51
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Generation and Characterization of a Polyclonal Antibody Against NS1 Protein for Detection of Zika Virus. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.96070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Reyes Y, Bowman NM, Becker-Dreps S, Centeno E, Collins MH, Liou GJA, Bucardo F. Prolonged Shedding of Zika Virus RNA in Vaginal Secretions, Nicaragua. Emerg Infect Dis 2019; 25:808-810. [PMID: 30882329 PMCID: PMC6433009 DOI: 10.3201/eid2504.180977] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Zika virus, an arthropod-borne flavivirus pathogen in humans, is unusual because it can be sexually transmitted and can be shed for prolonged periods in semen. We report viral shedding in vaginal secretions for up to 6 months, indicating the potential for sexual and vertical transmission by infected women.
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53
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Gorchakov R, Berry RM, Patel SM, El Sahly HM, Ronca SE, Murray KO. Optimizing PCR Detection of Zika Virus from Various Body Fluids. Am J Trop Med Hyg 2019; 100:427-433. [PMID: 30560770 PMCID: PMC6367632 DOI: 10.4269/ajtmh.18-0755] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Current diagnostic protocols of acute Zika virus (ZIKV) infection focus on detection of viral RNA in serum or urine using reverse transcription quantitative polymerase chain reaction (RT-qPCR); however, detecting infection can be a challenge, given that 80% of people with acute ZIKV infection are asymptomatic, and the window to detect viremia in serum is short. The ability to extend that window is needed to detect ZIKV at later time points after infection, particularly in high-risk individuals such as pregnant women. We evaluated RNA extraction methods to optimize detection of ZIKV in various body fluids using RT-qPCR as a means of improving the analytical sensitivity of detection. We optimized methods for ZIKV RNA recovery from a number of body fluids by spiking with three varying concentrations of virus, then comparing recovery with that of spiked buffer control. RNA extraction protocols were adjusted as necessary for maximum RNA recovery. Adjustment of the elution step was essential for improved ZIKV RNA recovery from whole blood, saliva, vaginal secretions, and breast milk. Optimal recovery from urine samples required the addition of Urine Conditioning Buffer, and the use of RLT Plus buffer and RNeasy Mini Spin Columns was necessary for RNA extractions from semen samples. Optimized QIAamp MinElute Virus Spin Kit (QIAGEN, Valencia, CA) protocol followed by the singleplex ZIKV RT-qPCR assay provided a reliable method for detection of ZIKV RNA in a variety of biological samples. Improved diagnostics are crucial for timely detection and diagnosis, particularly during pregnancy when the consequences of ZIKV infection can greatly impact the developing fetus.
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Affiliation(s)
- Rodion Gorchakov
- Department of Pediatrics-Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Rebecca M Berry
- Department of Pediatrics-Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Shital M Patel
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Hana M El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Shannon E Ronca
- Department of Pediatrics-Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Kristy O Murray
- Department of Pediatrics-Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
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Grubor-Bauk B, Wijesundara DK, Masavuli M, Abbink P, Peterson RL, Prow NA, Larocca RA, Mekonnen ZA, Shrestha A, Eyre NS, Beard MR, Gummow J, Carr J, Robertson SA, Hayball JD, Barouch DH, Gowans EJ. NS1 DNA vaccination protects against Zika infection through T cell-mediated immunity in immunocompetent mice. SCIENCE ADVANCES 2019; 5:eaax2388. [PMID: 31844662 PMCID: PMC6905874 DOI: 10.1126/sciadv.aax2388] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/08/2019] [Indexed: 05/08/2023]
Abstract
The causal association of Zika virus (ZIKV) with microcephaly, congenital malformations in infants, and Guillain-Barré syndrome in adults highlights the need for effective vaccines. Thus far, efforts to develop ZIKV vaccines have focused on the viral envelope. ZIKV NS1 as a vaccine immunogen has not been fully explored, although it can circumvent the risk of antibody-dependent enhancement of ZIKV infection, associated with envelope antibodies. Here, we describe a novel DNA vaccine encoding a secreted ZIKV NS1, that confers rapid protection from systemic ZIKV infection in immunocompetent mice. We identify novel NS1 T cell epitopes in vivo and show that functional NS1-specific T cell responses are critical for protection against ZIKV infection. We demonstrate that vaccine-induced anti-NS1 antibodies fail to confer protection in the absence of a functional T cell response. This highlights the importance of using NS1 as a target for T cell-based ZIKV vaccines.
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Affiliation(s)
- B. Grubor-Bauk
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
- Corresponding author.
| | - D. K. Wijesundara
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - M. Masavuli
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - P. Abbink
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - R. L. Peterson
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - N. A. Prow
- Experimental Therapeutics Laboratory, Cancer Research Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia
- Australian Infectious Diseases Research Centre, Brisbane, QLD 4072, Australia
| | - R. A. Larocca
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Z. A. Mekonnen
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - A. Shrestha
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
| | - N. S. Eyre
- Research Centre for Infectious Diseases, School of Biological Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - M. R. Beard
- Research Centre for Infectious Diseases, School of Biological Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - J. Gummow
- Gene Silencing and Expression Core Facility, Adelaide Health and Medical Sciences, Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia
| | - J. Carr
- Microbiology and Infectious Diseases, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - S. A. Robertson
- Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - J. D. Hayball
- Experimental Therapeutics Laboratory, Cancer Research Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia
- Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - D. H. Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - E. J. Gowans
- Discipline of Surgery, University of Adelaide and Basil Hetzel Institute for Translational Health Research, Adelaide, SA 5005, Australia
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55
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Lim SM, Wever R, Pas SD, Bonofacio G, Koopmans MPG, Martina BEE. Zika Virus Outbreak on Curaçao and Bonaire, a Report Based on Laboratory Diagnostics Data. Front Public Health 2019; 7:333. [PMID: 31781532 PMCID: PMC6861455 DOI: 10.3389/fpubh.2019.00333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/25/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Zika virus (ZIKV) emerged in May 2015 in Brazil, from which it spread to many other countries in Latin America. Cases of ZIKV infection were eventually also reported in Curaçao (January 2016) and Bonaire (February 2016). Methods: In the period of 16 December 2015 until 26 April 2017, serum, EDTA-plasma or urine samples were taken at Medical Laboratory Services (MLS) from patients on Curaçao and tested in qRT-PCR at the Erasmus Medical Centre (EMC) in the Netherlands. Between 17 October 2016 until 26 April 2017 all samples of suspected ZIKV-patients collected on Curaçao, as well as on Bonaire, were tested at MLS. Paired urine and/or serum samples from patients were analyzed for ZIKV shedding kinetics, and compared in terms of sensitivity for ZIKV RNA detection. Furthermore, the age and gender of patients were used to determine ZIKV incidence rates, and their geozone location to determine the spatial distribution of ZIKV cases. Results: In total, 781 patients of 2820 tested individuals were found qRT-PCR-positive for ZIKV on Curaçao. The first two ZIKV cases were diagnosed in December 2015. A total of 112 patients of 382 individuals tested qRT-PCR-positive for ZIKV on Bonaire. For both islands, the peak number of absolute cases occurred in November 2016, with 247 qRT-PCR confirmed cases on Curaçao and 66 qRT-PCR-positive cases on Bonaire. Overall, a higher proportion of women than men was diagnosed with ZIKV on both islands, as well as mostly individuals in the age category of 25–54 years old. Furthermore, ZIKV cases were mostly clustered in the east of the island, in Willemstad. Conclusions: ZIKV cases confirmed by qRT-PCR indicate that the virus was circulating on Curaçao between at least December 2015 and March 2017, and on Bonaire between at least October 2016 and February 2017, with peak cases occurring in November 2016. The lack of preparedness of Curaçao for the ZIKV outbreak was compensated by shipping all samples to the EMC for diagnostic testing; however, both islands will need to put the right infrastructure in place to enable a rapid response to an outbreak of any new emergent virus in the future.
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Affiliation(s)
| | - Robert Wever
- Medical Laboratory Services, Willemstad, Curaçao
| | - Suzan D Pas
- Department of Viroscience, WHO Collaborating Centre for Arboviruses and Hemorrhagic Fevers, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Marion P G Koopmans
- Department of Viroscience, WHO Collaborating Centre for Arboviruses and Hemorrhagic Fevers, Erasmus Medical Center, Rotterdam, Netherlands
| | - Byron E E Martina
- Artemis One Health Research Foundation, Delft, Netherlands.,Department of Viroscience, WHO Collaborating Centre for Arboviruses and Hemorrhagic Fevers, Erasmus Medical Center, Rotterdam, Netherlands
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56
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Tan MJA, Chan KWK, Ng IHW, Kong SYZ, Gwee CP, Watanabe S, Vasudevan SG. The Potential Role of the ZIKV NS5 Nuclear Spherical-Shell Structures in Cell Type-Specific Host Immune Modulation during ZIKV Infection. Cells 2019; 8:cells8121519. [PMID: 31779251 PMCID: PMC6953166 DOI: 10.3390/cells8121519] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 02/07/2023] Open
Abstract
The Zika virus (ZIKV) non-structural protein 5 (NS5) plays multiple viral and cellular roles during infection, with its primary role in virus RNA replication taking place in the cytoplasm. However, immunofluorescence assay studies have detected the presence of ZIKV NS5 in unique spherical shell-like structures in the nuclei of infected cells, suggesting potentially important cellular roles of ZIKV NS5 in the nucleus. Hence ZIKV NS5′s subcellular distribution and localization must be tightly regulated during ZIKV infection. Both ZIKV NS5 expression or ZIKV infection antagonizes type I interferon signaling, and induces a pro-inflammatory transcriptional response in a cell type-specific manner, but the mechanisms involved and the role of nuclear ZIKV NS5 in these cellular functions has not been elucidated. Intriguingly, these cells originate from the brain and placenta, which are also organs that exhibit a pro-inflammatory signature and are known sites of pathogenesis during ZIKV infection in animal models and humans. Here, we discuss the regulation of the subcellular localization of the ZIKV NS5 protein, and its putative role in the induction of an inflammatory response and the occurrence of pathology in specific organs during ZIKV infection.
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Affiliation(s)
- Min Jie Alvin Tan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Kitti Wing Ki Chan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Ivan H. W. Ng
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Sean Yao Zu Kong
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Chin Piaw Gwee
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Satoru Watanabe
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Subhash G. Vasudevan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Microbiology and Immunology, National University of Singapore, 5 Science Drive 2, Singapore 117545, Singapore
- Institute for Glycomics, Griffith University, Gold Coast Campus, Queensland 4022, Australia
- Correspondence: ; Tel.: +65-6516-6718
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57
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Saver AE, Crawford SA, Joyce JD, Bertke AS. Route of Infection Influences Zika Virus Shedding in a Guinea Pig Model. Cells 2019; 8:E1437. [PMID: 31739508 PMCID: PMC6912420 DOI: 10.3390/cells8111437] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/04/2019] [Accepted: 11/13/2019] [Indexed: 11/16/2022] Open
Abstract
Due to the recent epidemic of Zika virus (ZIKV) infection and resulting sequelae, as well as concerns about both the sexual and vertical transmission of the virus, renewed attention has been paid to the pathogenesis of this unique arbovirus. Numerous small animal models have been used in various ZIKV pathogenicity studies, however, they are often performed using immunodeficient or immunosuppressed animals, which may impact disease progression in a manner not relevant to immunocompetent humans. The use of immunocompetent animal models, such as macaques, is constrained by small sample sizes and the need for specialized equipment/staff. Here we report the establishment of ZIKV infection in an immunocompetent small animal model, the guinea pig, using both subcutaneous and vaginal routes of infection to mimic mosquito-borne and sexual transmission. Guinea pigs developed clinical signs consistent with mostly asymptomatic and mild disease observed in humans. We demonstrate that the route of infection does not significantly alter viral tissue tropism but does impact mucosal shedding mechanics. We also demonstrate persistent infection in sensory and autonomic ganglia, identifying a previously unrecognized niche of viral persistence that could contribute to viral shedding in secretions. We conclude that the guinea pig represents a useful and relevant model for ZIKV pathogenesis.
