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2.
Rev Inst Med Trop Sao Paulo ; 61: e40, 2019 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-31432989

RESUMEN

Several arboviruses have emerged and/or re-emerged in North, Central and South-American countries. Viruses from some regions of Africa and Asia, such as the Zika and Chikungunya virus have been introduced in new continents causing major public health problems. The aim of this study was to investigate the presence of RNA from Zika, Dengue and Chikungunya viruses in symptomatic patients from Rondonia, where the epidemiological profile is still little known, by one-step real-time RT-PCR. The main clinical signs and symtoms were fever (51.2%), headache (78%), chills (6.1%), pruritus (12.2%), exanthema (20.1%), arthralgia (35.3%), myalgia (26.8%) and retro-orbital pain (19.5%). Serum from 164 symptomatic patients were collected and tested for RNA of Zika, Dengue types 1 to 4 and Chikungunya viruses, in addition to antibodies against Dengue NS1 antigen. Direct microscopy for Malaria was also performed. Only ZIKV RNA was detected in 4.3% of the patients, and in the remaining 95.7% of the patients RNA for Zika, Dengue and Chikungunya viruses were not detected. This finding is intriguing as the region has been endemic for Dengue for a long time and more recently for Chikungunya virus as well. The results indicated that medical and molecular parameters obtained were suitable to describe the first report of symptomatic Zika infections in this region. Furthermore, the low rate of detection, compared to clinical signs and symptoms as the solely diagnosis criteria, suggests that molecular assays for detection of viruses or other pathogens that cause similar symptoms should be used and the corresponding diseases could be included in the compulsory notification list.


Asunto(s)
Fiebre Chikungunya/epidemiología , Virus Chikungunya/genética , Virus del Dengue/genética , Dengue/epidemiología , Infección por el Virus Zika/epidemiología , Virus Zika/genética , Brasil/epidemiología , Fiebre Chikungunya/diagnóstico , Dengue/diagnóstico , Humanos , Virus ARN/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Infección por el Virus Zika/diagnóstico
3.
Rev Soc Bras Med Trop ; 52: e20190105, 2019 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-31340371

RESUMEN

INTRODUCTION: Clinical and epidemiological data on suspected congenital Zika syndrome (CZS) cases from southern Mato Grosso (MT) in Brazil during the Zika virus (ZIKV) outbreak in 2015-2016 were evaluated. METHODS: This is a descriptive case series study of newborns whose mothers were suspected cases of ZIKV infections during their pregnancies. The medical records of all the suspected CZS cases (mothers and newborns) treated by the specialized ambulatory service from June 2015 to August 2016 were analyzed. RESULTS: Twenty suspected CZS cases were included in these analyses. They were categorized into four groups based on the clinical and laboratory findings: confirmed cases (n=1), highly probable cases (n=13), moderately probable cases (n=5), and somewhat probable cases (n=1). The mothers tested negative for STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) and other important congenital infections; however, specific ZIKV tests were not performed during the study period. Microcephaly was observed in the majority of these newborns, and all the patients showed altered cranial computed tomography image findings. Extracranial abnormalities such as arthrogryposis, and otological and ophthalmological manifestations were also observed. CONCLUSIONS: Although ZIKV was not confirmed to cause the congenital malformations, this study demonstrated that the clinical and epidemiological findings associated with a STORCH exclusion strengthened the CZS diagnosis. The suspected cases in MT occurred simultaneously with the first CZS cases reported in Brazil, suggesting ZIKV circulation in the study region during the same period.


