Zika Virus Infection in Pregnant Women and Microcephaly

Abstract

From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damage to the central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection's devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment. All of these changes of varying severity directly or indirectly compromise the future life of these children, and are already considered a congenital syndrome linked to the ZIKV. Diagnosis is one of the main difficulties in the approach of this infection. Considering the clinical part, it has manifestations common to infections by the dengue virus and the chikungunya fever, varying only in subjective intensities. conjunctivitis and arthralgia, among others. In terms of laboratory resources, there are also limitations to the subsidiary diagnosis. Molecular biology tests are based on polymerase chain reaction (PCR) with reverse transcriptase (RT) action, since the ZIKV is a ribonucleic acid (RNA) virus. The RT-PCR shows serum or plasma positivity for a short period of time, no more than five days after the onset of the signs and symptoms. The ZIKV urine test is positive for a longer period, up to 14 days. There are still no reliable techniques for the serological diagnosis of this infection. If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment. However, evidence is needed to rule out other infections that also cause rashes, such as dengue, chikungunya, syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes. There is no specific antiviral therapy against ZIKV, and the therapeutic approach to infected pregnant women is limited to the use of antipyretics and analgesics. Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded. There is no need to modify the schedule of prenatal visits for pregnant women infected by ZIKV, but it is necessary to guarantee three ultrasound examinations during pregnancy for low-risk pregnancies, and monthly for pregnant women with confirmed ZIKV infection. Vaginal delivery and natural breastfeeding are advised. ResumoDesde a descoberta do vírus Zika (VZIK) em 1947 em Uganda, na África, até sua chegada na América do Sul, não se tinha notícia de que ele seria capaz de comprometer a vida reprodutiva em humanos de forma tão severa. Hoje, sabe-se que os danos sobre o sistema nervoso central são múltiplos, e a microcefalia é considerada a ponta do iceberg, visto que na realidade ela representa o epílogo de um processo devastador desta infecção sobre o sistema nervoso central do embrião e do feto. Em decorrência da agressão do sistema nervoso central pelo VZIK, est...

First insights into insecticidal activity against Aedes aegypti and partial biochemical characterization of a novel low molecular mass chymotrypsin‐trypsin inhibitor purified from Lonchocarpus sericeus seeds

“…58 When exposed to treatment with a range of pHs, LsCTI was stable, with none of the pHs tested being able to reduce its inhibitory activity on chymotrypsin ( Figure 5C) and trypsin ( Figure 5D). Similarly, the protease inhibitor from T. dicoccoides (WeCI) was shown to be stable in a wide pH range (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) 47 but, in contrast, the BmPI from B. monosperma was shown to maintain activity only in a pH range of 5-10. 43 The stability of LsCTI after heat treatment was remarkable; the molecule was able to maintain its inhibitory activity at all temperatures tested (37-100 ∘ C) ( Figure 5E), even when heated at 100 ∘ C for 180 min (Figure 5F), for both chymotrypsin and trypsin.…”

“…Mosquitoes transmit about 30 arboviruses of great importance to global public health, among which Aedes aegypti (Diptera: Culicidae), an anthropophilic mosquito, is widespread throughout the world and is the main vector of chikungunya, dengue and Zika viruses. Zika virus deserves special attention in view of its ability to cross the transplacental barrier and to lodge in the fetal nervous system, causing not only microcephaly, but also vision problems, deafness, arthrogryposis and dysphagia . Zika virus can also settle and survive in immunoprivileged tissues, such as the germ tissues present in the testicles, and thus Zika fever is a potential sexually transmitted infection .…”

“…Zika virus deserves special attention in view of its ability to cross the transplacental barrier and to lodge in the fetal nervous system, causing not only microcephaly, but also vision problems, deafness, arthrogryposis and dysphagia. 4 Zika virus can also settle and survive in immunoprivileged tissues, such as the germ tissues present in the testicles, and thus Zika fever is a potential sexually transmitted infection. 5 These Ae.…”

“…Electrophoretic profile on SDS-PAGE (15% w/v) of LsCTI after isoelectric focusing on a 7-cm gel strip with an immobilized pH range(3)(4)(5)(6)(7)(8)(9)(10). Arrows indicate the isoelectric points for the observed isoforms.…”

Travel-related Zika virus cases in Canada: October 2015–June 2017

“…Brain abnormalities and microcephaly are commonly reported (17,18) but CZS is also known to include arthrogryposis (reduced mobility of multiple joints due to contractures), dysphagia (difficulty swallowing), auditory deficits, visual impairment and other anomalies (19). Reports from the United States Zika Pregnancy Registry found that an estimated 5% (95% confidence interval [CI] = 4%-7%) of completed pregnancies with laboratory evidence of possible recent ZIKV infection (i.e., recent flavivirus exposure) had a fetus or infant with evidence of CZS.…”