Association Between Zika Virus and Microcephaly in French Polynesia, 2013–2015

Cauchemez, Simon; Besnard, Marianne; Bompard, Priscillia; Dub, Timothée; Guillemette-Artur, Prisca; Eyrolle-Guignot, Dominique; Salje, Henrik; Kerkhove, Maria D. Van; Abadie, Véronique; Garel, Catherine; Fontanet, Arnaud; Mallet, Henri‐Pierre

doi:10.1097/01.ogx.0000491260.72445.aa

Cited by 48 publications

(65 citation statements)

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“…Our results suggest that 1.65 (1.45-2.06) million childbearing women and 93.4 (81.6-117.1) million people in total could become infected before the first wave of the epidemic concludes. Based on current estimates of rates of adverse fetal outcomes among infected women 2,4,5 , these results suggest that tens of thousands of pregnancies could be negatively impacted by the first wave of the epidemic. These projections constitute a revised upper limit of populations at risk in the current Zika epidemic, and our approach offers a new way to make rapid assessments of the threat posed by emerging infectious diseases more generally.…”

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confidence: 98%

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Model-based projections of Zika virus infections in childbearing women in the Americas

et al. 2016

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Zika virus is a mosquito-borne pathogen that is rapidly spreading across the Americas. Due to associations between Zika virus infection and a range of fetal maladies 1,2 , the epidemic trajectory of this viral infection poses a significant concern for the nearly 15 million children born in the Americas each year. Ascertaining the portion of this population that is truly at risk is an important priority. One recent estimate 3 suggested that 5.42 million childbearing women live in areas of the Americas that are suitable for Zika occurrence. To improve on that estimate, which did not take into account the protective effects of herd immunity, we developed a new approach that combines classic results from epidemiological theory with seroprevalence data and highly spatially resolved data about drivers of transmission to make location-specific projections of epidemic attack rates. Our results suggest that 1.65 (1.45-2.06) million childbearing women and 93.4 (81.6-117.1) million people in total could become infected before the first wave of the epidemic concludes. Based on current estimates of rates of adverse fetal outcomes among infected women 2,4,5 , these results suggest that tens of thousands of pregnancies could be negatively impacted by the first wave of the epidemic. These projections constitute a revised upper limit of populations at risk in the current Zika epidemic, and our approach offers a new way to make rapid assessments of the threat posed by emerging infectious diseases more generally.On 1 February 2016, the World Health Organization (WHO) designated the ongoing Zika virus epidemic in the Americas as a Public Health Emergency of International Concern (PHEIC), defined as an 'extraordinary event' that 'potentially require[s] a coordinated international response' 6 . This declaration acknowledges the high potential for Zika to establish across the Americas given that its dominant vector, the Aedes aegypti mosquito, is endophilic and occupies an exceptionally broad geographical range 7 . Concern underlying this rare WHO declaration also stems from an association between Zika virus infection in pregnant women and a range of adverse fetal outcomes 2 , most notably congenital microcephaly 1 . As of 30 June 2016, there were 1,674 confirmed cases of microcephaly associated with Zika virus infection in five countries 8 , and there is widespread concern that these numbers could increase further as the virus continues to spread across the Americas 9 .A number of uncertainties surround the future of the Zika epidemic in the Americas, particularly questions about how many women may be at risk of having children with congenital microcephaly and other adverse outcomes associated with Zika virus infection 10 . Of women who become infected with Zika virus during a vulnerable stage of their pregnancy, evidence is emerging that 1-13% may go on to develop congenital microcephaly 2,4,5 .However, the number of women who become infected with Zika virus during that timeframe is difficult to ascertain. One recent study 3 estimat...

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confidence: 98%

“…Of women who become infected with Zika virus during a vulnerable stage of their pregnancy, evidence is emerging that 1-13% may go on to develop congenital microcephaly 2,4,5 .…”

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confidence: 99%

Model-based projections of Zika virus infections in childbearing women in the Americas

et al. 2016

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“…This virus, a member of the family Flaviviridae, is transmitted by mosquito bite and is also potentially sexually transmitted (113)(114)(115)(116)(117). While historically an infection has been described as causing symptoms ranging from fever and rash to Guillain-Barre syndrome (118)(119)(120)(121)(122)(123)(124), during the most recent outbreak there was also a startling increase in the incidence of fetal brain and CNS abnormalities when mothers acquired the virus during pregnancy (32,(125)(126)(127)(128)(129)(130)(131)(132)(133)(134). A causal link between ZIKV and these defects was established when the ZIKV genome was identified in the amniotic fluid of women whose fetuses had microcephaly detected during fetal ultrasound (125-127, 132, 133, 135).…”

Section: Zikv and Pregnancymentioning

confidence: 99%

“…There is now a large body of work demonstrating that direct infection of the fetus with CMV, HSV-2, or rubella can cause major neurosensory deficits (26)(27)(28), learning disabilities, and psychiatric disorders (29)(30)(31). Microcephaly has also been associated with fetal CMV and ZIKV infection (ZIKV is further discussed below) (32,33). While these examples of direct infection of the fetus have the most severe individual consequences, in utero fetal viral infections are rare.…”

Section: Viral Infection At the Maternal-fetal Interfacementioning

confidence: 99%

Risks associated with viral infections during pregnancy

Racicot¹,

Mor

2017

Journal of Clinical Investigation

238

204

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“…1) and newborns infected with ZIKV. In an important new study, published in The Lancet, Simon Cauchemez and colleagues have analysed data from a previous ZIKV outbreak in French Polynesia to explore the link between ZIKV and microcephaly in detail 4 . Congenital microcephaly is a clinical sign, defined by the international INTERGROWTH-21 st Newborn Size Standards as a head circumference at least 2 SD smaller than the mean for sex and gestational age at birth.…”

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confidence: 99%