Asunto(s)
Microcefalia/virología , Complicaciones Infecciosas del Embarazo/virología , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/epidemiología , Virus Zika/aislamiento & purificación , Adolescente , Adulto , Brasil/epidemiología , Brotes de Enfermedades , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Factores Socioeconómicos , Adulto Joven , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/congénito
4.
BMC Infect Dis ; 19(1): 590, 2019 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-31277583

RESUMEN

BACKGROUND: Transfusion-Transmitted Zika virus (TT-ZIKV) has become an emerging threat to world blood banks due to the fast spread of ZIKV epidemics and high rate of asymptomatic infections. For the risk assessment of ZIKV infection in blood products, relevant studies in blood donations or blood donors tested for ZIKV were collected and analyzed systematically. The overall prevalence of ZIKV infection were estimated through meta-analysis and potential risk factors were detected. The results will provide important clues for the protocol design of blood screening tests. METHODS: Relevant articles about the rate of ZIKV detected in blood samples were identified from PubMed, Scopus and Web Of Science using key terms search strategy until October 7, 2017. Eligible articles were screened following inclusion and exclusion criteria. Meta-analysis and subgroup analyses were performed by software R3.4.1. Overall postdonation and posttransfusion follow-ups were analyzed. RESULTS: Ten literatures (528,947 blood samples) were included for meta-analysis. The overall pooled prevalence of ZIKV (RNA and antibody) in blood donations was 1.02% (95%CI 0.36-1.99). The pooled prevalence of ZIKV RNA in blood donations was 0.85% (95%CI 0.21-1.88) less than the pooled prevalence of anti-ZIKV antibodies 1.61% (95%CI 0.03-5.21), however the difference was not statistically significant (p = 0.52). The prevalence varied significantly in different geographical regions (p < 0.001). Blood donations were more than two times likely to be infected by ZIKV in Zika epidemic period (1.37, 95%CI 0.91-1.91) than in non-epidemic period (0.61, 95%CI 0-2.55). The prevalence of anti-ZIKV antibodies (1.61, 95%CI 0.03-5.21) was almost twice as much as ZIKV nucleic acid detected in blood donations (0.85, 95%CI 0.21-1.88). However, statistically significant differences were not observed. A total of 122 ZIKV positive blood donors were followed, of which 48 (39%) reported symptoms postdonation, but none of the 13 followed recipients reported any clinical symptoms related to Zika infection posttransfusion. CONCLUSION: The pooled prevalence of Zika infection in blood donations was 1.02%. The prevalence varied greatly and reached to high-risk level in most of the situations. The results suggest that nucleic acid tests (NAT) for blood screening and pathogen reduction/inactivation technology (PRT) should be implemented in Zika-endemic areas and appropriate strategies should be designed according to different conditions. More studies are needed in the future to provide more evidence.


Asunto(s)
Donantes de Sangre/estadística & datos numéricos , Infección por el Virus Zika , Virus Zika , Anticuerpos Antivirales/sangre , Humanos , Prevalencia , ARN Viral/sangre , Virus Zika/genética , Virus Zika/inmunología , Infección por el Virus Zika/sangre , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/epidemiología
5.
Analyst ; 144(14): 4266-4280, 2019 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-31180088

RESUMEN

The latest Zika virus (ZIKV) pandemic caused great international concern from explosively proliferating throughout the Americas. Currently, there is no vaccine to prevent Zika virus infection and available tests rely on antibodies or RNA. Unfortunately, antibody-based detection systems can result in false positive results and RNA-based detection systems are costly, time-consuming, and impractical for testing in remote regions. In this study, a potential point-of-care (POC) diagnostic system was developed using a chip-based potentiometric sensor to detect Zika virus using a 3D molecular imprinting technique. This chip-based potentiometric sensor system was able to detect 10-1 PFU mL-1 ZIKV in a buffered solution under 20 minutes without any sample manipulation. This sensor was tested against Dengue virus at clinical viral loads and showed no sign of cross-reactivity. When tested against human saliva samples containing clinical viral loads, this sensor was able to detect 10 PFU mL-1 ZIKV among the pool of bio-macromolecules. The high sensitivity and high selectivity demonstrated here proved that this lab-on-a-chip diagnostic has the potential to become a POC detection system for rapid and accurate screening of flaviviruses.


