolism and detoxification processes were associated with mono infections

To gain new insights into the potential of mother-to-child transmission of Zika virus (ZIKV) through breast milk or breastfeeding practices, we systematically searched regional and international databases and screened 1,658 non-duplicate records describing women with suspected or confirmed ZIKV infection, intending to breastfeed or give breast milk to an infant. Fourteen studies met our inclusion criteria and inform this analysis. These studies reported on 97 mother-children pairs who provided breast milk for ZIKV assessment. Seventeen breast milk samples from different women were found positive for ZIKV via RT-PCR, and ZIKV replication was found in cell cultures from five out of seven breast milk samples from different women. Only three out of six infants who had ZIKV infection were breastfed, no evidence of clinical complications were found to be associated with ZIKV RNA in breast milk. This review updates our previous report by synthesizing the evidence from 12 new articles and we find no evidence of mother-to-child transmission through breast milk intake or breastfeeding. As the certainty of the present evidence is low, additional studies are still warranted to completely understand any potential of transmission of ZIKV through breastfeeding.

Despite worldwide efforts to understand the transmission dynamics of Zika virus (ZIKV), scanty evaluation has been made on the vector competence of Aedes aegypti fed directly on viremic human and non-human primates (NHPs). We blood-fed Ae. aegypti from two districts in Rio de Janeiro on six ZIKV infected pregnant rhesus macaques at several time points, half of which were treated with Sofosbuvir (SOF). Mosquitoes were analyzed for vector competence after 3, 7 and 14 days of incubation. Although viremia extended up to eight days post monkey inoculation, only mosquitoes fed on the day of the peak of viremia, recorded on day two, became infected. The influence of SOF treatment could not be assessed because the drug was administered just after mosquito feeding on day two. The global infection, dissemination and transmission rates were quite low (4.09%, 1.91% and 0.54%, respectively), no mosquito was infected when viremia was below 1.26 &times, 105 RNA copies/mL. In conclusion, Ae. aegypti vector competence for ZIKV from macaques is low, likely to be due to low viral load and the short duration of ZIKV viremia in primates suitable for infecting susceptible mosquitoes. If ZIKV infection in human and macaques behaves similarly, transmission of the Zika virus in nature is most strongly affected by vector density.

The epidemic transmission of Zika virus (ZIKV) in Brazil has been identified as a cause of microcephaly and other neurological malformations in the babies of ZIKV-infected women. The frequency of adverse outcomes of Zika virus infection (ZIKVi) in pregnancy differs depending on the characteristics of exposure to infection, the time of recruitment of research participants, and the outcomes to be observed. This study provides a descriptive analysis&mdash, from the onset of symptoms to delivery&mdash, of a cohort registered as having maternal ZIKVi in pregnancy, from November 2015 to December 2016. Suspected cases were registered at a referral center for infectious and tropical diseases in Manaus, in the Amazonian region of Brazil. Of 834 women notified, 762 women with confirmed pregnancies were enrolled. Reverse-transcriptase polymerase chain reaction (RT-PCR) confirmed ZIKVi in 42.3% of the cohort. In 35.2% of the cohort, ZIKV was the sole infection identified. Severe adverse pregnancy outcomes (miscarriage, stillbirth, or microcephaly) were observed in both RT-PCR ZIKV-positive (5.0%) and ZIKV-negative (1.8%) cases (RR 3.1, 95% IC 1.4&ndash, 7.3, p &lt, 0.05), especially during the first trimester of pregnancy (RR 6.2, 95% IC 2.3&ndash, 16.5, 0.001). Although other infectious rash diseases were observed in the pregnant women in the study, having confirmed maternal ZIKVi was the most important risk factor for serious adverse pregnancy events.

BackgroundThe ZIKV infection outbreak in Brazil surged from late 2014, peaking in 2015. Vulnerable low-income groups, with inadequate housing conditions or sanitation were most affected by ZIKV-related neurologic syndrome. We aim to detect basal knowledge and beliefs, as well as knowledge gaps among vulnerable women.MethodsA cross-sectional study was carried out in two low-income urban community settings: a small municipality in the Center West with few ZIKV infection cases and a large municipality in the Southeast hard-hit by the epidemic. We developed an open-ended data collection instrument centered on awareness of ZIKV infection, sources of information, possible causes, symptoms, risk perception and consequences for pregnant women, and applied it to vulnerable women after informed consent. Interviews were recorded, transcribed and content coded for thematic analysis.ResultsSeventy-nine women responded. The majority had some knowledge of the disease, its causes and consequences but distanced themselves from ZIKV infection. Health services in both communities did not respond adequately and did not contribute to communicate risk for women and children. ConclusionsIn an uncertain future scenario as to reemergence of disease, we propose that awareness will be diminished and acquired knowledge lost. This is a great public health challenge that must be overcome to prepare both vulnerable groups and the health system for public health emergencies.

Zika virus (ZIKV) infection is a serious public threat with cases reported in about 70 countries and territories. One of the most serious consequences of ZIKV infection is congenital microcephaly in babies. Congenital microcephaly has been suggested to result from infection of neural progenitor cells (NPCs) in the developing fetal brain. However, the molecular and cellular mechanisms underlying microcephaly development remains to be fully elucidated. In this study, we employed quantitative proteomics to determine protein expression profile that occur during viral replication in NPCs. Bioinformatics analysis of the protein expression changes resulted in the identification of a wide range of cell signaling pathways. Specifically, pathways involved in neurogenesis and embryonic development were markedly altered, along with those associated with cell cycle, apoptosis, lipid metabolism and oxidative stress. Notably, the differential regulation of Ephrin Receptor and PPAR signaling pathways, as revealed by quantitative proteomics and validated by qPCR array, underscores the need to explore these pathways in disease development. Collectively, these results indicate that ZIKV-induced pathogenesis involves complex virus-host reactions; the findings reported here could help shed light on the mechanisms underlying ZIKV-induced microcephaly and ZIKV replication in NPCs.

A Zika self-amplifying mRNA vaccine delivered by a flexible bedside mixing formulation induces protective immunity in NHPs., Zika virus (ZIKV) is the cause of a pandemic associated with microcephaly in newborns and Guillain-Barre syndrome in adults. Currently, there are no available treatments or vaccines for ZIKV, and the development of a safe and effective vaccine is a high priority for many global health organizations. We describe the development of ZIKV vaccine candidates using the self-amplifying messenger RNA (SAM) platform technology delivered by cationic nanoemulsion (CNE) that allows bedside mixing and is particularly useful for rapid responses to pandemic outbreaks. Two immunizations of either of the two lead SAM (CNE) vaccine candidates elicited potent neutralizing antibody responses to ZIKV in mice and nonhuman primates. Both SAM (CNE) vaccines protected these animals from ZIKV challenge, with one candidate providing complete protection against ZIKV infection in nonhuman primates. The data provide a preclinical proof of concept that a SAM (CNE) vaccine candidate can rapidly elicit protective immunity against ZIKV.