Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.759
Filtrar
1.
Emerg Infect Dis ; 26(2): 315-319, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31967538

RESUMO

We queried hospital patients about international travel in the previous 30 days to assess potential importation of emerging infections. We used 12 months of deidentified data to analyze patient demographics, travel destinations, and diagnoses for exposure to Zika virus. Our approach could be used to analyze potential infectious disease exposures.

2.
Eur Neurol ; : 1-8, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31968331

RESUMO

BACKGROUND: In 1947, Zika virus (ZIKV) was first discovered in Monkeys, in Zika Forest, in Uganda, Africa. Five years later, (1952) the first human Zika infection was detected in Nigeria, Africa. After this date, only sporadic cases happened, until the first 3 epidemics occurred, all outside Africa. The first epidemic was in Yap Island in 2007, the second in French Polynesia in 2013, and the third in 2015 in the northeast of Brazil, and then the spread to the Americas in 2015 and 2016. However, it was only after the epidemic in the northeast of Brazil, in the first half of 2015, that many babies were born with microcephaly in the second semester of that same year and in 2016. Until now, every year, some babies are still born with congenital ZIKV syndrome (CZVS). SUMMARY: The objective of this article is to describe infrequent and rarely discussed imaging (computed tomography and magnetic resonance imaging) findings of CZVS, in addition to those classically described such as a simplified gyral pattern, ventriculomegaly, corpus callosum dysgenesis, craniofacial disproportion, and redundant scalp, thus suggesting an increase in the spectrum of neurological findings related to the syndrome.

3.
Clin Exp Dermatol ; 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31916616

RESUMO

Skin disorders are frequent in travelers, but data vary according to different studies. Our objectives were to describe imported dermatoses in the Bordeaux Geosentinel prospective database. between August 2015 and March 2018. During the study period, 1,025 travelers were seen in the clinic, 201 of them with dermatoses. Patients with skin disorders were more likely to be > 60 (OR 1.88, 95% CI [1.22-2.89]), tourists (OR 3.04, 95% CI [2.03-4.55]), travelers to South America (OR 2.18, 95% CI [1.29-3.67]) and less likely to be seen in pre-travel encounters (OR 0.53, 95% CI [0.31-0.91]). Skin bacterial infections (19.4%) and Zika virus infections (18.4%) were the most common dermatoses. Dengue fever and bacterial skin infections were the leading causes of hospitalization. The contribution of tropical diseases among imported dermatoses remains important. Lack of pre-travel advice puts tourists at risk of significant diseases such as dengue fever, Zika or bacterial infections.

4.
Cell Host Microbe ; 27(1): 14-24, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31917957

RESUMO

Humoral immunity is an essential component of the protective immune response to flavivirus infection. Typically, primary infection generates a robust neutralizing antibody response that mediates viral control and protection. It is becoming increasingly apparent that secondary infection with a closely related flavivirus strain can result in immunological cross-reactivity; however, the consequences to infection outcome remain controversial. Since its introduction to Brazil in 2015, Zika virus (ZIKV) has caused an epidemic of fetal congenital malformations within the Americas. Because ZIKV is a mosquito-borne flavivirus with a high degree of sequence and structural homology to Dengue virus (DENV), the role of immunological cross-reactivity in ZIKV and DENV infections has become a great concern. In this review, we highlight contemporary findings that implicate a role for flavivirus antibodies in mediating protection, contributing to pathogenesis, and seeding the human placenta.

7.
N C Med J ; 81(1): 14-22, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31908326

RESUMO

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.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Doença Relacionada a Viagens , Infecção por Zika virus/etnologia , Estudos Transversais , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , North Carolina , Gravidez , Fatores de Risco , Serviços de Saúde Rural
8.
Am J Trop Med Hyg ; 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31933455

RESUMO

During the 2016 Zika pandemic in Brazil, women's perceptions of infection risk, ability to adhere to Zika prevention strategies, or access to services following exposure were not emphasized in the public health response. Women in Fortaleza, Brazil, responded to a questionnaire on social factors related to perceived Zika risk and access to health care in June 2016. Data were coded using prespecified categories, and response frequency was reported. Of 37 respondents, most reported a lack of public services to support mosquito control (n = 19) or delayed access to reproductive health care (n = 14). Only 22% described specific maternal risks or fetal outcomes as a consequence of Zika infection. Respondents indicated an overall disconnect between public health efforts and women's perceptions of their reproductive control, including limited support concerning microcephaly in infants. Interventions targeting Zika may require a greater emphasis on strengthening health systems and infrastructure to realistically prevent transmission.