Asunto(s)
Técnicas Electroquímicas/métodos , Dispositivos Laboratorio en un Chip , Virus Zika/aislamiento & purificación , Adsorción , Técnicas Electroquímicas/instrumentación , Oro/química , Límite de Detección , Impresión Molecular/métodos , Pruebas en el Punto de Atención , Sensibilidad y Especificidad , Virus Zika/química , Infección por el Virus Zika/diagnóstico
6.
Int J Infect Dis ; 85: 167-174, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31202908

RESUMEN

OBJECTIVE: The nucleic acid-based polymerase chain reaction (PCR) assay is commonly applied to detect infection with Zika virus (ZIKV). However, the time- and labor-intensive sample pretreatment required to remove inhibitors that cause false-negative results in clinical samples is impractical for use in resource-limited areas. The aim was to develop a direct reverse-transcription quantitative PCR (dirRT-qPCR) assay for ZIKV diagnosis directly from clinical samples. METHODS: The combination of inhibitor-tolerant polymerases, polymerase enhancers, and dirRT-qPCR conditions was optimized for various clinical samples including blood and serum. Sensitivity was evaluated with standard DNA spiked in simulated samples. Specificity was evaluated using clinical specimens of other infections such as dengue virus and chikungunya virus. RESULTS: High specificity and sensitivity were achieved, and the limit of detection (LOD) of the assay was 9.5×101 ZIKV RNA copies/reaction. The on-site clinical diagnosis of ZIKV required a 5µl sample and the diagnosis could be completed within 2h. CONCLUSIONS: This robust dirRT-qPCR assay shows a high potential for point-of-care diagnosis, and the primer-probe combinations can also be extended for other viral detection. It realizes the goal of large-scale on-site screening for viral infections and could be used for early diagnosis and the prevention and control of viral outbreaks.


Asunto(s)
Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Infección por el Virus Zika/diagnóstico , Virus Zika/aislamiento & purificación , Adulto , Niño , Femenino , Humanos , Límite de Detección , Masculino , ARN Viral/análisis , ARN Viral/sangre , Sensibilidad y Especificidad , Virus Zika/genética
7.
BMC Res Notes ; 12(1): 326, 2019 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-31182146

RESUMEN

OBJECTIVE: Increase in the evidence of global occurrence of Zika viral infection suggests that in Africa the circulation of the virus which causes 80% of asymptomatic infection could be undetected and/or overlooked. We sought to serologically detect Zika virus infection in febrile patients at Greater Accra Regional Hospital, Ghana. RESULTS: Of the 160 patient serum samples analyzed, 33 were found to have antibodies against Zika virus infection. Among the sero-positives 30 (91%) of the cases were anti-Zika virus IgM with the 21-30-year age group recording the highest number of 8 (26%) and 2 (7%) cases being the least for the 61 years and above age group. All sero-positive febrile patients developed at least one symptom consistent with Zika virus infection: 33 (100%) fever, 25 (76%) muscle pain, 24 (73%) joint pain, and conjunctivitis 2 (6%). Digestive symptoms recorded include 16 (49%) nausea, 12 (36%) vomiting and diarrhea 18 (55%). In addition, 28 (85%) loss of appetite, 14 (75%) rapid respiration and chest pain 15 (42%) were reported by seropositive febrile patients. Our data indicates exposure to Zika virus which suggests the possible circulation of the virus among febrile patients in Ghana with a sero-prevalence rate of 20.6%.


Asunto(s)
Anticuerpos Antivirales/sangre , Artralgia/inmunología , Fiebre/inmunología , Mialgia/inmunología , Infección por el Virus Zika/inmunología , Virus Zika/inmunología , Adolescente , Adulto , Anciano , Artralgia/diagnóstico , Artralgia/epidemiología , Artralgia/fisiopatología , Niño , Preescolar , Conjuntivitis Viral/diagnóstico , Conjuntivitis Viral/epidemiología , Conjuntivitis Viral/inmunología , Conjuntivitis Viral/fisiopatología , Estudios Transversales , Diarrea/diagnóstico , Diarrea/epidemiología , Diarrea/inmunología , Diarrea/fisiopatología , Femenino , Fiebre/diagnóstico , Fiebre/epidemiología , Fiebre/fisiopatología , Ghana/epidemiología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Mialgia/diagnóstico , Mialgia/epidemiología , Mialgia/fisiopatología , Náusea/diagnóstico , Náusea/epidemiología , Náusea/inmunología , Náusea/fisiopatología , Estudios Seroepidemiológicos , Vómitos/diagnóstico , Vómitos/epidemiología , Vómitos/inmunología , Vómitos/fisiopatología , Virus Zika/crecimiento & desarrollo , Virus Zika/patogenicidad , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/fisiopatología
8.
Prensa méd. argent ; 105(5): 259-269, jun 2019. graf, tab
Artículo en Español | LILACS, BINACIS | ID: biblio-1024538

