RESUMEN
We investigated dengue and chikungunya virus antibody seroprevalence in French Polynesia during 2014-2015. Dengue virus seroprevalence was ≈60% among schoolchildren and >83% among the general population; chikungunya virus seroprevalence was <3% before and 76% after Zika virus emergence (2013). Dengue virus herd immunity may affect Zika virus infection and pathogenesis.
Asunto(s)
Anticuerpos Antivirales/inmunología , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/inmunología , Virus Chikungunya/inmunología , Virus del Dengue/inmunología , Dengue/epidemiología , Dengue/inmunología , Adolescente , Adulto , Anticuerpos Neutralizantes/inmunología , Fiebre Chikungunya/historia , Niño , Preescolar , Dengue/historia , Historia del Siglo XXI , Humanos , Persona de Mediana Edad , Pruebas de Neutralización , Polinesia/epidemiología , Estudios Seroepidemiológicos , Adulto JovenRESUMEN
Ross River virus (RRV), spread by Aedes and Culex mosquitoes, is the most commonly transmitted arbovirus in Australia. A serosurvey of blood donors in French Polynesia during 2011-2013 suggested that RRV circulated without being detected. We report RRV circulation in French Polynesia based on further screening of blood samples collected during 2014-2015.
Asunto(s)
Aedes/virología , Infecciones por Alphavirus/epidemiología , Anticuerpos Antivirales/sangre , Culex/virología , Inmunoglobulina G/sangre , Insectos Vectores/virología , Virus del Río Ross/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Alphavirus/transmisión , Infecciones por Alphavirus/virología , Animales , Enfermedades Asintomáticas , Donantes de Sangre , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polinesia/epidemiología , Virus del Río Ross/inmunología , Estudios SeroepidemiológicosRESUMEN
During 2013-2014, French Polynesia experienced an outbreak of Zika virus infection. Serosurveys conducted at the end of the outbreak and 18 months later showed lower than expected disease prevalence rates (49%) and asymptomatic:symptomatic case ratios (1:1) in the general population but significantly different prevalence rates (66%) and asymptomatic:symptomatic ratios (1:2) in schoolchildren.
Asunto(s)
Brotes de Enfermedades , Estudios Seroepidemiológicos , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/virología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polinesia/epidemiología , Adulto Joven , Infección por el Virus Zika/sangreRESUMEN
BACKGROUND: Between October, 2013, and April, 2014, French Polynesia experienced the largest Zika virus outbreak ever described at that time. During the same period, an increase in Guillain-Barré syndrome was reported, suggesting a possible association between Zika virus and Guillain-Barré syndrome. We aimed to assess the role of Zika virus and dengue virus infection in developing Guillain-Barré syndrome. METHODS: In this case-control study, cases were patients with Guillain-Barré syndrome diagnosed at the Centre Hospitalier de Polynésie Française (Papeete, Tahiti, French Polynesia) during the outbreak period. Controls were age-matched, sex-matched, and residence-matched patients who presented at the hospital with a non-febrile illness (control group 1; n=98) and age-matched patients with acute Zika virus disease and no neurological symptoms (control group 2; n=70). Virological investigations included RT-PCR for Zika virus, and both microsphere immunofluorescent and seroneutralisation assays for Zika virus and dengue virus. Anti-glycolipid reactivity was studied in patients with Guillain-Barré syndrome using both ELISA and combinatorial microarrays. FINDINGS: 42 patients were diagnosed with Guillain-Barré syndrome during the study period. 41 (98%) patients with Guillain-Barré syndrome had anti-Zika virus IgM or IgG, and all (100%) had neutralising antibodies against Zika virus compared with 54 (56%) of 98 in control group 1 (p<0.0001). 39 (93%) patients with Guillain-Barré syndrome had Zika virus IgM and 37 (88%) had experienced a transient illness in a median of 6 days (IQR 4-10) before the onset of neurological symptoms, suggesting recent Zika virus infection. Patients with Guillain-Barré syndrome had electrophysiological findings compatible with acute motor axonal neuropathy (AMAN) type, and had rapid evolution of disease (median duration of the installation and plateau phases was 6 [IQR 4-9] and 4 days [3-10], respectively). 12 (29%) patients required respiratory assistance. No patients died. Anti-glycolipid antibody activity was found in 13 (31%) patients, and notably against GA1 in eight (19%) patients, by ELISA and 19 (46%) of 41 by glycoarray at admission. The typical AMAN-associated anti-ganglioside antibodies were rarely present. Past dengue virus history did not differ significantly between patients with Guillain-Barré syndrome and those in the two control groups (95%, 89%, and 83%, respectively). INTERPRETATION: This is the first study providing evidence for Zika virus infection causing Guillain-Barré syndrome. Because Zika virus is spreading rapidly across the Americas, at risk countries need to prepare for adequate intensive care beds capacity to manage patients with Guillain-Barré syndrome. FUNDING: Labex Integrative Biology of Emerging Infectious Diseases, EU 7th framework program PREDEMICS. and Wellcome Trust.