9.
Viruses ; 12(1)2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31936159

RESUMO

In 2015 Zika virus (ZIKV) emerged for the first time in South America. The following ZIKV epidemic resulted in the appearance of a clinical phenotype with microcephaly and other severe malformations in newborns. So far, mechanisms of ZIKV induced damage to the fetus are not completely understood. Previous data suggest that ZIKV may bypass the placenta to reach the fetus. Thus, animal models for ZIKV infection are important to facilitate studies about ZIKV infection during pregnancy. Here, we used ultrasound based imaging (USI) to characterize ZIKV induced pathogenesis in the pregnant Type I interferon receptor-deficient (IFNAR-/-) mouse model. Based on USI we suggest the placenta to be a primary target organ of ZIKV infection enabling ZIKV spreading to the fetus. Moreover, in addition to direct infection of the fetus, the placental ZIKV infection may cause an indirect damage to the fetus through reduced uteroplacental perfusion leading to intrauterine growth retardation (IUGR) and fetal complications as early as embryonic day (ED) 12.5. Our data confirmed the capability of USI to characterize ZIKV induced modifications in mouse fetuses. Data from further studies using USI to monitor ZIKV infections will contribute to a better understanding of ZIKV infection in pregnant IFNAR-/- mice.

10.
Infect Genet Evol ; 80: 104180, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31918041

RESUMO

Zika virus (ZIKV) is a negative sense RNA virus from the Flaviviridae family, which was relatively unknown until the first human epidemic in Micronesia, in 2007. Since then, it spread to French Polynesia and the Americas. Recife, the capital of Pernambuco state and epicenter of the Zika epidemic in Brazil, experienced a large number of microcephaly cases and other congenital abnormalities associated to the ZIKV infection from, 2015 to 16. Evidences suggest that both Aedes aegypti and Culex quinquefasciatus mosquitoes from Recife are capable of replicating and transmitting the virus. Here, we conducted high throughput sequencing of ZIKV genomes directly from Ae. aegypti and Cx. quinquefasciatus mosquitoes collected during the ZIKV epidemics in Recife, in order to investigate the variability and evolution of the virus. We obtained 11 draft ZIKV genomes derived from 5 pools from each Ae. aegypti and Cx. quinquefasciatus species. Genome coverage breadth ranged from 16 to 100% and average depth from 45 to 46,584×. Two of these genomes were obtained from pools of Cx. quinquefasciatus females with no sign of blood in the abdomen. Amino acid substitutions found here were not species-specific. In addition, molecular clock dating estimated that ZIKV draft genomes obtained here were co-circulating in other regions of the country during the epidemics. Overall results highlight that viral mutations and even minor variants can be detected in genomes directly sequenced from mosquito samples and insights about natural viral genomic variability and viral evolution can be useful when designing tools for mosquito control programs.

11.
J Med Chem ; 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972088

RESUMO

Emerging and resurging mosquito-borne flaviviruses are an important public health challenge. The increased prevalence of dengue virus (DENV) infection has had a significant socio-economic impact on epidemic countries. The recent outbreak of Zika virus (ZIKV) has created an international public health emergency because ZIKV infection has been linked to congenital defects and Guillain-Barré syndrome. To develop potentially antiviral drugs for combatting these acute infectious diseases, we have targeted the host calcium/calmodulin-dependent kinase II (CaMKII) for inhibition. By using CaMKII structure-guided inhibitor design, we generated four families of benzenesulfonamide (BSA) derivatives for SAR analysis. Among these substances, N-(4-cycloheptyl-4-oxobutyl)-4-methoxy-N-phenylbenzenesulfonamide (9) showed superior properties as a lead CaMKII inhibitor and antiviral agent. BSA 9 inhibited CaMKII activity with an IC50 value of 0.79 µM and displayed EC50 values of 1.52 µM and 1.91 µM against DENV and ZIKV infections of human neuronal BE(2)C cells, respectively. Notably, 9 significantly reduced the viremia level and increased animal survival time in mouse-challenge models.