RESUMEN

El virus Zika, es un arbovirus del género flavivirus (familia Flaviviridae), muy cercano filogenéticamente a virus como el dengue, fiebre amarilla, la encefalitis japonesa, o el virus del Nilo Occidental. El presente estudio es de tipo exploratorio con base en el registro de casos de recién nacidos y lactantes hijos de mujeres embarazadas con infección de virus Zika en la Unidad de Medicina Familiar Nº 60 de Coatzacoalcos, Veracruz, dentro del período de diciembre del 2016 a julio del 2017. Se realizó un estudio polietápico que constó de revisión de casos por medio de uso de expediente clínico en la Consulta Externa en la Unidad Médico Familiar Nº 60 del IMSS de Coatzacoalcos, Veracruz. como primera aproximación epidemiológica en esta región en recién nacidos y lactantes hijos de madres con infección por virus Zika, que posteriormente fueron sometidos a estudios de valoración oftalmológica, neurológica y somatométrica; con ayuda del servicio de Salud Pública de dicha unidad (AU)


Zika virus is an arbovirus of the genusflavivirus (family Flaviviridae), very close phylogenetically to viruses such as denque, yellow fever, japanese encephalitis, or West Nile virus. The present study is exploratory based on the registry of cases of newborns and infants born to pregnant women with zika virus infection in the Family Medicine Unit Nº 60 of Coatzacalcos, Veracruz, within the period of December 2016 to July 2017. A multistage study was carried out that consisted of the review of cases through the use of a clinical file in the Outpatient Consultation in the Family Medical Unit Nº 60 of the IMSS. of Coatzacoalcos, Veracruz. As a first epidemiological approach in this region in newborns and infants born to mothers with Zika virus infection, who were subsequently subjected to ophtalmological, neurological and somatometric assessment studies; with the help of the Public Health service of said unit (AU)


Asunto(s)
Humanos , Recién Nacido , Lactante , Prevalencia , Estudios Transversales/estadística & datos numéricos , Edad Gestacional , Estudios de Validación como Asunto , Virus Zika/inmunología , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/prevención & control
9.
BMC Infect Dis ; 19(1): 418, 2019 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-31088375

RESUMEN

BACKGROUND: The global expansion of dengue (DENV), chikungunya (CHIKV), and Zika viruses (ZIKV) is having a serious impact on public health. Because these arboviruses are transmitted by the same mosquito species and co-circulate in the same area, a sensitive diagnostic assay that detects them together, with discrimination, is needed. METHODS: We present here a diagnostics panel based on reverse transcription-PCR amplification of viral RNA and an xMap Luminex architecture involving direct hybridization of PCRamplicons and virus-specific probes. Two DNA innovations ("artificially expanded genetic information systems", AEGIS, and "self-avoiding molecular recognition systems", SAMRS) increase the hybridization sensitivity on Luminex microspheres and PCR specificity of the multiplex assay compared to the standard approach (standard nucleotides). RESULTS: The diagnostics panel detects, if they are present, these viruses with a resolution of 20 genome equivalents (DENV1), or 10 (DENV3-4, CHIKV) and 80 (DENV2, ZIKV) genome equivalents per assay. It identifies ZIKV, CHIKV and DENV RNAs in a single infected mosquito, in mosquito pools comprised of 5 to 50 individuals, and mosquito saliva (ZIKV, CHIKV, and DENV2). Infected mosquitoes and saliva were also collected on a cationic surface (Q-paper), which binds mosquito and viral nucleic acids electrostatically. All samples from infected mosquitoes displayed only target-specific signals; signals from non-infected samples were at background levels. CONCLUSIONS: Our results provide an efficient and multiplex tool that may be used for surveillance of emerging mosquito-borne pathogens which aids targeted mosquito control in areas at high risk for transmission.


Asunto(s)
Virus Chikungunya/genética , Culicidae/virología , Virus del Dengue/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Virus Zika/genética , Animales , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/virología , Virus Chikungunya/aislamiento & purificación , Dengue/diagnóstico , Dengue/virología , Virus del Dengue/aislamiento & purificación , Humanos , Hibridación de Ácido Nucleico , ARN Viral/genética , ARN Viral/metabolismo , Juego de Reactivos para Diagnóstico , Saliva/virología , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/virología
10.
Medicine (Baltimore) ; 98(20): e15532, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31096455

RESUMEN

INTRODUCTION: Zika virus (ZIKV) has caused one of the most challenging global infectious epidemics in recent years because of its causal association with severe microcephaly and other congenital malformations. The diagnosis of viral infections usually relies on the detection of virus proteins or genetic material in clinical samples as well as on the infected host immune responses. Serial serologic testing is required for the diagnosis of congenital infection when diagnostic molecular biology is not possible. PATIENT CONCERNS: A 2-year-old girl, born to a mother with confirmed ZIKV infection during pregnancy, with a confirmed ZIKV infection in utero, showed at birth a severe microcephaly and clinical characteristics of fetal brain disruption sequence compatible with a congenital ZIKV syndrome (CZS). DIAGNOSIS: ZIKV-RNA and ZIKV-IgM serological response performed at birth and during the follow-up time tested always negative. Serial serologic ZIKV-IgG tests were performed to assess the laboratory ZIKV diagnosis, ZIKV-IgG seroreversion was observed at 21 months of age. ZIKV diagnosis of this baby had to be relied on her clinical and radiological characteristics that were compatible with a CZS. INTERVENTIONS: The patient was followed-up as per protocol at approximately 1, 4, 9, 12, 18-21, and 24 months of age. Neurological, radiological, audiological, and ophthalmological assessment were performed during this period of time. Prompt rehabilitation was initiated to prevent potential adverse long-term neurological outcomes. OUTCOMES: The growth of this girl showed a great restriction at 24 months of age with a weight of 8.5 kg (-2.5 z-score) and a head circumference of 40.5 cm (-4.8 z-score). She also had a great neurodevelopmental delay at the time of this report. CONCLUSION: We presume that as a consequence of prenatal ZIKV infection, the fetal brain and other organs are damaged before birth through direct injury. Following this, active infection ends during intrauterine life, and as a consequence the immune system of the infant is unable to build up a consistent immune response thereafter. Further understanding of the mechanisms taking part in the pathogenesis of ZIKV congenital infection is needed. This finding might change our paradigm regarding serological response in the ZIKV congenital infection.


Asunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Infección por el Virus Zika/diagnóstico , Encéfalo/anomalías , Preescolar , Femenino , Humanos , Microcefalia/etiología , Embarazo , Pruebas Serológicas , España , Infección por el Virus Zika/complicaciones
11.
Nat Commun ; 10(1): 1943, 2019 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-31028263

RESUMEN

Zika virus (ZIKV) outbreak in Americas led to extensive efforts to develop vaccines and ZIKV-specific diagnostics. In the current study, we use whole genome phage display library spanning the entire ZIKV genome (ZIKV-GFPDL) for in-depth immune profiling of IgG and IgM antibody repertoires in serum and urine longitudinal samples from individuals acutely infected with ZIKV. We observe a very diverse IgM immune repertoire encompassing the entire ZIKV polyprotein on day 0 in both serum and urine. ZIKV-specific IgG antibodies increase 10-fold between day 0 and day 7 in serum, but not in urine; these are highly focused on prM/E, NS1 and NS2B. Differential antibody affinity maturation is observed against ZIKV structural E protein compared with nonstructural protein NS1. Serum antibody affinity to ZIKV-E protein inversely correlates with ZIKV disease symptoms. Our study provides insight into unlinked evolution of immune response to ZIKV infection and identified unique targets for ZIKV serodiagnostics.


