scholarly journals Clinical manifestations and health outcomes associated with Zika virus infections in adults: A systematic review

2021 ◽  
Vol 15 (7) ◽  
pp. e0009516
Author(s):  
Sheliza Halani ◽  
Panashe E. Tombindo ◽  
Ryan O’Reilly ◽  
Rafael N. Miranda ◽  
Laura K. Erdman ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Zika Virus ◽  
Critical Appraisal ◽  
Neurological Complication ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Neurological Complications ◽  
Virus Infections ◽  
Case Definitions ◽  
Systemic Symptoms

Background Zika virus (ZIKV) has generated global interest in the last five years mostly due to its resurgence in the Americas between 2015 and 2016. It was previously thought to be a self-limiting infection causing febrile illness in less than one quarter of those infected. However, a rise in birth defects amongst children born to infected pregnant women, as well as increases in neurological manifestations in adults has been demonstrated. We systemically reviewed the literature to understand clinical manifestations and health outcomes in adults globally. Methods This review was registered prospectively with PROPSERO (CRD 42018096558). We systematically searched for studies in six databases from inception to the end of September 2020. There were no language restrictions. Critical appraisal was completed using the Joanna Briggs Institute Critical Appraisal Tools. Findings We identified 73 studies globally that reported clinical outcomes in ZIKV-infected adults, of which 55 studies were from the Americas. For further analysis, we considered studies that met 70% of critical appraisal criteria and described subjects with confirmed ZIKV. The most common symptoms included: exanthema (5,456/6,129; 89%), arthralgia (3,809/6,093; 63%), fever (3,787/6,124; 62%), conjunctivitis (2,738/3,283; 45%), myalgia (2,498/5,192; 48%), headache (2,165/4,722; 46%), and diarrhea (337/2,622; 13%). 36/14,335 (0.3%) of infected cases developed neurologic sequelae, of which 75% were Guillain-Barré Syndrome (GBS). Most subjects reported recovery from peak of neurological complications, though a small proportion endured chronic disability. Mortality was rare (0.1%) and hospitalization (11%) was often associated with co-morbidities or GBS. Conclusions The ZIKV literature in adults was predominantly from the Americas. The most common systemic symptoms were exanthema, fever, arthralgia, and conjunctivitis; GBS was the most prevalent neurological complication. Future ZIKV studies are warranted with standardization of testing and case definitions, consistent co-infection testing, reporting of laboratory abnormalities, separation of adult and pediatric outcomes, and assessing for causation between ZIKV and neurological sequelae.

scholarly journals Zika: an old virus with a new face

2016 ◽  
Vol 55 (4) ◽  
pp. 228-230 ◽  
Author(s):  
Tatjana Avšic Županc ◽  
Miroslav Petrovec
Keyword(s):  
Public Health ◽  
Zika Virus ◽  
Antiviral Treatment ◽  
Febrile Illness ◽  
Neurological Complications ◽  
Public Health Emergency ◽  
Virus Infections ◽  
Public Health Response ◽  
Health Response ◽  
Sporadic Cases

Abstract Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. This obscure virus was limited to sporadic cases in Africa and Asia, until the emergence of Zika virus in Brazil in 2015, when it rapidly spread throughout the Americas. Most Zika virus infections are subclinical or characterized by mild febrile illness. However, neurological complications, including Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a grave concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Thus, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.

scholarly journals Zika Virus-Derived E-DIII Protein Displayed on Immunologically Optimized VLPs Induces Neutralizing Antibodies without Causing Enhancement of Dengue Virus Infection

Vaccines ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 72 ◽  
Author(s):  
Gustavo Cabral-Miranda ◽  
Stephanie M. Lim ◽  
Mona O. Mohsen ◽  
Ilya V. Pobelov ◽  
Elisa S. Roesti ◽  
...  
Keyword(s):  
Dengue Virus ◽  
Zika Virus ◽  
Neutralizing Antibodies ◽  
Clinical Manifestations ◽  
First Trimester ◽  
Neurological Complications ◽  
Zikv Infection ◽  
First Trimester Of Pregnancy ◽  
Specific Igg