12.
Int J Gynaecol Obstet ; 148 Suppl 2: 9-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31975394

RESUMO

OBJECTIVE: To identify newborns with congenital Zika infection (CZI) at a maternity hospital in Salvador, Brazil, during the 2016 microcephaly outbreak. METHODS: A prospective study enrolled microcephalic and normocephalic newborns with suspected CZI between January and December 2016. Serology (immunoglobulins IgM and IgG) and quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) for the Zika virus were performed. Demographic and clinical characteristics of newborns with and without microcephaly were compared. RESULTS: Of the 151 newborns enrolled, 32 (21.2%) were classified as microcephalic. The majority of these cases were born between January and May 2016. IgM and IgG Zika virus antibodies were detected in 5 (23.8%) and 17 (80.9%) microcephalic newborn blood samples, respectively. Six (24%) microcephalic newborns tested positive for Zika virus by RT-qPCR in urine or placenta samples. Thirteen (11.8%) normocephalic newborns also tested positive for Zika virus by PCR in urine, plasma, or placenta samples, while IgM antibodies against Zika were detected in 4 (4.2%) others. CONCLUSIONS: Identification of 17 normocephalic CZI cases, confirmed by IgM serology or RT-qPCR for Zika virus, provides evidence that CZI can present asymptomatically at birth. This finding highlights the need for prenatal and neonatal screening for Zika virus in endemic regions.

13.
Int J Gynaecol Obstet ; 148 Suppl 2: 4-8, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31975396

RESUMO

OBJECTIVES: To describe the characteristics of pregnant women infected with Zika virus in two representative regions of Colombia, examine their pregnancy outcomes, and outline findings of the epidemiologic surveillance program established during the peak of the 2015-2016 epidemic. METHODS: A cohort study conducted in the municipalities of Cali and Villavicencio using data from the National Public Health Surveillance System (SIVIGILA) and clinical follow-up data from pregnant women. We describe sociodemographic characteristics, health insurance status, Zika virus, pregnancy-related characteristics, and pregnancy outcomes. RESULTS: A total of 1259 Zika-infected pregnant women were identified in Cali; of these, 2.3% (n=27) experienced pregnancy loss, 9.5% (n=113) had preterm birth, and 7.9% (n=91) had a low birthweight neonate. In Villavicencio, 3.0% (n=13) experienced pregnancy loss, 6.9% (n=30) had preterm birth, and 6.7% (n=28) had a low birthweight neonate. Compared with the general population, this population of Zika-infected pregnant women did not experience an increased frequency of preterm birth or low birthweight (relative risk of prematurity and low birthweight infant <1). CONCLUSIONS: Epidemiologic surveillance data showed that most neonates of Zika-infected pregnant women were born at term, and that the frequency of low birthweight neonates was low. Good quality data were obtained from the surveillance registries.

14.
Int J Gynaecol Obstet ; 148 Suppl 2: 29-35, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31975397

RESUMO

OBJECTIVE: To explore the perceptions and experiences of pregnant women in accessing healthcare services during the epidemic in Colombia during 2015-2016. METHODS: A qualitative study using semistructured interviews was conducted in Villavicencio. Six women who had been diagnosed with Zika virus infection during their pregnancies and whose fetus had suspected microcephaly participated in the investigation. Grounded theory was used and thematic content analysis was made for each category identified. RESULTS: Three main themes affecting access to healthcare services were identified: (1) women knew basic information about the virus, but it was limited; (2) access to services was delayed due to their lack of availability or limited supply in the municipality; and (3) most of the participants made out-of-pocket payments to get access to services that were not provided. CONCLUSIONS: Several gaps were identified in the provision of healthcare services to pregnant women during the Zika epidemic. Policy makers need to utilize the results from affected communities to develop and implement public policies that adapt and respond to their priorities and needs.

16.
Int J Gynaecol Obstet ; 148 Suppl 2: 55-60, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31975401

RESUMO

OBJECTIVE: To determine the spatial distribution of the risk of Zika virus disease in each region of Colombia during the 2015-2016 epidemic. METHODS: An ecological study was designed to estimate the risks for each Colombian region using first-order neighbors, covariate effects, and three adjacent periods of time (beginning, development, and end of the epidemic) to analyze the spatial distribution of the disease based on a Bayesian hierarchical model. RESULTS: Spatial distribution of the estimated risks of Zika virus disease showed that it increased in a strip that crosses the central area of the country from west to east. Analysis of the three time periods showed greater risk of the disease in the central and southern zones-Arauca and Santander-where the increase in risk was four times higher during the peak phase compared with the initial phase of the outbreak. CONCLUSION: In the identified high-risk areas, integrated surveillance systems for Zika virus disease and its complications must be strengthened to provide up-to-date and accurate epidemiological information. This information would allow those involved in policy and decision making to identify new outbreaks and risk clusters, enabling more focused and accurate measures to target at-risk populations.