Asunto(s)
Anticuerpos Antivirales/sangre , Infección por el Virus Zika/inmunología , Anticuerpos Antivirales/inmunología , Afinidad de Anticuerpos/fisiología , Ensayo de Inmunoadsorción Enzimática , Humanos , Inmunoglobulina G/sangre , Proteínas no Estructurales Virales/metabolismo , Vacunas Virales/inmunología , Virus Zika/inmunología , Infección por el Virus Zika/diagnóstico
12.
PLoS Negl Trop Dis ; 13(4): e0007184, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-31022183

RESUMEN

The frequency of epidemics caused by Dengue viruses 1-4, Zika virus and Chikungunya viruses have been on an upward trend in recent years driven primarily by uncontrolled urbanization, mobility of human populations and geographical spread of their shared vectors, Aedes aegypti and Aedes albopictus. Infections by these viruses present with similar clinical manifestations making them challenging to diagnose; this is especially difficult in regions of the world hyperendemic for these viruses. In this study, we present a targeted-enrichment methodology to simultaneously sequence the complete viral genomes for each of these viruses directly from clinical samples. Additionally, we have also developed a customized computational tool (BaitMaker) to design these enrichment baits. This methodology is robust in its ability to capture diverse sequences and is amenable to large-scale epidemiological studies. We have applied this methodology to two large cohorts: a febrile study based in Colombo, Sri Lanka taken during the 2009-2015 dengue epidemic (n = 170) and another taken during the 2016 outbreak of Zika virus in Singapore (n = 162). Results from these studies indicate that we were able to cover an average of 97.04% ± 0.67% of the full viral genome from samples in these cohorts. We also show detection of one DENV3/ZIKV co-infected patient where we recovered full genomes for both viruses.


Asunto(s)
Virus Chikungunya/genética , Virus del Dengue/genética , Genoma Viral , Técnicas de Amplificación de Ácido Nucleico/métodos , Virus Zika/genética , Línea Celular , Fiebre Chikungunya/diagnóstico , Virus Chikungunya/aislamiento & purificación , Coinfección/epidemiología , Coinfección/transmisión , Biología Computacional , Dengue/diagnóstico , Virus del Dengue/aislamiento & purificación , Brotes de Enfermedades , Genómica , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Singapur/epidemiología , Sri Lanka/epidemiología , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/diagnóstico
13.
Artículo en Inglés | MEDLINE | ID: mdl-30970110

RESUMEN

Zika virus (ZIKV) clinical presentation and frequency/duration of shedding need further clarification. Symptomatic ZIKV-infected individuals identified in two hospitals in Sao Paulo State, Brazil, were investigated regarding clinical characteristics, shedding in body fluids, and serodynamics. Ninety-four of 235 symptomatic patients (Site A: 58%; Site B: 16%) had Real-Time PCR-confirmed ZIKV infection; fever, headache and gastrointestinal symptoms were less frequent, and rash was more frequent compared to ZIKV-negative patients. Real-Time PCR in serum had worse performance compared to plasma, while urine had the highest sensitivity. Shedding in genital fluids and saliva was rare. IgM positivity was the highest <14 days after the symptoms onset (86%), decreasing >28 days (24%); IgG positivity increased >14 days (96%) remaining positive in 94% of patients >28 days. ZIKV prevalence varied importantly in two neighboring cities during the same transmission season. Urine Real-Time PCR can improve diagnostic sensitivity; serum testing is less useful. Accurate serological tests are needed to improve diagnosis and surveillance.