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Affiliation(s)
- Ashley E. Saver
- Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute & State University, Blacksburg, VA 24061, USA; (A.E.S.); (S.A.C.)
| | - Stephanie A. Crawford
- Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute & State University, Blacksburg, VA 24061, USA; (A.E.S.); (S.A.C.)
| | - Jonathan D. Joyce
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute & State University, Blacksburg, VA 24061, USA;
| | - Andrea S. Bertke
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute & State University, Blacksburg, VA 24061, USA;
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58
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Caine EA, Scheaffer SM, Broughton DE, Salazar V, Govero J, Poddar S, Osula A, Halabi J, Skaznik-Wikiel ME, Diamond MS, Moley KH. Zika Virus Causes Acute Infection and Inflammation in the Ovary of Mice Without Apparent Defects in Fertility. J Infect Dis 2019; 220:1904-1914. [PMID: 31063544 PMCID: PMC6834068 DOI: 10.1093/infdis/jiz239] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/06/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Zika virus (ZIKV) has become a global concern because infection of pregnant mothers was linked to congenital birth defects. Zika virus is unique from other flaviviruses, because it is transmitted vertically and sexually in addition to by mosquito vectors. Prior studies in mice, nonhuman primates, and humans have shown that ZIKV targets the testis in males, resulting in persistent infection and oligospermia. However, its effects on the corresponding female gonads have not been evaluated. METHODS In this study, we assessed the effects of ZIKV on the ovary in nonpregnant mice. RESULTS During the acute phase, ZIKV productively infected the ovary causing accumulation of CD4+ and virus-specific CD8+ T cells. T cells protected against ZIKV infection in the ovary, as higher viral burden was measured in CD8-/- and TCRβδ-/- mice. Increased cell death and tissue inflammation in the ovary was observed during the acute phase of infection, but this normalized over time. CONCLUSIONS In contrast to that observed with males, minimal persistence and no long-term consequences of ZIKV infection on ovarian follicular reserve or fertility were demonstrated in this model. Thus, although ZIKV replicates in cells of the ovary and causes acute oophoritis, there is rapid resolution and no long-term effects on fertility, at least in mice.
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Affiliation(s)
- Elizabeth A Caine
- Departments of Medicine, Molecular Microbiology, Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Suzanne M Scheaffer
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Darcy E Broughton
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Vanessa Salazar
- Departments of Medicine, Molecular Microbiology, Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer Govero
- Departments of Medicine, Molecular Microbiology, Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Subhajit Poddar
- Departments of Medicine, Molecular Microbiology, Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Augustine Osula
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Jacques Halabi
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | | | - Michael S Diamond
- Departments of Medicine, Molecular Microbiology, Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Kelle H Moley
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
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da Cruz TE, Souza RP, Pelloso SM, Morelli F, Suehiro TT, Damke E, Bonfim-Mendonça PDS, da Silva VRS, Consolaro MEL. Case Reports: Prolonged Detection of Zika Virus RNA in Vaginal and Endocervical Samples from a Brazilian Woman, 2018. Am J Trop Med Hyg 2019; 100:183-186. [PMID: 30398145 DOI: 10.4269/ajtmh.18-0623] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Zika virus (ZIKV) infection is an emerging public health problem, associated with increased risk for Guillain-Barré syndrome and adverse fetal outcomes, including congenital microcephaly. Zika virus sexual transmission is known, but detection of the virus in different parts of the female reproductive tract is not well established. In this case report, we describe prolonged detection of ZIKV RNA in the vaginal secretion and endocervical mucosa from a Brazilian woman convalescent to ZIKV infection. A viral load of 2 × 102 copies/mL was detected up to 31 days after symptom onset in both samples. Other biological fluids, including whole blood, plasma, serum, urine, and saliva samples, were negative for ZIKV RNA. These findings advance the understanding of ZIKV infection and provide data for additional testing strategies.
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Affiliation(s)
- Taís E da Cruz
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
| | - Raquel P Souza
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
| | - Sandra M Pelloso
- Department of Nursing, Universidade Estadual de Maringá, Paraná, Brazil
| | - Fabrício Morelli
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
| | - Tamy T Suehiro
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
| | - Edilson Damke
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
| | | | - Vânia R S da Silva
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
| | - Marcia E L Consolaro
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Paraná, Brazil
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60
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Productive Infection of Mouse Mammary Glands and Human Mammary Epithelial Cells by Zika Virus. Viruses 2019; 11:v11100950. [PMID: 31619008 PMCID: PMC6832565 DOI: 10.3390/v11100950] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 11/17/2022] Open
Abstract
Zika virus (ZIKV) belongs to the large category of arboviruses. Surprisingly, several human-to-human transmissions of ZIKV have been notified, either following sexual intercourse or from the mother to fetus during pregnancy. Importantly, high viral loads have been detected in the human breast milk of infected mothers, and the existence of breastfeeding as a new mode of mother-to-child transmission of ZIKV was recently hypothesized. However, the maternal origin of infectious particles in breast milk is currently unknown. Here, we show that ZIKV disseminates to the mammary glands of infected mice after both systemic and local exposure with differential kinetics. Ex vivo, we demonstrate that primary human mammary epithelial cells were sensitive and permissive to ZIKV infection in this study. Moreover, by using in vitro models, we prove that mammary luminal- and myoepithelial-phenotype cell lines are both able to produce important virus progeny after ZIKV exposure. Our data suggest that the dissemination of ZIKV to the mammary glands and subsequent infection of the mammary epithelium could be one mechanism of viral excretion in human breast milk.
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61
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Prisant N, Joguet G, Herrmann-Stock C, Moriniere C, Pavili L, Lurel S, Bujan L. Upper and lower genital tract Zika virus screening in a large cohort of reproductive-age women during the Americas epidemic. Reprod Biomed Online 2019; 39:624-632. [PMID: 31375360 DOI: 10.1016/j.rbmo.2019.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 11/21/2022]
Abstract
RESEARCH QUESTION To determine whether there is a risk of localized Zika virus (ZIKV) infection in the upper genital tract, specifically the oocytes, follicular fluids and endometrium, in exposed and/or recently infected reproductive-age women. ZIKV is an Aedes mosquito-borne Flavivirus that can lead to birth defects and to developmental anomalies when it infects pregnant women. DESIGN Controlled observational clinical study following 179 female patients undergoing oocyte vitrification cycles in an academic fertility centre during the ZIKV epidemic in the French territories of the Americas. At the time, the French Ministry of Health issued a ban on medically-induced pregnancies. Oocyte vitrification cycles were the only means of preserving fertility options and ensuring Zika-free oocyte cryopreservation for currently exposed and/or recently infected patients. Samples of serum, urine, lower genital tract, endometrium, follicular fluid and immature oocytes were tested for ZIKV RNA (vRNA) by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Serological analysis for ZIKV antibodies was performed in succession for the duration of the study. The follow-up protocol was set up for more than 6 months post-exposure or post-onset. RESULTS No vRNA was detected in the various samples from exposed patients. Furthermore, no vRNA was found in the upper genital tracts of women with a recent (3 months) history of acute infection. CONCLUSION These findings represent evidence of a lack of vRNA persistence in the reproductive tract in ZIKV exposed and/or recently infected reproductive-age women and could help simplify current guidelines.
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Affiliation(s)
- Nadia Prisant
- Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France; Department of Pathology, Sheba Medical Center, Tel HaShomer, Israel.
| | - Guillaume Joguet
- Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France
| | - Cecile Herrmann-Stock
- Centre Hospitalier Universitaire de Pointe-à-Pitre, Laboratoire de Microbiologie Clinique et Environnementale, Guadeloupe FWI, France
| | - Catherine Moriniere
- Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France
| | - Lynda Pavili
- Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France
| | - Sylvia Lurel
- Centre Hospitalier Universitaire de Pointe-à-Pitre, CCMR CECOS Caraïbes, Pôle Parents Enfants, Guadeloupe FWI, France
| | - Louis Bujan
- Research Group on Human Fertility (EA3694), Toulouse III University and CECOS Hôpital Paule de Viguier, CHU Toulouse, France
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62
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Ximenes RADA, Miranda-Filho DDB, Brickley EB, Montarroyos UR, Martelli CMT, de Araújo TVB, Rodrigues LC, de Albuquerque MDFPM, de Souza WV, Castanha PMDS, França RFO, Dhália R, Marques ETA. Zika virus infection in pregnancy: Establishing a case definition for clinical research on pregnant women with rash in an active transmission setting. PLoS Negl Trop Dis 2019; 13:e0007763. [PMID: 31589611 PMCID: PMC6797234 DOI: 10.1371/journal.pntd.0007763] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/17/2019] [Accepted: 09/08/2019] [Indexed: 12/26/2022] Open
Abstract
Defining cases of Zika virus (ZIKV) infection is a critical challenge for epidemiological research. Due to ZIKV's overlapping clinical features and potential immunologic cross-reactivity with other flaviviruses and the current lack of an optimal ZIKV-specific diagnostic assay, varying approaches for identifying ZIKV infections have been employed to date. This paper presents the laboratory results and diagnostic criteria developed by the Microcephaly Epidemic Research Group for defining cases of maternal ZIKV infection in a cohort of pregnant women with rash (N = 694) recruited during the declining 2015-2017 epidemic in northeast Brazil. For this investigation, we tested maternal sera for ZIKV by quantitative reverse transcription polymerase chain reaction (qRT-PCR), Immunoglobulin (Ig) M and IgG3 enzyme-linked immunosorbent assays (ELISAs), and Plaque Reduction Neutralization Test (PRNT50). Overall, 23.8% of participants tested positive by qRT-PCR during pregnancy (range of detection: 0-72 days after rash onset). However, the inter-assay concordance was lower than expected. Among women with qRT-PCR-confirmed ZIKV and further testing, only 10.1% had positive IgM tests within 90 days of rash, and only 48.5% had ZIKV-specific PRNT50 titers ≥20 within 1 year of rash. Given the complexity of these data, we convened a panel of experts to propose an algorithm for identifying ZIKV infections in pregnancy based on all available lines of evidence. When the diagnostic algorithm was applied to the cohort, 26.9% of participants were classified as having robust evidence of a ZIKV infection during pregnancy, 4.0% as having moderate evidence, 13.3% as having limited evidence of a ZIKV infection but with uncertain timing, and 19.5% as having evidence of an unspecified flavivirus infection before or during pregnancy. Our findings suggest that integrating longitudinal data from nucleic acid and serologic testing may enhance diagnostic sensitivity and underscore the need for an on-going dialogue regarding the optimization of strategies for defining cases of ZIKV in research.
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Affiliation(s)
- Ricardo Arraes de Alencar Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE, Brasil
- Departamento de Medicina Interna, Universidade de Pernambuco, Recife, PE, Brasil
| | | | - Elizabeth B. Brickley
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Laura C. Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Priscila Mayrelle da Silva Castanha
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brasil
| | | | - Rafael Dhália
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil
| | - Ernesto T. A. Marques
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Zika Virus Pathogenesis: From Early Case Reports to Epidemics. Viruses 2019; 11:v11100886. [PMID: 31546589 PMCID: PMC6832697 DOI: 10.3390/v11100886] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 01/01/2023] Open
Abstract
For the first 60 years following its isolation, Zika virus (ZIKV) remained a relatively poorly described member of the Flaviviridae family. However, since 2007, it has caused a series of increasingly severe outbreaks and is now associated with neurological symptoms such as Guillain-Barré syndrome and congenital Zika syndrome (CZS). A number of reports have improved our understanding of rare complications that may be associated with ZIKV infection in adults, the areas of the body to which it spreads, and viral persistence in various tissues. Likewise, studies on the effect of ZIKV infection during pregnancy have identified risk factors for CZS and the impact this syndrome has on early childhood. Understanding these outcomes and the factors that drive ZIKV pathogenesis are key to developing vaccination and therapeutic approaches to avoid these severe and potentially debilitating symptoms.
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Sherley M, Ong CW. Sexual transmission of Zika virus: a literature review. Sex Health 2019; 15:183-199. [PMID: 29268073 DOI: 10.1071/sh17046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 09/25/2017] [Indexed: 01/02/2023]
Abstract
Zika virus is an emerging health threat worldwide. A member of the yellow fever virus family, it is primarily spread by mosquitoes of the Aedes (Stegomyia) genus. Unusually for a mosquito-borne virus, sexual spread has also been reported; with cases of male-to-female, female-to-male and male-to-male sexual transmission all now published in the scientific literature, in both symptomatic and asymptomatic infection. Female-to-female sexual transmission has not yet been reported, but is biologically plausible. The extent of the effect of sexual transmission on the spread of Zika virus around the world is not well-characterised, but has particular relevance to travellers to and from non-endemic regions, and assisted reproduction services.
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Affiliation(s)
- Miranda Sherley
- Canberra Sexual Health Centre, Building 5, Level 1, Canberra Hospital, Garran, ACT. PO Box 11, Woden, ACT 2606, Australia
| | - Chong-Wei Ong
- Infectious Diseases Unit, Building 10, Level 4, Canberra Hospital, Garran, ACT. PO Box 11, Woden, ACT 2606, Australia
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Zambrano LI, Rodriguez E, Espinoza-Salvado IA, Rodríguez-Morales AJ. Dengue in Honduras and the Americas: The epidemics are back! Travel Med Infect Dis 2019; 31:101456. [DOI: 10.1016/j.tmaid.2019.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 02/06/2023]
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Abstract
Zika virus (ZIKV) is an arthropod-borne virus that belongs to the Flaviviridae family. Although most cases are mild or go undetected, rare severe neurologic effects, including congenital ZIKV syndrome (CZS) and Guillain-Barré syndrome, have been identified. The serious neurologic complications associated with ZIKV prompted the declaration of the public health emergency of international concern by the World Health Organization. Overall, transmission occurred throughout South and Central America as well as the Caribbean, affecting 48 countries and territories from March 2015 to March 2017. Long-term management of CZS requires a comprehensive combination of supportive services throughout early development.
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Affiliation(s)
- Savina Reid
- Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA
| | - Kathryn Rimmer
- Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA
| | - Kiran Thakur
- Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA.
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Werner SL, Banda BK, Burnsides CL, Stuber AJ. Zoonosis: Update on Existing and Emerging Vector-Borne Illnesses in the USA. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2019; 7:91-106. [PMID: 32288973 PMCID: PMC7102350 DOI: 10.1007/s40138-019-00189-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This review describes mosquito- and tick-borne diseases found in the Western Hemisphere. It focuses on emerging diseases and recent geographic shifts in the presence of disease vectors. RECENT FINDINGS Mosquito and tick vectors have become more widespread as environmental conditions have become more favorable. Zika recently has emerged as a concern for fetal anomalies. West Nile Virus has become widespread. Lyme disease and other tick-borne diseases are more prevalent in areas previously inhospitable to these ticks. SUMMARY Healthcare providers must consider the possibility of mosquito- and tick-borne diseases in broader geographic areas and council patients traveling to endemic areas on precautions against these diseases. Treatment for suspected cases of serious tick-borne illnesses should not be delayed pending culture results.
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Affiliation(s)
- Sandra Lee Werner
- MetroHealth/Cleveland Clinic/CWRU Emergency Medicine Residency Program, Department of Emergency Medicine, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109 USA
| | - Bhanu Kirthi Banda
- MetroHealth/Cleveland Clinic/CWRU Emergency Medicine Residency Program, Department of Emergency Medicine, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109 USA
| | - Christopher Lee Burnsides
- MetroHealth/Cleveland Clinic/CWRU Emergency Medicine Residency Program, Department of Emergency Medicine, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109 USA
| | - Alexander James Stuber
- MetroHealth/Cleveland Clinic/CWRU Emergency Medicine Residency Program, Department of Emergency Medicine, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109 USA
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Abstract
PURPOSE OF REVIEW Zika virus has recently emerged from an obscure mosquito-borne pathogen to an international public health concern. It is the first viral agent newly demonstrated to cause birth defects in several decades, and it is the only arbovirus now known to be transmitted sexually. The purpose of this review is to provide an overview of current understanding of sexual transmission of Zika virus and its possible clinical and public health consequences. RECENT FINDINGS Sexual transmission of Zika virus has been reported from at least 13 countries without simultaneous mosquito-borne transmission; it is undoubtedly also occurring in countries with active arthropod transmission. Most published cases involve transmission from symptomatically infected men to women partners. Nevertheless, transmission from a symptomatic man to another man, from a symptomatic woman to a man, and from an asymptomatic man to a woman has also been reported. Sexual transmission has occurred before symptom onset, during illness, and after resolution of the source partner's symptoms. With the exception of a woman who developed symptomatic infection 44 days after onset of her husband's illness, nearly all instances reported to date have occurred within 20 days of the source partner's illness. Zika virus RNA has been detected in semen, saliva, blood, urine, and vaginal and cervical secretions; the length of time during which RNA can be detected varies widely across different body fluids but is especially lengthy in semen. Although semen has been found to contain ZIKV RNA for more than 180 days after illness onset, only a small proportion of samples with detectable RNA yield replicative virus whenever cultured. SUMMARY Public health agencies have promulgated interim recommendations to prevent sexual transmission of Zika virus; however, much remains unknown regarding the duration of contagiousness and risk factors for transmission. Given the risk for birth defects, the greatest concern is for transmission of the virus to women who are pregnant or attempting to become pregnant. To prevent sexual transmission in general, couples are advised to use condoms or not have sex for at least 6 months from the start of the male partner's symptoms or the date he was diagnosed with Zika or after he has returned from an area with risk of ZIKV infection. Women who have symptomatic ZIKV infection or have traveled to an area of risk are advised to use condoms or avoid sex for 8 weeks from the start of the woman's symptoms or the date she was diagnosed with Zika or after the woman returns from the area of risk.
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Collins MH, Waggoner JJ. Detecting Vertical Zika Transmission: Emerging Diagnostic Approaches for an Emerged Flavivirus. ACS Infect Dis 2019; 5:1055-1069. [PMID: 30951637 DOI: 10.1021/acsinfecdis.9b00003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Zika virus (Zika) was recently responsible for a massive epidemic that spread throughout Latin America and beyond. Though Zika is typically asymptomatic or self-limiting, the sheer numbers of Zika infections led to the identification of unexpected phenotypes including sexual transmission, Guillain-Barré syndrome, and teratogenicity. Thousands of infants in South, Central, and North America have now been born with microcephaly or one of a number of fetal anomalies constituting the congenital Zika syndrome (CZS). Diagnosing CZS is based on a combination of clinical risk assessment and laboratory testing (which includes determining whether the mother has experienced a possible Zika infection during her pregnancy). A newborn suspected of having congenital Zika infection (due to maternal Zika infection or a birth defect described in association with congenital Zika infection) is then specifically tested for presence of Zika virus in neonatal tissue or anti-Zika IgM in the blood or cerebrospinal fluid. Though the guidelines are clear, there is room for considerable practice variation to emerge from individualized patient-provider encounters, largely due to limitations in diagnostic testing for Zika. The natural history of Zika further obscures our ability to know who, when, and how to test. Molecular diagnostics are highly specific but may not serve well those with asymptomatic infection. Serologic assays expand the diagnostic window but are complicated by cross-reactivity among related flaviviruses and passive immunity transferred from mother to baby. Furthermore, existing and emerging diagnostic tools may not be widely available due to limitations in resources and infrastructure of health systems in affected areas. Improvements in assay parameters as well as advances in platforms and deployability hold promise for optimizing diagnostic approaches for congenital Zika infection. The diagnostic tools and technologies under development must be integrated with forthcoming clinical knowledge of congenital Zika infection to fully realize the value that laboratory testing holds for diagnosing in utero mother to child transmission but also for understanding, predicting, and managing the health outcomes due to congenital Zika infection.
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Affiliation(s)
- Matthew H. Collins
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia 30322, United States
| | - Jesse J. Waggoner
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia 30322, United States
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
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Arévalo Romero H, Vargas Pavía TA, Velázquez Cervantes MA, Flores Pliego A, Helguera Repetto AC, León Juárez M. The Dual Role of the Immune Response in Reproductive Organs During Zika Virus Infection. Front Immunol 2019; 10:1617. [PMID: 31354746 PMCID: PMC6637308 DOI: 10.3389/fimmu.2019.01617] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/28/2019] [Indexed: 12/16/2022] Open
Abstract
Zika virus is a mosquito-borne viral disease that emerged as a significant health problem in the Americas after an epidemic in 2015. Especially concerning are cases where Zika is linked to the development of brain abnormalities in newborns. Unlike other flaviviruses, Zika can be transmitted sexually, increasing the potential for intraspecies infection. Several reports show that the virus can persist for months in the testis of males after clearance of viremia, and that females are highly susceptible to infection via sexual transmission. The most common route of sexual transmission is male-to-female, which suggests that the mechanism driving persistence of Zika in the testis is essential for dissemination. The immune system plays an essential role in Zika infection. In females, a robust response inhibits the virus to control the infection. In males, however, the immunological response to Zika infection correlates with viral persistence. Thus, the immune system may have a dual role in sexually transmitted pathogenesis. The mechanism by which the immune system allows the virus to enter an immune-privileged site while continuing to disseminate is unclear. In this mini-review, we highlight advances in our knowledge of sexually transmitted Zika virus pathogenesis and the possible mechanisms mounted by the immune system that control or exacerbate the infection.
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Affiliation(s)
- Haruki Arévalo Romero
- Laboratory of Immunology and Molecular Microbiology, Multidisciplinary Academic Division of Jalpa de Méndez, Department of Genomics, University Juárez Autonomous of Tabasco, Jalpa de Méndez, Mexico
| | - Tania A Vargas Pavía
- Laboratory of Perinatal Virology, Department of Immuno-Biochemistry, National Institution of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Manuel A Velázquez Cervantes
- Laboratory of Perinatal Virology, Department of Immuno-Biochemistry, National Institution of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Arturo Flores Pliego
- Laboratory of Perinatal Virology, Department of Immuno-Biochemistry, National Institution of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Addy C Helguera Repetto
- Laboratory of Perinatal Virology, Department of Immuno-Biochemistry, National Institution of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
| | - Moises León Juárez
- Laboratory of Perinatal Virology, Department of Immuno-Biochemistry, National Institution of Perinatology "Isidro Espinosa de los Reyes", Mexico City, Mexico
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Hu Y, Dong X, He Z, Wu Y, Zhang S, Lin J, Yang Y, Chen J, An S, Yin Y, Shen Z, Zeng G, Tian H, Cai J, Yang Y, Guan H, Wu J, Li M, Zhu X. Zika virus antagonizes interferon response in patients and disrupts RIG-I-MAVS interaction through its CARD-TM domains. Cell Biosci 2019; 9:46. [PMID: 31183075 PMCID: PMC6555941 DOI: 10.1186/s13578-019-0308-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 05/29/2019] [Indexed: 12/21/2022] Open
Abstract
Background The emerging threat to global health associated with the Zika virus (ZIKV) epidemics and its link to severe complications highlights a growing need to better understand the pathogenic mechanisms of ZIKV. Accumulating evidence for a critical role of type I interferon (IFN-I) in protecting hosts from ZIKV infection lies in the findings that ZIKV has evolved various strategies to subvert the host defense line by counteracting the early IFN induction or subsequent IFN signaling. Yet, mechanisms underlying the counter-IFN capability of ZIKV and its proteins, which might contribute to the well-recognized broad cellular tropisms and persistence of ZIKV, remain incompletely understood. Results Using RNA sequencing-based transcriptional profiling of whole blood cells isolated from patients acutely infected by ZIKV, we found that transcriptional signature programs of antiviral interferon-stimulated genes and innate immune sensors in ZIKV-infected patients remained inactive as compared to those of healthy donors, suggesting that ZIKV was able to suppress the induction of IFN-I during the natural infection process in humans. Furthermore, by analyzing the molecular interaction in a ZIKV NS4A-overexpression system, or in the context of actual ZIKV infection, we identified that ZIKV NS4A directly bound MAVS and thereby interrupted the RIG-I/MAVS interaction through the CARD-TM domains, leading to attenuated production of IFN-I. Conclusions Our findings collectively revealed that ZIKV NS4A targeted MAVS and contributed to ZIKV immune evasion through abrogating MAVS-mediated IFN production. These findings obtained from patient studies have added new knowledge and molecular details to our understanding regarding how ZIKV mediates suppression of the IFN-I system and may provide a new basis for the future development of anti-ZIKV strategies. Electronic supplementary material The online version of this article (10.1186/s13578-019-0308-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yiwen Hu
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,Changsha Customs District P. R. China, Changsha, 410000 China
| | - Xinhuai Dong
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Zhenjian He
- 4School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yun Wu
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Shihao Zhang
- 5Department of Basic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Jiajie Lin
- 6Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yi Yang
- 5Department of Basic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Jiahui Chen
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Shu An
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Yingxian Yin
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623 China
| | - Zhiyong Shen
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China
| | - Gucheng Zeng
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Han Tian
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China
| | - Junchao Cai
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China
| | - Yi Yang
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,8Department of Pharmacology, Zhongshan School of Medicine, SunYat-sen University, Guangzhou, 510080 China
| | - Hongyu Guan
- 9Department of Endocrinology, The First Affiliated Hospital of SunYat-sen University, Guangzhou, 510080 China
| | - Jueheng Wu
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Mengfeng Li
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China
| | - Xun Zhu
- 1Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080 China.,3Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 China.,10Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, Guangzhou, 510080 China
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Abstract
PURPOSE OF REVIEW We review the range of dermatological signs seen in Zika infection and the possible relationship between the rash and viremia. We also hoped to explore the utility of mucocutaneous manifestations in narrowing the differential diagnosis from other similar flaviviruses. RECENT FINDINGS Clinical manifestations of Zika infection share many similarities with other mosquito-borne viruses such as dengue. These include non-specific symptoms such as a fever, rash, arthralgia, myalgia, and conjunctivitis. The morphology of the rash in Zika infection is not very specific and commonly described as maculopapular and centrifugal that usually extends to become diffuse. We reviewed 123 publications, encompassing a total of 368 Zika cases. One hundred seven cases with rash had sufficient data for detailed analysis. 8.4% of cases with rash had hemorrhagic manifestations such as palatal petechiae and bleeding ulcers. Only 20 reported cases were tested for viremia during presence of rash, and 70.6% of these cases were positive. While mucocutaneous complications are common in Zika infection, more research is necessary to determine the impact of rash on diagnosis, prognosis, and transmissibility in Zika infection.
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Affiliation(s)
- Xuan Qi Koh
- National University Health System, NUHS Residency Program, Medical Affairs (Education)/Internal Medicine, 1E Kent Ridge Road, NUHS Tower Block, Level 10, Singapore, 119228, Singapore.
| | | | - Paul Anantharajah Tambyah
- Department of Medicine (Infectious Disease), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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73
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Yao Y, Huo T, Lin YL, Nie S, Wu F, Hua Y, Wu J, Kneubehl AR, Vogt MB, Rico-Hesse R, Song Y. Discovery, X-ray Crystallography and Antiviral Activity of Allosteric Inhibitors of Flavivirus NS2B-NS3 Protease. J Am Chem Soc 2019; 141:6832-6836. [PMID: 31017399 DOI: 10.1021/jacs.9b02505] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Flaviviruses, including dengue, West Nile and recently emerged Zika virus, are important human pathogens, but there are no drugs to prevent or treat these viral infections. The highly conserved Flavivirus NS2B-NS3 protease is essential for viral replication and therefore a drug target. Compound screening followed by medicinal chemistry yielded a series of drug-like, broadly active inhibitors of Flavivirus proteases with IC50 as low as 120 nM. The inhibitor exhibited significant antiviral activities in cells (EC68: 300-600 nM) and in a mouse model of Zika virus infection. X-ray studies reveal that the inhibitors bind to an allosteric, mostly hydrophobic pocket of dengue NS3 and hold the protease in an open, catalytically inactive conformation. The inhibitors and their binding structures would be useful for rational drug development targeting Zika, dengue and other Flaviviruses.
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74
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Gorchakov R, Gulas-Wroblewski BE, Ronca SE, Ruff JC, Nolan MS, Berry R, Alvarado RE, Gunter SM, Murray KO. Optimizing PCR Detection of West Nile Virus from Body Fluid Specimens to Delineate Natural History in an Infected Human Cohort. Int J Mol Sci 2019; 20:ijms20081934. [PMID: 31010160 PMCID: PMC6514913 DOI: 10.3390/ijms20081934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022] Open
Abstract
West Nile virus (WNV), a mosquito-borne arbovirus, remains a major global health concern. In this study, we optimized PCR methods then assessed serially-collected whole blood (WB), urine (UR), saliva, and semen specimens from a large cohort of WNV-positive participants to evaluate the natural history of infection and persistent shedding of WNV RNA. Viral RNA extraction protocols for frozen WB and UR specimens were optimized and validated through spiking experiments to maximize recovery of viral RNA from archived specimens and to assess the degradation of WNV RNA in stored UR specimens. The resultant procedures were used in conjunction with PCR detection to identify WNV-positive specimens and to quantify their viral loads. A total of 59 of 352 WB, 10 of 38 UR, and 2 of 34 saliva specimens tested positive for WNV RNA. Although a single semen specimen was positive 22 days post onset, we could not definitively confirm the presence of WNV RNA in the remaining specimens. WNV RNA-positive UR specimens exhibited profound loss of viral RNA during storage, highlighting the need for optimal preservation pre-storage. This study provides optimized methods for WNV RNA detection among different fluid types and offers alternative options for diagnostic testing during the acute stages of WNV.
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Affiliation(s)
- Rodion Gorchakov
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Bonnie E Gulas-Wroblewski
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
- Department of Wildlife and Fisheries Sciences, Texas A&M University, College Station, TX 77843, USA.
| | - Shannon E Ronca
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Jeanne C Ruff
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Melissa S Nolan
- University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, USA.
| | - Rebecca Berry
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - R Elias Alvarado
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Sarah M Gunter
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Kristy O Murray
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
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Collins MH. Serologic Tools and Strategies to Support Intervention Trials to Combat Zika Virus Infection and Disease. Trop Med Infect Dis 2019; 4:E68. [PMID: 31010134 PMCID: PMC6632022 DOI: 10.3390/tropicalmed4020068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/11/2019] [Accepted: 04/15/2019] [Indexed: 12/30/2022] Open
Abstract
Zika virus is an emerging mosquito-borne flavivirus that recently caused a large epidemic in Latin America characterized by novel disease phenotypes, including Guillain-Barré syndrome, sexual transmission, and congenital anomalies, such as microcephaly. This epidemic, which was declared an international public health emergency by the World Health Organization, has highlighted shortcomings in our current understanding of, and preparation for, emerging infectious diseases in general, as well as challenges that are specific to Zika virus infection. Vaccine development for Zika virus has been a high priority of the public health response, and several candidates have shown promise in pre-clinical and early phase clinical trials. The optimal selection and implementation of imperfect serologic assays are among the crucial issues that must be addressed in order to advance Zika vaccine development. Here, I review key considerations for how best to incorporate into Zika vaccine trials the existing serologic tools, as well as those on the horizon. Beyond that, this discussion is relevant to other intervention strategies to combat Zika and likely other emerging infectious diseases.
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Affiliation(s)
- Matthew H Collins
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, GA 30030, USA.
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76
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Gregory CJ, Oduyebo T, Brault AC, Brooks JT, Chung KW, Hills S, Kuehnert MJ, Mead P, Meaney-Delman D, Rabe I, Staples E, Petersen LR. Modes of Transmission of Zika Virus. J Infect Dis 2019; 216:S875-S883. [PMID: 29267909 DOI: 10.1093/infdis/jix396] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
For >60 years, Zika virus (ZIKV) has been recognized as an arthropod-borne virus with Aedes species mosquitoes as the primary vector. However in the past 10 years, multiple alternative routes of ZIKV transmission have been identified. We review the available data on vector and non-vector-borne modes of transmission and interventions undertaken, to date, to reduce the risk of human infection through these routes. Although much has been learned during the outbreak in the Americas on the underlying mechanisms and pathogenesis of non-vector-borne ZIKV infections, significant gaps remain in our understanding of the relative incidence of, and risk from, these modes compared to mosquito transmission. Additional research is urgently needed on the risk, pathogenesis, and effectiveness of measures to mitigate non-vector-borne ZIKV transmission.
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Affiliation(s)
- Christopher J Gregory
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Titilope Oduyebo
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aaron C Brault
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - John T Brooks
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Koo-Whang Chung
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan Hills
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Matthew J Kuehnert
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul Mead
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Dana Meaney-Delman
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ingrid Rabe
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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Seferovic MD, Turley M, Valentine GC, Rac M, Castro ECC, Major AM, Sanchez B, Eppes C, Sanz-Cortes M, Dunn J, Kautz TF, Versalovic J, Muldrew KL, Stout T, Belfort MA, Demmler-Harrison G, Aagaard KM. Clinical Importance of Placental Testing among Suspected Cases of Congenital Zika Syndrome. Int J Mol Sci 2019; 20:ijms20030712. [PMID: 30736425 PMCID: PMC6387308 DOI: 10.3390/ijms20030712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 01/24/2019] [Accepted: 02/01/2019] [Indexed: 12/15/2022] Open
Abstract
Contemporaneous Zika virus (ZIKV) strains can cause congenital Zika syndrome (CZS). Current ZIKV clinical laboratory testing strategies are limited and include IgM serology (which may wane 12 weeks after initial exposure) and nucleic acid testing (NAT) of maternal serum, urine, and placenta for (+) strand ZIKV RNA (which is often transient). The objectives of this study were to determine if use of additional molecular tools, such as quantitative PCR and microscopy, would add to the diagnostic value of current standard placental ZIKV testing in cases with maternal endemic exposure and indeterminate testing. ZIKV RNA was quantified from dissected sections of placental villi, chorioamnion sections, and full cross-sections of umbilical cord in all cases examined. Quantitation with high-resolution automated electrophoresis determined relative amounts of precisely verified ZIKV (74-nt amplicons). In order to localize and visualize stable and actively replicating placental ZIKV in situ, labeling of flaviviridae glycoprotein, RNA ISH against both (+) and (⁻) ZIKV-specific ssRNA strands, and independent histologic examination for significant pathologic changes were employed. We demonstrate that the use of these molecular tools added to the diagnostic value of placental ZIKV testing among suspected cases of congenital Zika syndrome with poorly ascribed maternal endemic exposure.
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Affiliation(s)
- Maxim D Seferovic
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Michelle Turley
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Gregory C Valentine
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
- Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Martha Rac
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Eumenia C C Castro
- Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Angela M Major
- Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Brianna Sanchez
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Catherine Eppes
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Magdalena Sanz-Cortes
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - James Dunn
- Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Tiffany F Kautz
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - James Versalovic
- Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.
- Microbiology and Molecular Virology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Kenneth L Muldrew
- Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Timothy Stout
- Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Michael A Belfort
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Gail Demmler-Harrison
- Pediatrics, Section of Infectious Diseases at Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA.
| | - Kjersti M Aagaard
- Departments of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
- Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.
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78
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Zika virus diagnosis: challenges and solutions. Clin Microbiol Infect 2019; 25:142-146. [DOI: 10.1016/j.cmi.2018.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 01/03/2023]
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Abstract
Zika virus is a mosquito-borne Flavivirus responsible for symptomatic and asymptomatic infections in humans. Zika was first identified in Africa as a cause of sporadic febrile illness. Beginning in 2015, Zika virus infection was identified in Brazil and linked with several symptomatic infections. Notably, congenital infections were observed with marked neurologic abnormalities. Diagnosis relies on detection of Zika virus by real-time polymerase chain reaction or by the presence of anti-Zika antibodies. Treatment of this viral illness remains supportive; however, proactive screening and interventions are indicated in the treatment of infants with symptomatic congenital infection.
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Affiliation(s)
- David Taylor Hendrixson
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St. Louis, St. Louis Children's Hospital, Campus Box 8116, 1 Children's Place, St Louis, MO 63110, USA.
| | - Jason G Newland
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St. Louis, St. Louis Children's Hospital, Campus Box 8116, 1 Children's Place, St Louis, MO 63110, USA
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Tancharoen C, Sukjee W, Thepparit C, Jaimipuk T, Auewarakul P, Thitithanyanont A, Sangma C. Electrochemical Biosensor Based on Surface Imprinting for Zika Virus Detection in Serum. ACS Sens 2019; 4:69-75. [PMID: 30596236 DOI: 10.1021/acssensors.8b00885] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Zika virus (ZIKV) is a flavivirus that was first identified in 1947. Initially, the virus was of little concern for health authorities given there were very few casualties among those suffering an infection. As such, only limited studies were performed on ZIKV. Recently, the viral infection has been linked to microcephaly in infants, which has prompted a dramatic increase in scientific interest in ZIKV research, including methods to allow for rapid virus identification. In this work we report the development of a new type of ZIKV electrochemical biosensor based on surface imprinted polymers and graphene oxide composites. The biosensor was used to detect ZIKV by measuring changes in the electrical signal with changing virus concentrations in buffer and serum using standard electrochemical techniques. The detection limit of our method is similar to the detection limit of the real-time quantitative reverse transcription PCR method.
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Affiliation(s)
- Chompoonuch Tancharoen
- Department of Chemistry, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Wannisa Sukjee
- Department of Chemistry, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Chutima Thepparit
- Institute of Molecular Biosciences, Mahidol University, Bangkok, Nakhon Pathom 73170, Thailand
| | - Thitigun Jaimipuk
- Institute of Molecular Biosciences, Mahidol University, Bangkok, Nakhon Pathom 73170, Thailand
| | - Prasert Auewarakul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Arunee Thitithanyanont
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Chak Sangma
- Department of Chemistry, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
- Center for Advanced Studies in Nanotechnology for Chemical, Food and Agricultural Industries, Kasetsart University Institute for Advanced Studies, Kasetsart University, Bangkok 10900, Thailand
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81
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Challenges in diagnosing Zika-experiences from a reference laboratory in a non-endemic setting. Eur J Clin Microbiol Infect Dis 2019; 38:771-778. [PMID: 30680570 DOI: 10.1007/s10096-019-03472-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
Diagnosing a patient with Zika infection is not always straightforward. Here, we aim to describe our data collected from December 2015 to December 2017 and discuss the implemented algorithm and diagnostic challenges we encountered. At the National Reference Center for Arboviruses at the Institute of Tropical Medicine, Antwerp, Belgium (ITM), a commercial Zika virus (ZIKV) enzyme-linked immunosorbent assay (ELISA) detecting immunoglobulin (Ig) M and IgG, a commercial ZIKV immunofluorescence assay (IFA) detecting IgM, and an in-house Zika virus neutralization test (VNT) were implemented. For molecular detection of ZIKV, an in-house and a commercial real-time RT-PCR were applied. An algorithm, adapted from the European Centre for Disease Control and Prevention (ECDC), was implemented. Between December 2015 and December 2017, we tested 6417 patients for ZIKV. Of those, according to ECDC criteria, 127 (2.0%) were classified as a confirmed Zika infection of which 39 by RT-PCR (0.6%), 15 (0.2%) as a probable Zika infection, 73 (1.1%) as undefined, and 65 (1.0%) as false positive reactions. Main challenges were the brief window for detection of IgM, cross-reactivity of antibodies with other flaviviruses and malaria, and low VNT titers in the acute phase. In RT-PCR negative samples, classification of ZIKV infection as recent or past proved difficult, when IgM was negative. The majority of patients could be classified according to ECDC criteria, though 1.1% of patients remained "undefined" and 1.0% were ELISA false positive reactions. Complementary IFA IgM was of added value to increase IgM detection rates. Improved serological assays and more longitudinal data on antibody kinetics are needed.
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82
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Amerson-Brown MH, Miller AL, Maxwell CA, White MM, Vincent KL, Bourne N, Pyles RB. Cultivated Human Vaginal Microbiome Communities Impact Zika and Herpes Simplex Virus Replication in ex vivo Vaginal Mucosal Cultures. Front Microbiol 2019; 9:3340. [PMID: 30692980 PMCID: PMC6340164 DOI: 10.3389/fmicb.2018.03340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/24/2018] [Indexed: 01/07/2023] Open
Abstract
The human vaginal microbiome (VMB) is a complex bacterial community that interacts closely with vaginal epithelial cells (VECs) impacting the mucosal phenotype and its responses to pathogenic insults. The VMB and VEC relationship includes nutrient exchange and regulation of signaling molecules that controls numerous host functions and defends against invading pathogens. To better understand infection and replication of sexually transmitted viral pathogens in the human vaginal mucosa we used our ex vivo VEC multilayer culture system. We tested the hypothesis that selected VMB communities could be identified that alter the replication of sexually transmitted viruses consistent with reported clinical associations. Sterile VEC multilayer cultures or those colonized with VMB dominated by specific Lactobacillus spp., or VMB lacking lactobacilli, were infected with Zika virus, (ZIKV) a single stranded RNA virus, or Herpes Simplex Virus type 2 (HSV-2), a double stranded DNA virus. The virus was added to the apical surface of the cultured VEC multilayer to model transmission during vaginal intercourse. Viral replication was measured 48 h later by qPCR. The results indicated that VEC cultures colonized by VMB containing Staphylococcus spp., previously reported as inflammatory, significantly reduced the quantity of viral genomes produced by ZIKV. HSV-2 titers were decreased by nearly every VMB tested relative to the sterile control, although Lactobacillus spp.-dominated VMBs caused the greatest reduction in HSV-2 titer consistent with clinical observations. To explore the mechanism for reduced ZIKV titers, we investigated inflammation created by ZIKV infection, VMB colonization or pre-exposure to selected TLR agonists. Finally, expression levels of human beta defensins 1–3 were quantified in cultures infected by ZIKV and those colonized by VMBs that impacted ZIKV titers. Human beta defensins 1–3 produced by the VEC showed no association with ZIKV titers. The data presented expands the utility of this ex vivo model system providing controlled and reproducible methods to study the VMB impact on STIs and indicated an association between viral replication and specific bacterial species within the VMB.
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Affiliation(s)
- Megan H Amerson-Brown
- Graduate School of Biomedical Sciences, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Aaron L Miller
- Department of Pediatrics, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Carrie A Maxwell
- Department of Microbiology and Immunology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Mellodee M White
- Department of Pediatrics, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Kathleen L Vincent
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Nigel Bourne
- Department of Pediatrics, The University of Texas Medical Branch at Galveston, Galveston, TX, United States.,Department of Microbiology and Immunology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Richard B Pyles
- Department of Pediatrics, The University of Texas Medical Branch at Galveston, Galveston, TX, United States.,Department of Microbiology and Immunology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
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83
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Pérez-Padilla J, Paz-Bailey G, Meaney-Delman D, Doyle K, Gary J, Rodriguez DM, Bhatnagar J, Pérez-Rodriguez NM, Montalvo S, Alvarado L, Sharp TM. Persistent Zika Virus Infection Associated with Early Fetal Demise: A Case Report. ACTA ACUST UNITED AC 2019; 9:698-706. [PMID: 31799062 PMCID: PMC6889876 DOI: 10.4236/ojog.2019.95069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Infection with Zika virus (ZIKV) during pregnancy is known to cause birth defects and could also be linked to pregnancy loss. Case: A pregnant woman in Puerto Rico contracted ZIKV at 16 weeks gestation. ZIKV RNA persisted in serum from her initial test at 16 weeks through 24 weeks gestation, when fetal demise occurred, and was detected in placental tissue. Conclusion: Prolonged detection of ZIKV RNA in maternal serum was associated with ZIKV RNA detection in the placenta of a patient who experienced fetal demise. While detection of placenta ZIKV RNA does not establish that ZIKV conclusively caused the demise, these findings support emerging evidence that the placenta may serve as a reservoir for ZIKV, which may be associated with prolonged detection of ZIKV RNA in serum.
