Warning to Families and Couples in Tropical Americas: Zika Spreading Fast.

[robert sailor]

Wow..the fear machines are in full force. Quit drinking or smoking or both because those two habits are going to be far worse than the Zika virus. Or keep smoking and drinking and forget about the Zika virus.

[Alan Mighty]

A case study: from infection to liquidized brain: Rita Driggers and colleagues present a case study following a 33 year old Finnish female who contracted ZIKV (possibly in Guatemala) through to the 20th week of her pregnancy with a microcephalic foetus. The New England Journal of Medicine.

Note: The case of the Finnish woman has been mentioned in passing in earlier posts. This is compulsory reading, albeit not for the faint of heart.

The foetus was aborted at week 21.

[Alan Mighty]

A review of everything known about ZIKV to 30 March 2016: The New England Journal of Medicine.

Compulsory reading. Long form.

[Alan Mighty]

Pointers to what is not known about ZIKV. Dr Charlotte Haug and colleagues point to questions that need answers, fast. The New England Journal of Medicine.

[Alan Mighty]

Strong scientific consensus that ZIKV causes microcephaly: World Health Organization on 31 March declared that a strong consensus existed, among scientists, based on observational studies, cohort studies, and case-control studies that ZIKV causes microcephaly. WHO.

[barnakiel]

Martinique 15440 cases. This makes about 50% number grows month to month.

2 cases of microcephaly.

2 cases of GBS.

Zika virus found in GBS patients' urine.

b.

[Alan Mighty]

CDC Press Kit: The US Centers for Disease Control (CDC) held a talkfest with US local and state govt officials to formulate a coordinated response to likely transmission of ZIKV in the continental US. See the CDC press kit, the CDC media release on the talkfest, and parts of the ZAP (Zika Action Plan).

[Alan Mighty]

CT scans show brain development abnormalities; tests rule out causes other than ZIKV: Adriano Hazin and colleagues used computer tomography to image the brains of 23 microcephalic infants in Brazil; 13 female and 10 male with ages ranging from 3 days to 5 months. Samples of cerebrospinal fluid were analysed for 7 of the infants. Other known causes of microcephaly (rubella virus, HIV, toxoplasmosis, syphilis, varicella, parvovirus, cytomegalovirus etc) were not present but ZIKV antibody was present in all samples. Scans showed evidence of disruption of brain development, not destruction of the brain. 6 April 2016. The New England Journal of Medicine.

Images

[Alan Mighty]

ZIKV can kill children and adults: Colombia and Brazil: Andrea Sarmiento-Ospina and colleague describe 4 cases of ZIKV-caused deaths in Colombia: a 2 year old girl; a 30 year old woman; a 61 year old man; and a 72 year old woman. The authors also reference two ZIKV-caused deaths of adults reported by the Ministry of Health of Brazil in 2015. 7 April 2016. The Lancet.

[Alan Mighty]

ZIKV and Acute Disseminated Encephalomyelitis (ADEM): Maria Lucia Brita Ferreira and colleagues report two cases of ADEM - an otherwise relatively rare autoimmune disease characterised by a sudden inflammatory attack on the myelin insulating sheath around nerves of the central nervous system - that were associated with ZIKV infection in Brazil. April 2016 annual meeting of the American Academy of Neurology.

ADEM has much in common with multiple sclerosis (MS). ADEM is usually a single attack on myelin, in contrast to MS with multiple attacks over a long period.


ADEM is relatively rare, about 8 cases per million population. Usually children, most of whom recover (i.e. a low morbidity rate) after 6 months or so. Associated with various viruses (including but not only measles, mumps, rubella, Epstein-Barr, & herpes) and a few bacteria.


The import is: (1) ZIKV may now also be one of the several causes of ADEM; and (2) ZIKV seems capable of causing many problems, all associated with damage to the nervous system.

[Alan Mighty]

ZIKV: overview of the first outbreak (in 1H of 2015) in the State of Rio de Janeiro: Patricia Brasil and colleagues overview the epidemiology of the first outbreak of ZIKV in the State of Rio de Janeiro (population ~16 million) in the first half of 2015. They discuss the epidemiology of 324 suspected cases (116 of them later confirmed by RNA testing). They also did genetic testing of the ZIKV and present a phylogenetic tree showing the relationship of the ZIKV found in Brazil to the earlier cases in Micronesia (and support further the hypothesis that members of canoe teams from the S Pacific competing in races in Brazil in 2014 introduced the virus). PLOS Neglected Tropical Diseases.

Earlier papers investigating the evolution of ZIKV can be found at:


PLOS Neglected Tropical Diseases: Molecular Evolution of Zika Virus during Its Emergence in the 20th Century


PLOS Neglected Tropical Diseases: Genetic Characterization of Zika Virus Strains: Geographic Expansion of the Asian Lineage

[Alan Mighty]

ZIKV and microcephaly: Sonja A. Rasmussen and colleagues review and analyse the arguments and evidence on the causal link between ZIKV infection of pregnant women and microcephaly. They suggest sufficient evidence exists to infer that ZIKV does cause microcephaly. The New England Journal of Medicine.

[Alan Mighty]

Sexual transmission of ZIKV: Eric D'Ortenzio and colleagues report on a couple who had copulated orally (with ejaculation) and vaginally (but reportedly without ejaculation) in Paris, France, in early 2016. The male had spent time in Brazil and suffered a short fever which continued on the day he returned to Paris. The female had travelled to Okinawa, Japan, and reported no fever. Three days after their oral copulation, the female reported a fever. Samples of urine and saliva from the female showed presence of ZIKV; samples of urine and semen from the male showed presence of ZIKV but samples of plasma and saliva did not. Genetic tests of the ZIKV from the two showed 4 mutation differences; the ZIKV from the two belonged to the same cluster of the phylogenetic tree. The data suggest sexual transmission probably through semen but transmission through pre-ejaculate or saliva cannot be ruled out (testing of the saliva of the male was not done until 10 days after the start of his symptoms). The New England Journal of Medicine.

[Alan Mighty]

ZIKV targets human brain cells and reduces their growth and development: Patricia P. Garcez and colleagues exposed cultured nerve stem cells to ZIKV. Infected stem cells developed abnormally and few survived. Garcez and colleagues also exposed cultured brain organoids to ZIKV. Infected organoids grew 40% slower than uninfected organoids. Garcez and colleagues repeated the tests using Dengue virus (DENV). DENV infection of cultured nerve stem cells and cultured brain organoids did not show the abnormalities and slower growth produced by ZIKV. Garcez and colleagues concluded that their tests reinforce the body of evidence causally linking ZIKV to brain malformations including microcephaly. Science.

[Alan Mighty]

Originally Posted by Alan Mighty

The male had spent time in Brazil and suffered a short fever which continued on the day he returned to Paris.

An error. This should read "The male had spent time in Brazil and suffered a short fever and rash which had resolved on the day he returned to Paris."