Asunto(s)
Secreciones Corporales/virología , Infección por el Virus Zika/diagnóstico , Virus Zika/aislamiento & purificación , Adulto , Brasil/epidemiología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Prevalencia , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y Especificidad , Carga Viral , Infección por el Virus Zika/epidemiología
15.
Travel Med Infect Dis ; 29: 21-27, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30853504

RESUMEN

BACKGROUND: In 2016, Zika virus (ZIKV) spread rapidly throughout the Americas and Caribbean in an explosive outbreak. In the UK, testing for ZIKV infection is performed at Public Health England's Rare and Imported Pathogens Laboratory. Here we present the UK's experience of imported ZIKV during the epidemic. METHOD: A retrospective review was performed on the laboratory computer system searching by orders for ZIKV PCR and/or ELISA serology tests between 1st January 2016 and 31st December 2017. Each individual request form and result was reviewed. RESULTS: Of 6333 symptomatic patients tested for ZIKV, 374 (6%) had molecular or serological evidence consistent with recent infection; most of these had travelled to the Caribbean in 2016. On follow-up of PCR-confirmed cases, ZIKV IgM disappeared within 6 weeks and often didn't appear in patients with previous dengue infection. Rash was the commonest symptom in PCR-confirmed infection (93%). There were only single cases of presumed sexual transmission and of in-utero transmission. CONCLUSIONS: The rise and fall in numbers of imported ZIKV cases largely reflected the temporal course of the outbreak in the Caribbean. ZIKV serology is difficult to interpret but the absence of antibodies to ZIKV 14 days after symptom onset makes infection very unlikely.


Asunto(s)
Enfermedad Relacionada con los Viajes , Infección por el Virus Zika/diagnóstico , Américas/epidemiología , Dengue/inmunología , Brotes de Enfermedades , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Embarazo , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Reino Unido/etnología , Virus Zika , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/inmunología
16.
Top Magn Reson Imaging ; 28(1): 15-17, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30817675

RESUMEN

The recommendations for laboratory diagnosis of ZIKV infection are the detection of viral-RNA by molecular methods, detection of ZIKV-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies by serologic tests and the plaque reduction neutralization test (PRNT) for confirmation of positive IgM results, in pregnant women. In the acute phase of disease ZIKV may be detected in blood (whole blood, serum, plasma), urine, saliva, cerebrospinal fluid (CSF), and other fluids; in urine, the virus may be detected over a longer period, viz., 15-20 days from the onset of symptoms. An accurate laboratory diagnosis requires combining serologic data to molecular testing, as well as clinical and epidemiological criteria, especially for pregnant women and children born with Zika congenital syndromes.


Asunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Infección por el Virus Zika/congénito , Infección por el Virus Zika/diagnóstico , Anticuerpos Antivirales/sangre , Femenino , Humanos , Inmunoglobulina M/sangre , Lactante , Recién Nacido , Pruebas de Neutralización , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Síndrome , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/sangre
17.
Top Magn Reson Imaging ; 28(1): 23-27, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30817677

RESUMEN

The recent Zika virus (ZIKV) outbreak and the link to birth defects in newborns exposed in utero, caught international attention. Due to its rapid spread throughout the Americas, authorities declared ZIKV a Public Health Emergency of International Concern that lasted from February to November 2016."Congenital Zika Syndrome" (CZS) is a new entity that reflects a broad spectrum of symptoms and signs observed in newborns infected by the ZIKV in utero. A recent review concluded that CZS differs from other congenital infections for its five distinct features: "(1) severe microcephaly with partially collapsed skull; (2) thin cerebral cortices with subcortical calcifications; (3) macular scarring and focal pigmentary retinal mottling; (4) congenital contractures; and (5) marked early hypertonia and symptoms of extrapyramidal involvement."Diagnosing and managing CZS has become a challenge for health professionals including ophthalmologists. The ocular manifestations of CZS are unique and have important consequences on vision. This article reviews the ocular manifestations of the CZS, addresses the visual outcomes of affected infants, and elucidates the early intervention protocols for visual improvement.