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Affiliation(s)
- Janice Pérez-Padilla
- Centers for Disease Control and Prevention (CDC), Dengue Branch, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Centers for Disease Control and Prevention (CDC), Dengue Branch, San Juan, Puerto Rico
| | - Dana Meaney-Delman
- CDC, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA, USA
| | - Kate Doyle
- CDC, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | - Joy Gary
- CDC, Infectious Disease Pathology Branch, Atlanta, GA, USA
| | - Dania M Rodriguez
- Centers for Disease Control and Prevention (CDC), Dengue Branch, San Juan, Puerto Rico
| | - Julu Bhatnagar
- CDC, Infectious Disease Pathology Branch, Atlanta, GA, USA
| | | | - Sara Montalvo
- Ponce Health Sciences University/Saint Luke's Episcopal Hospital, Ponce, Puerto Rico
| | - Luisa Alvarado
- Ponce Health Sciences University/Saint Luke's Episcopal Hospital, Ponce, Puerto Rico
| | - Tyler M Sharp
- Centers for Disease Control and Prevention (CDC), Dengue Branch, San Juan, Puerto Rico
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84
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Jääskeläinen AJ, Korhonen EM, Huhtamo E, Lappalainen M, Vapalahti O, Kallio-Kokko H. Validation of serological and molecular methods for diagnosis of zika virus infections. J Virol Methods 2019; 263:68-74. [DOI: 10.1016/j.jviromet.2018.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 12/17/2022]
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85
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El Sahly HM, Gorchakov R, Lai L, Natrajan MS, Patel SM, Atmar RL, Keitel WA, Hoft DF, Barrett J, Bailey J, Edupuganti S, Raabe V, Wu HM, Fairley J, Rouphael N, Murray KO, Mulligan MJ. Clinical, Virologic, and Immunologic Characteristics of Zika Virus Infection in a Cohort of US Patients: Prolonged RNA Detection in Whole Blood. Open Forum Infect Dis 2019; 6:ofy352. [PMID: 30697574 PMCID: PMC6343961 DOI: 10.1093/ofid/ofy352] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 11/30/2018] [Accepted: 12/14/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Clinical, virologic, and immunologic characteristics of Zika virus (ZIKV) infections in US patients are poorly defined. METHODS US subjects with suspected ZIKV infection were enrolled. Clinical data and specimens were prospectively collected for ZIKV RNA detection and serologic and cellular assays. Confirmed ZIKV infection (cases) and ZIKV-negative (controls) subjects were compared. Dengue-experienced and dengue-naïve cases were also compared. RESULTS We enrolled 45 cases and 14 controls. Commonly reported symptoms among cases and controls were maculopapular rash (97.8% and 81.8%), fatigue (86.7% and 81.8%), and arthralgia (82.2% and 54.5%), respectively. The sensitivity (94%) and duration of infection detection (80% positivity at 65-79 days after disease onset) by polymerase chain reaction were highest in whole-blood specimens. ZIKV-neutralizing antibodies had a half-life of 105 days and were significantly higher in dengue virus-experienced cases than naïve ones (P = .046). In intracellular cytokine staining assays, the ZIKV proteins targeted most often by peripheral blood mononuclear cells from cases were structural proteins C and E for CD4+ T cells and nonstructural proteins NS3, NS5, and NS4B for CD8+ T cells. CONCLUSIONS ZIKV RNA detection was more frequent and prolonged in whole-blood specimens. Immunoglobulin G (IgG) and neutralizing antibodies, but not IgM, were influenced by prior dengue infection. Robust cellular responses to E and nonstructural proteins have potential vaccine development implications.
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Affiliation(s)
- Hana M El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Rodion Gorchakov
- Section of Pediatric Tropical Medicine, Center for Human Immunobiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Lilin Lai
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Muktha S Natrajan
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Shital M Patel
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Robert L Atmar
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Wendy A Keitel
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Daniel F Hoft
- Departments of Molecular Microbiology & Immunology and Internal Medicine, Division of Infectious Diseases, Allergy & Immunology, Saint Louis University, St. Louis, Missouri
| | | | | | - Srilatha Edupuganti
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Vanessa Raabe
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Henry M Wu
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Jessica Fairley
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Nadine Rouphael
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Kristy O Murray
- Section of Pediatric Tropical Medicine, Center for Human Immunobiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Mark J Mulligan
- Division of Infectious Diseases and Microbiology and NYU Langone Vaccine Center, New York University, New York City, New York
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86
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Diamond MS, Ledgerwood JE, Pierson TC. Zika Virus Vaccine Development: Progress in the Face of New Challenges. Annu Rev Med 2018; 70:121-135. [PMID: 30388054 DOI: 10.1146/annurev-med-040717-051127] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Zika virus (ZIKV) emerged at a global level when it spread to the Americas and began causing congenital malformations and microcephaly in 2015. A rapid response by academia, government, public health infrastructure, and industry has enabled the expedited development and testing of a suite of vaccine platforms aiming to control and eliminate ZIKV-induced disease. Analysis of key immunization and pathogenesis studies in multiple animal models, including during pregnancy, has begun to define immune correlates of protection. Nonetheless, the deployment of ZIKV vaccines, along with the confirmation of their safety and efficacy, still has major challenges, one of which is related to the waning of the epidemic. In this review, we discuss the measures that enabled rapid progress and highlight the path forward for successful deployment of ZIKV vaccines.
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Affiliation(s)
- Michael S Diamond
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, Missouri 63110, USA;
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA;
| | - Theodore C Pierson
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA;
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Assay Challenges for Emerging Infectious Diseases: The Zika Experience. Vaccines (Basel) 2018; 6:vaccines6040070. [PMID: 30279372 PMCID: PMC6313918 DOI: 10.3390/vaccines6040070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 09/24/2018] [Accepted: 09/26/2018] [Indexed: 01/07/2023] Open
Abstract
From the perspective of vaccine development, it is imperative to accurately diagnose target infections in order to exclude subjects with prior exposure from evaluations of vaccine effectiveness, to track incident infection during the course of a clinical trial and to differentiate immune reactions due to natural infections from responses that are vaccine related. When vaccine development is accelerated to a rapid pace in response to emerging infectious disease threats, the challenges to develop such diagnostic tools is even greater. This was observed through the recent expansion of Zika virus infections into the Western Hemisphere in 2014⁻2017. When initial Zika vaccine clinical trials were being designed and launched in response to the outbreak, there were no standardized sets of viral and immunological assays, and no approved diagnostic tests for Zika virus infection. The diagnosis of Zika virus infection is still an area of active research and development on many fronts. Here we review emerging infectious disease vaccine clinical assay development and trial execution with a special focus on the state of Zika virus clinical assays and diagnostics.
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Valentine GC, Seferovic MD, Fowler SW, Major AM, Gorchakov R, Berry R, Swennes AG, Murray KO, Suter MA, Aagaard KM. Timing of gestational exposure to Zika virus is associated with postnatal growth restriction in a murine model. Am J Obstet Gynecol 2018; 219:403.e1-403.e9. [PMID: 29902449 DOI: 10.1016/j.ajog.2018.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Vertical transmission of Zika virus leads to infection of neuroprogenitor cells and destruction of brain parenchyma. Recent evidence suggests that the timing of infection as well as host factors may affect vertical transmission. As a result, congenital Zika virus infection may only become clinically apparent in the postnatal period. OBJECTIVE We sought to develop an outbred mouse model of Zika virus vertical transmission to determine if the timing of gestational Zika virus exposure yields phenotypic differences at birth and through adolescence. We hypothesized that later gestational inoculations would only become apparent in adolescence. STUDY DESIGN To better recapitulate human exposures, timed pregnant Swiss-Webster dams (n = 15) were subcutaneously inoculated with 1 × 104 plaque-forming units of first passage contemporary Zika virus HN16 strain or a mock injection on embryonic day 4, 8, or 12 with bioactive antiinterferon alpha receptor antibody administered in days preceding and proceeding inoculation. The antibody was given to prevent the robust type I interferon signaling cascade that make mice inherently resistant to Zika virus infection. At birth and adolescence (6 weeks of age) offspring were assessed for growth, brain weight, and biparietal head diameters, and Zika virus viral levels by reverse transcription-polymerase chain reaction or in situ hybridization. RESULTS Pups of Zika virus-infected dams infected at embryonic days 4 and 8 but not 12 were growth restricted (P < .003). Brain weights were significantly smaller at birth (P = .01) for embryonic day 8 Zika virus-exposed offspring. At 6 weeks of age, biparietal diameters were smaller for all Zika virus-exposed males and females (P < .05), with embryonic day 8-exposed males smallest by biparietal diameter and growth-restriction measurements (weight >2 SD, P = .0007). All pups and adolescent mice were assessed for Zika virus infection by reverse transcription-polymerase chain reaction. Analysis of all underweight pups reveled 1 to be positive for neuronal Zika virus infection by in situ hybridization, while a second moribund animal was diffusely positive at 8 days of age by Zika virus infectivity throughout the brain, kidneys, and intestine. CONCLUSION These findings demonstrate that postnatal effects of infection occurring at single time points continue to be detrimental to offspring in the postnatal period in a subset of littermates and subject to a window of gestational susceptibility coinciding with placentation. This model recapitulates frequently encountered clinical scenarios in nonendemic regions, including the majority of the United States, where travel-related exposure occurs in short and well-defined windows of gestation. Our low rate of infection and relatively rare evidence of congenital Zika syndrome parallels human population-based data.
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89
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Waggoner JJ, Rojas A, Pinsky BA. Yellow Fever Virus: Diagnostics for a Persistent Arboviral Threat. J Clin Microbiol 2018; 56:e00827-18. [PMID: 30021822 PMCID: PMC6156298 DOI: 10.1128/jcm.00827-18] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Yellow fever (YF) is the prototypical hemorrhagic fever and results from infection with yellow fever virus (YFV), which is endemic to regions of Africa and South America. Despite the availability of an effective vaccine, YFV continues to cause disease throughout regions where it is endemic, including intermittent large outbreaks among undervaccinated populations. A number of diagnostic methods and assays have been described for the detection of YFV infection, including viral culture, molecular testing, serology, and antigen detection. Commercial diagnostics are not widely available, and testing is generally performed at a small number of reference laboratories. The goal of this article, therefore, is to review available clinical diagnostics for YFV, which may not be familiar to many practitioners outside areas where it is endemic. Additionally, we identify gaps in our current knowledge about YF that pertain to diagnosis and describe interventions that may improve YFV detection.
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Affiliation(s)
- Jesse J Waggoner
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Global Health, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Alejandra Rojas
- Departamento de Producción, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Benjamin A Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
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90
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The emergence of Zika virus and its new clinical syndromes. Nature 2018; 560:573-581. [PMID: 30158602 DOI: 10.1038/s41586-018-0446-y] [Citation(s) in RCA: 266] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 07/19/2018] [Indexed: 11/08/2022]
Abstract
Zika virus (ZIKV) is a mosquito-transmitted flavivirus that has emerged as a global health threat because of its potential to generate explosive epidemics and ability to cause congenital disease in the context of infection during pregnancy. Whereas much is known about the biology of related flaviviruses, the unique features of ZIKV pathogenesis, including infection of the fetus, persistence in immune-privileged sites and sexual transmission, have presented new challenges. The rapid development of cell culture and animal models has facilitated a new appreciation of ZIKV biology. This knowledge has created opportunities for the development of countermeasures, including multiple ZIKV vaccine candidates, which are advancing through clinical trials. Here we describe the recent advances that have led to a new understanding of the causes and consequences of the ZIKV epidemic.
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91
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Preliminary Studies on Immune Response and Viral Pathogenesis of Zika Virus in Rhesus Macaques. Pathogens 2018; 7:pathogens7030070. [PMID: 30127237 PMCID: PMC6160936 DOI: 10.3390/pathogens7030070] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/18/2018] [Accepted: 08/10/2018] [Indexed: 01/08/2023] Open
Abstract
Zika Virus (ZIKV) is primarily transmitted through mosquito bites. It can also be transmitted during sexual intercourse and in utero from mother to fetus. To gain preliminary insight into ZIKV pathology and immune responses on route of transmission, rhesus macaques (RMs) were inoculated with ZIKV (PRVABC59) via intravaginal (IVAG) (n = 3) or subcutaneous (sub Q) (n = 2) routes. Systemic ZIKV infection was observed in all RMs, regardless of the route of inoculation. After 9 days postinfection (dpi), ZIKV was not detected in the plasma of IVAG- and sub-Q-inoculated RMs. Importantly, RMs harbored ZIKV up to 60 dpi in various anatomical locations. Of note, ZIKV was also present in several regions of the brain, including the caudate nucleus, parietal lobe, cortex, and amygdala. These observations appear to indicate that ZIKV infection may be systemic and persistent regardless of route of inoculation. In addition, we observed changes in key immune cell populations in response to ZIKV infection. Importantly, IVAG ZIKV infection of RMs is associated with increased depletion of CD11C hi myeloid cells, reduced PD-1 expression in NK cells, and elevated frequencies of Ki67+ CD8+ central memory cells as compared to sub Q ZIKV-infected RMs. These results need to interpreted with caution due to the small number of animals utilized in this study. Future studies involving large groups of animals that have been inoculated through both routes of transmission are needed to confirm our findings.
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92
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Li A, Yu J, Lu M, Ma Y, Attia Z, Shan C, Xue M, Liang X, Craig K, Makadiya N, He JJ, Jennings R, Shi PY, Peeples ME, Liu SL, Boyaka PN, Li J. A Zika virus vaccine expressing premembrane-envelope-NS1 polyprotein. Nat Commun 2018; 9:3067. [PMID: 30076287 PMCID: PMC6076265 DOI: 10.1038/s41467-018-05276-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 06/19/2018] [Indexed: 02/08/2023] Open
Abstract
Current efforts to develop Zika virus (ZIKV) subunit vaccines have been focused on pre-membrane (prM) and envelope (E) proteins, but the role of NS1 in ZIKV-specific immune response and protection is poorly understood. Here, we develop an attenuated recombinant vesicular stomatitis virus (rVSV)-based vaccine expressing ZIKV prM-E-NS1 as a polyprotein. This vectored vaccine candidate is attenuated in mice, where a single immunization induces ZIKV-specific antibody and T cell immune responses that provide protection against ZIKV challenge. Co-expression of prM, E, and NS1 induces significantly higher levels of Th2 and Th17 cytokine responses than prM-E. In addition, NS1 alone is capable of conferring partial protection against ZIKV infection in mice even though it does not induce neutralizing antibodies. These results demonstrate that attenuated rVSV co-expressing prM, E, and NS1 is a promising vaccine candidate for protection against ZIKV infection and highlights an important role for NS1 in ZIKV-specific cellular immune responses.
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MESH Headings
- Animals
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/immunology
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Antigens, Viral/metabolism
- Cytokines/metabolism
- Disease Models, Animal
- Female
- Genetic Vectors/immunology
- Male
- Mice
- Mice, Inbred BALB C
- Polyproteins/genetics
- Polyproteins/immunology
- Th17 Cells/metabolism
- Th2 Cells/metabolism
- Vaccination
- Vaccines, Attenuated
- Vaccines, DNA/immunology
- Vaccines, Synthetic
- Vesiculovirus/immunology
- Viral Envelope Proteins/genetics
- Viral Envelope Proteins/immunology
- Viral Nonstructural Proteins/genetics
- Viral Nonstructural Proteins/immunology
- Viral Nonstructural Proteins/metabolism
- Viral Vaccines/genetics
- Viral Vaccines/immunology
- Zika Virus/genetics
- Zika Virus/immunology
- Zika Virus/metabolism
- Zika Virus Infection/immunology
- Zika Virus Infection/prevention & control
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Affiliation(s)
- Anzhong Li
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Jingyou Yu
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
- Center for Retrovirus Research, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Mijia Lu
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Yuanmei Ma
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Zayed Attia
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Chao Shan
- Department of Biochemistry & Molecular Biology, Department of Pharmacology & Toxicology, and Sealy Center for Structural Biology & Molecular Biophysics, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA
| | - Miaoge Xue
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Xueya Liang
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Kelsey Craig
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Nirajkumar Makadiya
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Jennifer J He
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Ryan Jennings
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Pei-Yong Shi
- Department of Biochemistry & Molecular Biology, Department of Pharmacology & Toxicology, and Sealy Center for Structural Biology & Molecular Biophysics, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA
| | - Mark E Peeples
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, 370W. 9th Ave., Columbus, OH, 43210, USA
| | - Shan-Lu Liu
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
- Center for Retrovirus Research, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
- Infectious Diseases Institute, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
- Department of Microbial Infection and Immunity, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Prosper N Boyaka
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
- Infectious Diseases Institute, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA
| | - Jianrong Li
- Department of Veterinary Biosciences, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA.
- Infectious Diseases Institute, The Ohio State University, 1925 Coffey Road, Columbus, OH, 43210, USA.
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93
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WYLIE KM, WYLIE TN, CAHILL AG, MACONES GA, TUULI MG, STOUT MJ. The vaginal eukaryotic DNA virome and preterm birth. Am J Obstet Gynecol 2018; 219:189.e1-189.e12. [PMID: 29738749 PMCID: PMC6066425 DOI: 10.1016/j.ajog.2018.04.048] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Despite decades of attempts to link infectious agents to preterm birth, an exact causative microbe or community of microbes remains elusive. Culture-independent sequencing of vaginal bacterial communities demonstrates community characteristics are associated with preterm birth, although none are specific enough to apply clinically. Viruses are important components of the vaginal microbiome and have dynamic relationships with vaginal bacterial communities. We hypothesized that vaginal eukaryotic DNA viral communities (the "vaginal virome") either alone or in the context of bacterial communities are associated with preterm birth. OBJECTIVE The objective of this study was to use high-throughput sequencing to examine the vaginal eukaryotic DNA virome in a cohort of pregnant women and examine associations between vaginal community characteristics and preterm birth. STUDY DESIGN This is a nested case-control study within a prospective cohort study of women with singleton pregnancies, not on supplemental progesterone, and without cervical cerclage in situ. Serial midvaginal swabs were obtained at routine prenatal visits. DNA was extracted, bacterial communities were characterized by 16S ribosomal RNA gene sequencing, and eukaryotic viral communities were characterized by enrichment of viral nucleic acid with the ViroCap targeted sequence capture panel followed by nucleic acid sequencing. Viral communities were analyzed according to presence/absence of viruses, diversity, dynamics over time, and association with bacterial community data obtained from the same specimens. RESULTS Sixty subjects contributed 128 vaginal swabs longitudinally across pregnancy. In all, 24 patients delivered preterm. Participants were predominantly African American (65%). Six families of eukaryotic DNA viruses were detected in the vaginal samples. At least 1 virus was detected in 80% of women. No specific virus or group of viruses was associated with preterm delivery. Higher viral richness was significantly associated with preterm delivery in the full group and in the African American subgroup (P = .0005 and P = .0003, respectively). Having both high bacterial diversity and high viral diversity in the first trimester was associated with the highest risk for preterm birth. CONCLUSION Higher vaginal viral diversity is associated with preterm birth. Changes in vaginal virome diversity appear similar to changes in the vaginal bacterial microbiome over pregnancy, suggesting that underlying physiology of pregnancy may regulate both bacterial and viral communities.
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Affiliation(s)
- Kristine M. WYLIE
- Department of Pediatrics, Washington University School of Medicine, St. Louis
- The McDonnell Genome Institute, Washington University School of Medicine, St. Louis
| | - Todd N. WYLIE
- Department of Pediatrics, Washington University School of Medicine, St. Louis
- The McDonnell Genome Institute, Washington University School of Medicine, St. Louis
| | - Alison G. CAHILL
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University School of Medicine, St. Louis
| | - George A. MACONES
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University School of Medicine, St. Louis
| | - Methodius G. TUULI
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University School of Medicine, St. Louis
| | - Molly J. STOUT
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University School of Medicine, St. Louis
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94
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Arora N, Banerjee AK, Narasu ML. Zika outbreak aftermath: status, progress, concerns and new insights. Future Virol 2018. [DOI: 10.2217/fvl-2018-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Zika, a neurotrophic virus belonging to Flaviviridae family of viruses and transmitted by vector mosquitoes of Aedes species, took the world by storm during its recent outbreak. Its spread to newer territories, unprecedented pace of transmission, lack of existing therapeutic agents and vaccines and an empty drug pipeline raised an alarm. Uncertainty about full spectrum of diseases and its long-term consequences, newly discovered modes of transmission and controversies over vector status of mosquito species like Culex quinquefasciatus led to layers of complexity and presented new hurdles and challenges in Zika virus research. This review summarizes the progress and updates of efforts, concerns, financial burden and available resources in light of newly acquired knowledge in Zika virus research.
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Affiliation(s)
- Neelima Arora
- Centre for Biotechnology, Institute of Science & Technology (Autonomous), Jawaharlal Nehru Technological University-Hyderabad, Kukatpally, Hyderabad 500085, Telangana, India
| | - Amit K Banerjee
- Biology Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad 500007, Telangana, India
| | - Mangamoori L Narasu
- Centre for Biotechnology, Institute of Science & Technology (Autonomous), Jawaharlal Nehru Technological University-Hyderabad, Kukatpally, Hyderabad 500085, Telangana, India
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95
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Supramaniam A, Lui H, Bellette BM, Rudd PA, Herrero LJ. How myeloid cells contribute to the pathogenesis of prominent emerging zoonotic diseases. J Gen Virol 2018; 99:953-969. [DOI: 10.1099/jgv.0.001024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Aroon Supramaniam
- 1Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, QLD, Australia
| | - Hayman Lui
- 2School of Medicine, Griffith University, Gold Coast Campus, Southport, QLD, Australia
| | | | - Penny A. Rudd
- 1Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, QLD, Australia
| | - Lara J. Herrero
- 1Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, QLD, Australia
- 2School of Medicine, Griffith University, Gold Coast Campus, Southport, QLD, Australia
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96
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Counotte MJ, Kim CR, Wang J, Bernstein K, Deal CD, Broutet NJN, Low N. Sexual transmission of Zika virus and other flaviviruses: A living systematic review. PLoS Med 2018; 15:e1002611. [PMID: 30040845 PMCID: PMC6057622 DOI: 10.1371/journal.pmed.1002611] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/14/2018] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Health authorities in the United States and Europe reported an increasing number of travel-associated episodes of sexual transmission of Zika virus (ZIKV) following the 2015-2017 ZIKV outbreak. This, and other scientific evidence, suggests that ZIKV is sexually transmissible in addition to having its primary mosquito-borne route. The objective of this systematic review and evidence synthesis was to clarify the epidemiology of sexually transmitted ZIKV. METHODS AND FINDINGS We performed a living (i.e., continually updated) systematic review of evidence published up to 15 April 2018 about sexual transmission of ZIKV and other arthropod-borne flaviviruses in humans and other animals. We defined 7 key elements of ZIKV sexual transmission for which we extracted data: (1) rectal and vaginal susceptibility to infection, (2) incubation period following sexual transmission, (3) serial interval between the onset of symptoms in a primary and secondary infected individuals, (4) duration of infectiousness, (5) reproduction number, (6) probability of transmission per sex act, and (7) transmission rate. We identified 1,227 unique publications and included 128, of which 77 presented data on humans and 51 presented data on animals. Laboratory experiments confirm that rectal and vaginal mucosae are susceptible to infection with ZIKV and that the testis serves as a reservoir for the virus in animal models. Sexual transmission was reported in 36 human couples: 34/36 of these involved male-to-female sexual transmission. The median serial symptom onset interval in 15 couples was 12 days (interquartile range: 10-14.5); the maximum was 44 days. We found evidence from 2 prospective cohorts that ZIKV RNA is present in human semen with a median duration of 34 days (95% CI: 28-41 days) and 35 days (no CI given) (low certainty of evidence, according to GRADE). Aggregated data about detection of ZIKV RNA from 37 case reports and case series indicate a median duration of detection of ZIKV of 40 days (95% CI: 30-49 days) and maximum duration of 370 days in semen. In human vaginal fluid, median duration was 14 days (95% CI: 7-20 days) and maximum duration was 37 days (very low certainty). Infectious virus in human semen was detected for a median duration of 12 days (95% CI: 1-21 days) and maximum of 69 days. Modelling studies indicate that the reproduction number is below 1 (very low certainty). Evidence was lacking to estimate the incubation period or the transmission rate. Evidence on sexual transmission of other flaviviruses was scarce. The certainty of the evidence is limited because of uncontrolled residual bias. CONCLUSIONS The living systematic review and sexual transmission framework allowed us to assess evidence about the risk of sexual transmission of ZIKV. ZIKV is more likely transmitted from men to women than from women to men. For other flaviviruses, evidence of sexual transmissibility is still absent. Taking into account all available data about the duration of detection of ZIKV in culture and from the serial interval, our findings suggest that the infectious period for sexual transmission of ZIKV is shorter than estimates from the earliest post-outbreak studies, which were based on reverse transcription PCR alone.
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Affiliation(s)
| | - Caron Rahn Kim
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Jingying Wang
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Kyle Bernstein
- Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Carolyn D. Deal
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | | | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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97
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Mansuy JM, Lhomme S, Cazabat M, Pasquier C, Martin-Blondel G, Izopet J. Detection of Zika, dengue and chikungunya viruses using single-reaction multiplex real-time RT-PCR. Diagn Microbiol Infect Dis 2018; 92:284-287. [PMID: 30029808 DOI: 10.1016/j.diagmicrobio.2018.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/25/2018] [Accepted: 06/19/2018] [Indexed: 01/08/2023]
Abstract
Zika (ZIKV), Dengue (DENV) and Chikungunya viruses (CHIKV) co-circulate in the same geographical areas during the same seasonal period through the same biting arthropods. Therefore a rapid sensitive and specific molecular assay for these viruses would be a considerable help in the disease management and the epidemiological survey. We developed a one-step multiplex real-time PCR for the simultaneous detection of these viruses. Intra and inter-reproducibilities varied from 0.41% to 3.29% and from 1.13% to 4.93% for each virus respectively. The specificity was 100%. Whole blood, plasma and urines were used for comparison with commercially available monoplex assays (RealStar® kits, Altona Diagnostics GmbH, Hamburg, Germany). The concordance was 96%, 92.9% and 95.7% for ZIKV, DENV and CHIKV respectively. No cross reaction and no PCR inhibition were observed for any of the clinical samples. This test can thus be used as a rapid molecular assay for ZIKV, DENV1-4 and CHIKV infections.
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Affiliation(s)
| | - Sébastien Lhomme
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Michelle Cazabat
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Christophe Pasquier
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Guillaume Martin-Blondel
- INSERM, UMR1043, Toulouse, France; Department of Infectious and Tropical Diseases, CHU Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Jacques Izopet
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
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98
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Caswell RJ, Manavi K. Emerging sexually transmitted viral infections: 2. Review of Zika virus disease. Int J STD AIDS 2018; 29:1238-1246. [PMID: 29945539 DOI: 10.1177/0956462418779465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A sudden increase in the number of newborn infants with microcephaly in Brazil in 2015 brought Zika virus (ZIKV), a less-known infection, to public attention. The rapid increase in the number of cases across the Americas and the devastating complications of infection with ZIKV highlighted the gravity of the situation. Within a relatively short period of time, our knowledge of this infection has significantly increased. This includes the realisation that ZIKV can be sexually transmitted. The aim of the present article is to provide a concise summary on this novel sexually transmitted infection linked to human birth defects and Guillain-Barre Syndrome. According to World Health Organization, individuals living outside areas of ZIKV mosquito transmission where one or both partners have been exposed to ZIKV should abstain from sex or have sex with condoms for at least six months after the last day of possible exposure.
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Affiliation(s)
- R J Caswell
- Department of HIV and Genitourinary Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - K Manavi
- Department of HIV and Genitourinary Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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99
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Abstract
Congenital cytomegalovirus is the most common viral congenital infection, and affects up to 2% of neonates. Significant sequelae may develop after congenital cytomegalovirus, including hearing loss, cognitive defects, seizures, and death. Zika virus is an emerging virus with perinatal implications; a congenital Zika virus syndrome has been identified, and includes findings such as microcephaly, fetal nervous system abnormalities, and neurologic sequelae after birth. Screening, diagnosis, prevention, and treatment of these perinatal infections are reviewed in this article.
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100
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Burger-Calderon R, Gonzalez K, Ojeda S, Zambrana JV, Sanchez N, Cerpas Cruz C, Suazo Laguna H, Bustos F, Plazaola M, Lopez Mercado B, Elizondo D, Arguello S, Carey Monterrey J, Nuñez A, Coloma J, Waggoner JJ, Gordon A, Kuan G, Balmaseda A, Harris E. Zika virus infection in Nicaraguan households. PLoS Negl Trop Dis 2018; 12:e0006518. [PMID: 29851968 PMCID: PMC6014677 DOI: 10.1371/journal.pntd.0006518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 06/22/2018] [Accepted: 05/10/2018] [Indexed: 12/29/2022] Open
Abstract
Zika virus (ZIKV) infection recently caused major epidemics in the Americas and is linked to congenital birth defects and Guillain-Barré Syndrome. A pilot study of ZIKV infection in Nicaraguan households was conducted from August 31 to October 21, 2016, in Managua, Nicaragua. We enrolled 33 laboratory-confirmed Zika index cases and their household members (109 contacts) and followed them on days 3–4, 6–7, 9–10, and 21, collecting serum/plasma, urine, and saliva specimens along with clinical, demographic, and socio-economic status information. Collected samples were processed by rRT-PCR to determine viral load (VL) and duration of detectable ZIKV RNA in human bodily fluids. At enrollment, 11 (10%) contacts were ZIKV rRT-PCR-positive and 23 (21%) were positive by IgM antibodies; 3 incident cases were detected during the study period. Twenty of 33 (61%) index households had contacts with ZIKV infection, with an average of 1.9 (range 1–6) positive contacts per household, and in 60% of these households, ≥50% of the members were positive for ZIKV infection. Analysis of clinical information allowed us to estimate the symptomatic to asymptomatic (S:A) ratio of 14:23 (1:1.6) among the contacts, finding 62% of the infections to be asymptomatic. The maximum number of days during which ZIKV RNA was detected was 7 days post-symptom onset in saliva and serum/plasma and 22 days in urine. Overall, VL levels in serum/plasma, saliva, and urine specimens were comparable, with means of 5.6, 5.3 and 4.5 log10 copies/ml respectively, with serum attaining the highest VL peak at 8.1 log10 copies/ml. Detecting ZIKV RNA in saliva over a similar time-period and level as in serum/plasma indicates that saliva could potentially serve as a more accessible diagnostic sample. Finding the majority of infections to be asymptomatic emphasizes the importance of silent ZIKV transmission and helps inform public health interventions in the region and globally. Zika virus (ZIKV) infection has become a major concern due to its association with congenital birth defects and Guillain-Barré Syndrome. We enrolled 33 laboratory-confirmed Zika cases (index cases) and their household members (109 contacts) in Managua, Nicaragua, and followed them for three weeks, collecting serum/plasma, urine and saliva specimens along with clinical, demographic, and socio-economic status information. We found that 61% of the index households had contacts with ZIKV infection, with an average of 1.9 (range 1–6) positive contacts per household, and in 60% of these households, ≥50% of the members were ZIKV-positive. Analysis of clinical information allowed estimating the symptomatic to asymptomatic (S:A) ratio of 14:23 (1:1.6) among the contacts. Finding 62% of the infections to be asymptomatic emphasizes the importance of silent transmission. Evaluating the maximum number of days during which ZIKV RNA was detectable showed that ZIKV was found up to 7 days post-symptom onset in serum/plasma and saliva and 22 days post-symptom onset in urine. Finding ZIKV RNA in saliva over a similar time period and concentration as serum/plasma indicates that saliva could potentially serve as a more accessible diagnostic sample. Overall, these data increase our understanding of ZIKV transmission and help inform public health interventions in the region and globally.
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Affiliation(s)
- Raquel Burger-Calderon
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Karla Gonzalez
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Cristhiam Cerpas Cruz
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | | | - Fausto Bustos
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | | | | | | | | | | | - Andrea Nuñez
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Jesse J. Waggoner
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Michigan, United States of America
| | - Guillermina Kuan
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail:
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