Zika virus (ZIKV) is a flavivirus similar to Dengue virus (DENV) in terms of transmission and clinical manifestations, and usually both viruses are found to co-circulate. ZIKV is usually transmitted by mosquitoes bites, but may also be transmitted by blood transfusion, via the maternal–foetal route, and sexually. After 2015, when the most extensive outbreak of ZIKV had occurred in Brazil and subsequently spread throughout the rest of South America, it became evident that ZIKV infection during the first trimester of pregnancy was associated with microcephaly and other neurological complications in newborns. As a result, the development of a vaccine against ZIKV became an urgent goal. A major issue with DENV vaccines, and therefore likely also with ZIKV vaccines, is the induction of antibodies that fail to neutralize the virus properly and cause antibody-dependent enhancement (ADE) of the infection instead. It has previously been shown that antibodies against the third domain of the envelope protein (EDIII) induces optimally neutralizing antibodies with no evidence for ADE for other viral strains. Therefore, we generated a ZIKV vaccine based on the EDIII domain displayed on the immunologically optimized Cucumber mosaic virus (CuMVtt) derived virus-like particles (VLPs) formulated in dioleoyl phosphatidylserine (DOPS) as adjuvant. The vaccine induced high levels of specific IgG after a single injection. The antibodies were able to neutralise ZIKV without enhancing infection by DENV in vitro. Thus, the here described vaccine based on EDIII displayed on VLPs was able to stimulate production of antibodies specifically neutralizing ZIKV without potentially enhancing disease caused by DENV.

scholarly journals Contemporary Zika Virus Isolates Induce More dsRNA and Produce More Negative-Strand Intermediate in Human Astrocytoma Cells

Viruses ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 728 ◽  
Author(s):  
Trisha Barnard ◽  
Maaran Rajah ◽  
Selena Sagan
Keyword(s):  
Zika Virus ◽  
Febrile Illness ◽  
Neurological Complications ◽  
Replicative Fitness ◽  
Negative Strand ◽  
Astrocytoma Cells ◽  
Recent Emergence ◽  
Human Astrocytoma ◽  
Asian Lineage ◽  
Human Astrocytoma Cells

The recent emergence and rapid geographic expansion of Zika virus (ZIKV) poses a significant challenge for public health. Although historically causing only mild febrile illness, recent ZIKV outbreaks have been associated with more severe neurological complications, such as Guillain-Barré syndrome and fetal microcephaly. Here we demonstrate that two contemporary (2015) ZIKV isolates from Puerto Rico and Brazil may have increased replicative fitness in human astrocytoma cells. Over a single infectious cycle, the Brazilian isolate replicates to higher titers and induces more severe cytopathic effects in human astrocytoma cells than the historical African reference strain or an early Asian lineage isolate. In addition, both contemporary isolates induce significantly more double-stranded RNA in infected astrocytoma cells, despite similar numbers of infected cells across isolates. Moreover, when we quantified positive- and negative-strand viral RNA, we found that the Asian lineage isolates displayed substantially more negative-strand replicative intermediates than the African lineage isolate in human astrocytoma cells. However, over multiple rounds of infection, the contemporary ZIKV isolates appear to be impaired in cell spread, infecting a lower proportion of cells at a low MOI despite replicating to similar or higher titers. Taken together, our data suggests that contemporary ZIKV isolates may have evolved mechanisms that allow them to replicate with increased efficiency in certain cell types, thereby highlighting the importance of cell-intrinsic factors in studies of viral replicative fitness.

scholarly journals A Genome-Wide CRISPR Activation Screen Identifies Genes Involved in Protection from Zika Virus Infection

Proceedings ◽  
2020 ◽  
Vol 50 (1) ◽  
pp. 149
Author(s):  
Anna Dukhovny ◽  
Kevin Lamkiewicz ◽  
Qian Chen ◽  
Markus Fricke ◽  
Nabila Jabrane-Ferrat ◽  
...  
Keyword(s):  
Cell Death ◽  
Zika Virus ◽  
Early Stage ◽  
Specific Treatment ◽  
Febrile Illness ◽  
Neurological Complications ◽  
Host Factors ◽  
Zikv Infection ◽  
A Genome ◽  
Crispr Activation

Zika virus (ZIKV) is an arthropod-borne emerging pathogen causing febrile illness. ZIKV is associated with the Guillain–Barré syndrome and other neurological complications. The vertical transmission of ZIKV can cause fetus demise, stillbirths or severe congenital abnormalities and neurological complications. There is still no vaccine or specific treatment for ZIKV infection. To identify the host factors that can rescue cells from ZIKV infection, we used a genome-scale CRISPR activation screen. Our highly ranking hits included a short list of interferon-stimulated genes (ISGs) previously reported to have antiviral activity. Validation of the screen results highlighted interferon lambda 2 (IFN-lamda2) and interferon alpha-inducible protein 6 (IFI6) as genes providing high levels of protection from ZIKV infection. The activation of these genes had an effect at an early stage in the viral infection. In addition, infected cells expressing single guide RNAs (sgRNAs) for both of these genes displayed lower levels of cell death than did the controls. Furthermore, the identified genes were significantly induced in ZIKV-infected placenta explants. These results highlighted a set of ISGs directly relevant for rescuing cells from ZIKV infection or its associated cell death, thus substantiating CRISPR activation screens as a valid tool for identifying host factors impeding pathogen infection.

Cerebellitis as a rare manifestation of scrub typhus fever

2020 ◽  
Vol 13 (5) ◽  
pp. e233993
Author(s):  
Samiksha Gupta ◽  
Sahil Grover ◽  
Monica Gupta ◽  
Daljinderjit Kaur
Keyword(s):  
Scrub Typhus ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Neurological Complications ◽  
Uneventful Recovery ◽  
Cerebellar Dysfunction ◽  
Chigger Mite ◽  
Rickettsial Disease ◽  
Rare Manifestation ◽  
Typhus Fever

Scrub typhus is a mite-borne rickettsial disease caused by Orientia tsutsugamushi, a gram-negative coccobacilli transmitted through the bite of chigger mite. Scrub typhus has diverse clinical manifestations, often presenting either as a simple febrile illness or as a complicated multi-organ dysfunction. Neurological complications in scrub typhus are diverse but their exact incidence is unknown. Cerebellitis is another rare neurological manifestation associated with scrub typhus. Here, we report the case of a 26-year-old woman with serologically confirmed scrub typhus presenting with fever and gross cerebellar dysfunction. MRI was normal. She was managed with antimicrobials and made an uneventful recovery.

scholarly journals Zika virus infections in Nigeria: virological and seroepidemiological investigations in Oyo State

1979 ◽  
Vol 83 (2) ◽  
pp. 213-219 ◽  
Author(s):  
A. H. Fagbami
Keyword(s):  
Yellow Fever ◽  
Zika Virus ◽  
Neutralizing Antibodies ◽  
Haemagglutination Inhibition ◽  
Febrile Illness ◽  
Neutralizing Antibody ◽  
Virus Infections ◽  
West Nile ◽  
High Prevalence

summaryA study of Zika virus infections was carried out in four communities in Oyo State, Nigeria. Virus isolation studies between 1971 and 1975 yielded two virus isolations from human cases of mild febrile illness. Haemagglutination-inhibition tests revealed a high prevalence of antibodies to Zika and three other flaviviruses used. The percentages of positive sera were as follows: Zika (31%), Yellow fever (50%), West Nile (46%), and Wesselsbron (59%). Neutralization tests showed that 40% of Nigerians had Zika virus neutralizing antibody. Fifty per cent of Zika virus immune persons had neutralizing antibody to Zika alone or to Zika and one other flavivirus. A total of 121 sera had antibody to Zika virus; of these 48 (40%) also showed antibody to two other flaviviruses, and 12 (10%) had antibodies to three or more other viruses. The percentage of neutralizing antibodies to other flaviviruses in Zika virus immune sera was 81% to Dengue type 1, 58% to Yellow fever, 7% to Wesselsbron, 6% to West Nile and 3% to Uganda S.

scholarly journals Differential Pattern of Soluble Immune Markers in Asymptomatic Dengue, West Nile and Zika Virus Infections

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Rafaelle Fares-Gusmao ◽  
Bruno Coelho Rocha ◽  
Emilia Sippert ◽  
Marion C. Lanteri ◽  
Germán Áñez ◽  
...  
Keyword(s):  
Zika Virus ◽  
Viral Infections ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Virus Infections ◽  
Immune Markers ◽  
West Nile ◽  
Differential Pattern ◽  
Asymptomatic Stage ◽  
Asymptomatic Phase

AbstractInfections with dengue virus (DENV), West Nile virus (WNV) and Zika virus (ZIKV) usually present similar mild symptoms at early stages, and most infections (~80%) are asymptomatic. However, these infections may progress to severe disease with different clinical manifestations. In this study we attempted to identify unique characteristics for each infection at the presymptomatic/asymptomatic stage of infection and compared levels of soluble immune markers that have been shown to be altered during clinical course of these viral infections. Levels of soluble markers were determined by Luminex-based assays or by ELISA in plasma samples from asymptomatic blood donors who were reactive for RNA from DENV (n = 71), WNV (n = 52) or ZIKV (n = 44), and a control or non-infected (NI) group (n = 22). Results showed that even in the absence of symptoms, increased interleukin (IL) levels of IL-12, IL-17, IL-10, IL-5, CXCL9, E-Selectin and ST2/IL-1R4; and decreased levels of IL-13 and CD40 were found in all flavivirus group samples, compared to those from NI donors. DENV-infected donors demonstrated variation in expression of IL-1ra and IL-2; WNV-infected donors demonstrated variation in expression of IL-1ra, P-Selectin, IL-4 and IL-5; ZIKV-infected donors demonstrated variation in expression of IL-1ra, P-Selectin, IL-4, RANK-L, CD40L and C3a. The findings suggest that, even in the presymptomatic/asymptomatic phase of the infection, different immunomodulation profiles were associated with DENV, WNV and ZIKV infections.

scholarly journals The Etiologies and Clinical Characteristics of Patients Hospitalized with an Acute Febrile Illness and Central Nervous System Sydromes in Indonesia

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S304-S305
Author(s):  
Abu Tholib Aman ◽  
Muhammad Hussein Gasem ◽  
Emiliana Tjitra ◽  
Bachti Alisjahbana ◽  
Herman Kosasih ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Diagnostic Testing ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Standard Of Care ◽  
Neurological Complications ◽  
Acute Febrile Illness ◽  
Referral Hospitals ◽  
Underlying Diseases

Abstract Background Acute febrile illness is a common reason for hospitalization in many developing countries, including Indonesia. While patients can often be categorized and managed based on clinical presentations, diagnostic capacity in these countries remains limited, leading to poor patient outcomes. For patients with central nervous system (CNS) infections, identifying the underlying etiologies is particularly important to prevent lifelong neurological complications and death. Methods As part of a study conducted at 8 top-referral hospitals across Indonesia from 2013 to 2016, 114 of 1,486 enrolled subjects presented with an acute fever and a CNS syndrome. To identify the etiologies and clinical manifestations of these infections, as well as the management of febrile patients at the hospitals, demographic and clinical data were collected at enrollment, and blood samples were collected for diagnostic testing at enrollment, once during days 14–28, and at 3 months after enrollment. Results Subject ages ranged from 1 to 63.2 years old (median of 4.9 years old), and underlying diseases were reported in 35 (30.7%) subjects. Standard-of-care, molecular, and serological testing identified pathogens in 56 (49.1%) cases, as detailed in the table. Of the 19 subjects who died, 18 presented with decreased consciousness and 5 were infected with Rickettsia typhi, which was clinically misdiagnosed in each case. Conclusion The findings from this study will improve the diagnosis and treatment of patients presenting with CNS syndromes in Indonesia. Additionally, the discovery of misdiagnosed, fatal etiologies highlights the general need for greater diagnostic testing capacity to aid clinicians and inform public health policy makers. Disclosures All authors: No reported disclosures.

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