Asunto(s)
Oftalmopatías/diagnóstico , Oftalmopatías/etiología , Complicaciones Infecciosas del Embarazo/diagnóstico , Infección por el Virus Zika/congénito , Infección por el Virus Zika/complicaciones , Niño , Oftalmopatías/virología , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Síndrome , Virus Zika , Infección por el Virus Zika/diagnóstico
18.
PLoS Negl Trop Dis ; 13(3): e0007246, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30856223

RESUMEN

Laboratory confirmation of Zika virus (ZIKV) infection during pregnancy is challenging due to cross-reactivity with dengue virus (DENV) and limited knowledge about the kinetics of anti-Zika antibody responses during pregnancy. We described ZIKV and DENV serological markers and the maternal-fetal transfer of antibodies among mothers and neonates after the ZIKV microcephaly outbreak in Northeast Brazil (2016). We included 89 microcephaly cases and 173 neonate controls at time of birth and their mothers. Microcephaly cases were defined as newborns with a particular head circumference (2 SD below the mean). Two controls without microcephaly were matched by the expected date of delivery and area of residence. We tested maternal serum for recent (ZIKV genome, IgM and IgG3 anti-NS1) and previous (ZIKV and DENV neutralizing antibodies [NAbs]) markers of infection. Multiple markers of recent or previous ZIKV and DENV infection in mothers were analyzed using principal component analysis (PCA). At delivery, 5.6% of microcephaly case mothers and 1.7% of control mothers were positive for ZIKV IgM. Positivity for ZIKV IgG3 anti-NS1 was 8.0% for case mothers and 3.5% for control mothers. ZIKV NAbs was slightly higher among mothers of cases (69.6%) than that of mothers of controls (57.2%; p = 0.054). DENV exposure was detected in 85.8% of all mothers. PCA discriminated two distinct components related to recent or previous ZIKV infection and DENV exposure. ZIKV NAbs were higher in newborns than in their corresponding mothers (p<0.001). We detected a high frequency of ZIKV exposure among mothers after the first wave of the ZIKV outbreak in Northeast Brazil. However, we found low sensitivity of the serological markers to recent infection (IgM and IgG3 anti-NS1) in perinatal samples of mothers of microcephaly cases. Since the neutralization test cannot precisely determine the time of infection, testing for ZIKV immune status should be performed as early as possible and throughout pregnancy to monitor acute Zika infection in endemic areas.


Asunto(s)
Anticuerpos Neutralizantes/sangre , Anticuerpos Antivirales/sangre , Dengue/diagnóstico , Microcefalia/epidemiología , Microcefalia/etiología , Complicaciones Infecciosas del Embarazo/diagnóstico , Infección por el Virus Zika/diagnóstico , Adolescente , Adulto , Brasil/epidemiología , Estudios de Casos y Controles , Dengue/epidemiología , Virus del Dengue/inmunología , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Recién Nacido , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto Joven , Virus Zika/inmunología , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/epidemiología
20.
Rev Soc Bras Med Trop ; 52: e20180351, 2019 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-30892549

RESUMEN

INTRODUCTION: The state of São Paulo has been monitoring cases of microcephaly and pregnant women presenting with acute rash, through CeVeSP. METHODS: This was a descriptive study focusing on pregnant women with rash and the outcome of their pregnancy, based on the notifications through the CeVeSP. RESULTS: During 2016, 2,209 cases of pregnant women with rash were reported and investigated. Of these, 36.6% were confirmed. Of the pregnant women who tested positive for ZIKV, 6.4% did not have a favorable outcome. CONCLUSIONS: Our results allowed the characterization of pregnant women exposed to ZIKV and the outcome of pregnancy.


Asunto(s)
Exantema/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Vigilancia de Guardia , Infección por el Virus Zika/diagnóstico , Adolescente , Adulto , Brasil/epidemiología , Exantema/epidemiología , Exantema/virología , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto Joven , Infección por el Virus Zika/epidemiología
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