17.
Int J Gynaecol Obstet ; 148 Suppl 2: 15-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31975403

RESUMO

OBJECTIVES: To describe the mechanisms of implementation of Zika virus diagnosis, prevention, and management guidelines in Colombia, and to characterize their influence on efforts to defend sexual and reproductive rights. METHODS: A qualitative study performed between February and April 2018 in three municipalities in Colombia. We conducted 30 semistructured interviews and five focus groups with key informants who played a role during the epidemic. These included decision-makers, program coordinators, healthcare providers, pregnant women diagnosed with Zika virus, and members of affected communities. RESULTS: We identified barriers to and facilitators for the implementation of the national Zika virus response plan. Barriers included a lack of coordination between vector control efforts and in the realms of sexual and reproductive rights. Facilitators included healthcare providers' response to the epidemic, the development of technical skills, and the establishment of coordination and referral networks across different institutions. CONCLUSION: A multidimensional approach that considers healthcare services, gender issues, and the environment is crucial. We highlight the epidemic's effects on women's sexual and reproductive rights, mainly related to inequalities in sexual and reproductive health such as the increased risk of sexually transmitted infections experienced by the poorest and most vulnerable women.

19.
PLoS One ; 14(12): e0225699, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31809512

RESUMO

The question of how Zika virus (ZIKV) changed from a seemingly mild virus to a human pathogen capable of microcephaly and sexual transmission remains unanswered. The unexpected emergence of ZIKV's pathogenicity and capacity for sexual transmission may be due to genetic changes, and future changes in phenotype may continue to occur as the virus expands its geographic range. Alternatively, the sheer size of the 2015-16 epidemic may have brought attention to a pre-existing virulent ZIKV phenotype in a highly susceptible population. Thus, it is important to identify patterns of genetic change that may yield a better understanding of ZIKV emergence and evolution. However, because ZIKV has an RNA genome and a polymerase incapable of proofreading, it undergoes rapid mutation which makes it difficult to identify combinations of mutations associated with viral emergence. As next generation sequencing technology has allowed whole genome consensus and variant sequence data to be generated for numerous virus samples, the task of analyzing these genomes for patterns of mutation has become more complex. However, understanding which combinations of mutations spread widely and become established in new geographic regions versus those that disappear relatively quickly is essential for defining the trajectory of an ongoing epidemic. In this study, multiscale analysis of the wealth of genomic data generated over the course of the epidemic combined with in vivo laboratory data allowed trends in mutations and outbreak trajectory to be assessed. Mutations were detected throughout the genome via deep sequencing, and many variants appeared in multiple samples and in some cases become consensus. Similarly, amino acids that were previously consensus in pre-outbreak samples were detected as low frequency variants in epidemic strains. Protein structural models indicate that most of the mutations associated with the epidemic transmission occur on the exposed surface of viral proteins. At the macroscale level, consensus data was organized into large and interactive databases to allow the spread of individual mutations and combinations of mutations to be visualized and assessed for temporal and geographical patterns. Thus, the use of multiscale modeling for identifying mutations or combinations of mutations that impact epidemic transmission and phenotypic impact can aid the formation of hypotheses which can then be tested using reverse genetics.

20.
Sci Rep ; 9(1): 18596, 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31819129

RESUMO

The presence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) in Brazil, may result in a difficult diagnosis due to the signs and symptoms shared by those. Moreover, as DENV and ZIKV belong to the same family, serological assays may show a high rate of cross-reactivity. Here, we evaluated a Dengue NS1 capture assay for early and differential diagnosis of dengue during the Zika epidemic occurred in Brazil in 2016. Samples (n = 227) from 218 patients included sera, plasma and urine from previously confirmed acute cases of Zika, dengue and Zika/dengue co-infections. Nine of those patients presented two specimens. The Dengue NS1 test was very specific for dengue diagnosis (99.32%), even in the co-circulation with ZIKV, and exhibited a high accuracy in not detecting acute Zika infections (92.43%). Our findings showed that the dengue NS1 capture test analyzed here was not able to recognize the ZIKV NS1 and its potential for cross-reaction.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA