Use of infectious disease surveillance reports to monitor the Zika virus epidemic in Latin America and the Caribbean from 2015 to 2017: strengths and deficiencies

ObjectivesTo summarise the occurrence of congenital Zika syndrome (CZS) in Latin America and the Caribbean from 2015 to 2017 using two outcome measures derived from infectious disease surveillance reports and to assess the completeness of these reports.DesignSurveillance study.SettingPan American Health Organization (PAHO)/WHO epidemiology reports on confirmed and suspected Zika virus infection and cases of CZS.ParticipantsPopulations of 47 countries in the South and Central Americas, Mexico and the Caribbean.Primary and secondary outcome measuresThe number of CZS cases per 1000 births (using 2016–2017 births as a denominator) and the number of CZS cases per 1000 births in women with Zika virus infection during pregnancy.ResultsBy 4 January 2018, 548623 suspected and 239063 confirmed Zika virus infections had been reported to PAHO/WHO from 47 countries. In 25 countries, over 80% of infections were reported as suspected. There were 3617 confirmed CZS cases in 25 countries; 2952 (82%) had occurred in Brazil. The number of CZS cases per 1000 births varied considerably with Brazil and several Caribbean island communities (Puerto Rico, St Martin, Martinique, Guadeloupe and Grenada) having the highest CZS prevalence above 0.5 per 1000 births. Analysing the number of CZS cases per 1000 births in women infected with Zika virus during their pregnancy highlighted the inaccuracies of the data, with Venezuela likely to have had severe under-reporting of CZS.ConclusionsExpressing data on CZS in relation to total births, rather than as absolute numbers, better illustrates the burden of disease, providing that under-reporting of CZS is not too severe. Data on infections in pregnant women enable potential under-reporting of CZS to be identified. Both measures are recommended for future PAHO/WHO publications. Evidence of severe under-reporting of Zika virus infections and CZS makes interpretation of the data and comparisons between countries challenging.

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Zika virus infections in three travellers returning from South America and the Caribbean respectively, to Montpellier, France, December 2015 to January 2016

Eurosurveillance ◽

10.2807/1560-7917.es.2016.21.6.30131 ◽

2016 ◽

Vol 21 (6) ◽

Cited By ~ 47

Author(s):

Alexandre Thibault Maria ◽

Marianne Maquart ◽

Alain Makinson ◽

Olivier Flusin ◽

Michel Segondy ◽

...

Keyword(s):

Virus Infection ◽

South America ◽

Zika Virus ◽

Mosquito Vectors ◽

Virus Infections ◽

Southern France ◽

Zika Virus Infection ◽

The Caribbean

We report three unrelated cases of Zika virus infection in patients returning from Martinique, Brazil and Colombia respectively, to Montpellier, France. They developed symptoms compatible with a mosquito-borne disease, and serological and molecular investigations indicated a recent Zika virus infection. Considering the recent warning for the likely teratogenicity of Zika virus and the presence of competent mosquito vectors in southern France, these cases highlight the need for awareness of physicians and laboratories in Europe.

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Asymptomatic Prenatal Zika Virus Infection and Congenital Zika Syndrome

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy073 ◽

2018 ◽

Vol 5 (4) ◽

Cited By ~ 17

Author(s):

Enny S Paixao ◽

Wei-Yee Leong ◽

Laura C Rodrigues ◽

Annelies Wilder-Smith

Keyword(s):

Virus Infection ◽

Birth Defects ◽

Prospective Studies ◽

Zika Virus ◽

Retrospective Studies ◽

Recall Bias ◽

Virus Infections ◽

Fetal Outcomes ◽

Zika Virus Infection ◽

Congenital Zika Syndrome

Abstract To investigate to what extent asymptomatic vs symptomatic prenatal Zika virus infections contribute to birth defects, we identified 3 prospective and 8 retrospective studies. The ratio varied greatly in the retrospective studies, most likely due to recruitment and recall bias. The prospective studies revealed a ratio of 1:1 for asymptomatic vs symptomatic maternal Zika infections resulting in adverse fetal outcomes.

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Poster 363: Transverse Myelitis Caused by Zika Virus Infection in the Caribbean: A Case Report

PM&R ◽

10.1016/j.pmrj.2017.08.302 ◽

2017 ◽

Vol 9 ◽

pp. S247-S247 ◽

Cited By ~ 1

Author(s):

Rafael A. Romeu-Mejia ◽

Joanne M. Delgado-Lebron ◽

Eduardo Nadal-Ortiz

Keyword(s):

Case Report ◽

Virus Infection ◽

Zika Virus ◽

Transverse Myelitis ◽

Zika Virus Infection ◽

The Caribbean

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An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America

BMC Public Health ◽

10.1186/s12889-018-5566-7 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Leonelo E. Bautista ◽

Víctor M. Herrera

Keyword(s):

Public Health ◽

Latin America ◽

Virus Infection ◽

Zika Virus ◽

Public Health Surveillance ◽

Health Surveillance ◽

Zika Virus Infection

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Assay Challenges for Emerging Infectious Diseases: The Zika Experience

Vaccines ◽

10.3390/vaccines6040070 ◽

2018 ◽

Vol 6 (4) ◽

pp. 70 ◽

Cited By ~ 2

Author(s):

Christine Roberts ◽

Joel Maslow

Keyword(s):

Infectious Disease ◽

Virus Infection ◽

Zika Virus ◽

Vaccine Development ◽

Emerging Infectious Diseases ◽

Emerging Infectious Disease ◽

Western Hemisphere ◽

Diagnostic Tools ◽

Special Focus ◽

Zika Virus Infection

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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Navigating the Zika panic

F1000Research ◽

10.12688/f1000research.9370.1 ◽

2016 ◽

Vol 5 ◽

pp. 1914 ◽

Cited By ~ 1

Author(s):

Nathan D. Grubaugh ◽

Kristian G. Andersen

Keyword(s):

Virus Infection ◽

Zika Virus ◽

Ebola Virus ◽

Scientific Evidence ◽

Severe Disease ◽

Conclusive Evidence ◽

Virus Infections ◽

Outbreak Response ◽

Zika Virus Infection ◽

Virus Research

The epidemics of Ebola virus in West Africa and Zika virus in America highlight how viruses can explosively emerge into new territories. These epidemics also exposed how unprepared we are to handle infectious disease emergencies. This is also true when we consider hypothesized new clinical features of infection, such as the associations between Zika virus infection and severe neurological disease, including microcephaly and Guillain-Barré syndrome. On the surface, these pathologies appear to be new features of Zika virus infection, however, causal relationships have not yet been established. Decades of limited Zika virus research are making us scramble to determine the true drivers behind the epidemic, often at the expense of over-speculation without credible evidence. Here we review the literature and find no conclusive evidence at this time for significant biological differences between the American Zika virus strains and those circulating elsewhere. Rather, the epidemic scale in the Americas may be facilitated by an abnormally warm climate, dense human and mosquito populations, and previous exposure to other viruses. Severe disease associated with Zika virus may therefore not be a new trait for the virus, rather it may have been overlooked due to previously small outbreaks. Much of the recent panic regarding Zika virus has been about the Olympics in Brazil. We do not find any substantial evidence that the Olympics will result in a significant number of new Zika virus infections (~10 predicted) or that the Olympics will promote further epidemic spread over what is already expected. The Zika virus epidemic in the Americas is a serious situation and decisions based on solid scientific evidence - not hyped media speculations - are required for effective outbreak response.

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Correlation between Zika virus and microcephaly as a consequence of congenital infection

10.5327/1516-3180.629 ◽

2021 ◽

Author(s):

Ana Flávia Silva Castro ◽

Natália Barros Salgado Vieira ◽

Sarah Joanny da Silva Pereira

Keyword(s):

Nervous System ◽

Virus Infection ◽

Zika Virus ◽

Complex Disease ◽

Congenital Infection ◽

Virus Infections ◽

Zika Virus Infection ◽

The Central Nervous System ◽

Neurological Effects ◽

The Relationship

Introduction: The Zika virus (ZIKV) is an arbovirus of RNA, whose transmission is mainly vector - by mosquitoes of the genus Aedes - but it also occurs through sexual, blood and transplacental transmission, with the last mentioned it was possible to verify serious neurological effects in the epidemic in South America, especially in Brazil, between 2015 and 2016. Objectives: To analyze the relationship between Zika virus infection and microcephaly in recent scientific literature. Methodology: Refers to a bibliographic review in the databases SciELO, LILACS and MEDLINE / Pubmed, with the terms “zika virus”, “infection” and “microcephaly” correlated in Portuguese and in English; 78 articles were found, but only 7 followed for analysis. Articles published more than 5 years ago and out of the proposed theme were disregarded. Results: The Zika virus, although similar to the dengue and chikungunya virus, it has a tendency to cause damage to the central nervous system such as Guillain-Barré Syndrome. However, the association between microcephaly and ZIKV started to be more observed through the increase of the disease among fetuses and newborns of mothers who had been infected during the gestational phase in the epidemic that happened in Brazil. It is known that the development of the nervous system is the product of processes of high proliferation and cellular differentiation, in which even small errors generate dangerous impacts, and it is during this period that ZIKV affects the CNS of the fetus. The disease is characterized by the reduction of the brain perimeter, in this context, is a consequence of abnormalities influenced by the virus. Conclusions: Microcephaly is a complex disease; therefore, it is necessary to emphasize the importance of primary care and other spheres for monitoring Zika virus infections, prenatal care and constant psychosocial monitoring. Furthermore, it is necessary to understand the relevance of studies about ZIKV and microcephaly, and to encourage scientific production in this area.

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Primary care nurses’ knowledge on Zika virus infection during pregnancy

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n11p10 ◽

2020 ◽

Vol 10 (11) ◽

pp. 10

Author(s):

Paula Mikaelle Barbosa Costa ◽

Jessika Lopes Figueiredo Pereira Batista ◽

Inacia Sátiro Xavier de França ◽

Mágna Leite Pereira ◽

Millena Zaíra Cartaxo da Silva ◽

...

Keyword(s):

Primary Care ◽

Health Education ◽

Virus Infection ◽

Zika Virus ◽

Professional Training ◽

Public Health Problem ◽

Virus Infections ◽

Zika Virus Infection ◽

Primary Care Nurses ◽

Nurses Knowledge

Cases related to Zika Virus infections in Brazil have become a severe public health problem due to its relation to microcephaly and other neurological and development problems in newborn babies of mothers who were infected by the Zika virus. Nurses are vital professionals in combating this infection, both for prevention and vector control; as well as handling the target public. Therefore, the research aimed to investigate Primary Care nurses’ knowledge on Zika virus infection during pregnancy. It is a descriptive field study with qualitative approach carried out at Family Health Strategy, in the city of Cajazeiras, Paraíba, Brazil. Semi-structured interviews were conducted for data collection, which were submitted to thematic-content analysis. The nurses replied that there is not much information about Zika virus infections, and reported brain impairment as the main consequence for the newborn baby. Nurses also revealed that many women of the community showed negative feelings towards the pregnancy, and they pointed out the importance of health education actions in the community for dissemination of information on Zika virus infection control and prevention. Nurses’ contribution regarding the assistance provided to the community is considered satisfactory. However, there was a need to bring efficient and updated professional training to the reality of each community. Therefore, it is suggested that training be provided through continued health education to professionals.

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Zika virus detection in cerebrospinal fluid from two patients with encephalopathy, Martinique, February 2016

Eurosurveillance ◽

10.2807/1560-7917.es.2016.21.16.30205 ◽

2016 ◽

Vol 21 (16) ◽

Cited By ~ 45

Author(s):

Benoît Rozé ◽

Fatiha Najioullah ◽

Aïssatou Signate ◽

Kossivi Apetse ◽

Yannick Brouste ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Virus Infection ◽

Zika Virus ◽

Virus Detection ◽

Neurological Complications ◽

Virus Infections ◽

Zika Virus Infection

We report two cases of encephalopathy (one with seizures, one with electroencephalogram changes) in patients with Zika virus infection. The cases occurred on Martinique in February 2016, during the Zika virus outbreak. Awareness of the various neurological complications of Zika virus infection is needed for patients living in areas affected by Zika virus infections or for travellers to these areas.

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