Clinical, Serological, and Molecular Observations from a Case Series Study during the Asian Lineage Zika Virus Outbreak in Grenada during 2016

Brenciaglia, Marco; Noël, Trevor; Fields, Paul J.; Bidaisee, Satesh; Myers, Todd E.; Nelson, William M.; Venkateswaran, Neeraja; Venkateswaran, K.; Parameswaran, Nishanth; Bahadoor, Avi; Yearwood, Katherine R.; Mapp-Alexander, Veronica; Mitchell, George W.; LaBeaud, A. Desiree; Macpherson, C. N. L.

doi:10.1155/2018/4635647

Cited by 13 publications

(9 citation statements)

References 42 publications

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“…9 In the current study, we prospectively tracked neurodevelopment in a large cohort of ZIKV exposed and unexposed children who were born during a period of active ZIKV transmission in Grenada, Carriacou and Petite Martinique. 10 We conducted the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA), 11 Cardiff…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure

et al. 2021

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ObjectiveZika virus (ZIKV) targets neural stem cells in the developing brain. However, the majority of ZIKV-exposed children are born without apparent neurological manifestations. It remains unclear if these children were protected from ZIKV neurotropism or if they harbour subtle pathology that is disruptive to brain development. We assess this by comparing neurodevelopmental outcomes in normocephalic ZIKV-exposed children relative to a parallel control group of unexposed controls.DesignCohort study.SettingPublic health centres in Grenada, West Indies.Patients384 mother–child pairs were enrolled during a period of active ZIKV transmission (April 2016–March 2017) and prospectively followed up to 30 months. Child exposure status was based on laboratory assessment of prenatal and postnatal maternal serum.Main outcome measuresThe INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) package and Cardiff Vision Tests, administered and scored by research staff masked to child’s exposure status.ResultsA total of 131 normocephalic ZIKV exposed (n=68) and unexposed (n=63) children were assessed between 22 and 30 months of age. Approximately half of these children completed vision testing. There were no group differences in sociodemographics. Deficits in visual acuity (31%) and contrast sensitivity (23%) were apparent in the ZIKV-exposed infants in the absence of cognitive, motor, language or behavioural delays.ConclusionsOverall neurodevelopment is likely to be unaffected in ZIKV-exposed children with normal head circumference at birth and normal head growth in the first 2 years of life. However, the visual system may be selectively vulnerable, which indicates the need for vision testing by 3 years of age.

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Section: Introductionmentioning

confidence: 99%

Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure

et al. 2021

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“…In this review, there was epidemiologic data supporting an association between adult ZIKV infections and neurological complications, namely GBS, given the mirroring of the trends of these two diseases [32,35,43,49,70,121]. After excluding studies that intentionally enriched for patients with neurological complications, we calculated a risk of neurological sequelae in ZIKV infection of 0.3%.…”

Section: Discussionmentioning

confidence: 99%

“…There were also children in this study from range of one day old to 90 years old (age range). [70] g Daudens-Vaysse et al reported on 9077 suspected cases in the French Territories of America and 7,600 of these were from Martinique; 58 from Saint-Martin, 1,030 from French Guiana, and 389 from Guadeloupe. Total confirmed among the territories was 249 cases.…”

Section: Zikv Case Definitionsmentioning

confidence: 99%

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

et al. 2021

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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.

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“…In 2016, the tri-island nation of Grenada, Carriacou, and Petit Martinique experienced a ZIKV outbreak with peak transmission from May through October of 2016 [ 13 ]. In April 2016, the Ministry of Health and the Windward Islands Education and Research Foundation (WINDREF) began recruiting pregnant women for participation in a ZIKV surveillance study during their antenatal and postnatal care appointments at local health centers, regardless of whether they presented with ZIKV symptoms.…”

Section: Introductionmentioning

confidence: 99%

Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure

et al. 2020

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Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003–0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings.

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Clinical, Serological, and Molecular Observations from a Case Series Study during the Asian Lineage Zika Virus Outbreak in Grenada during 2016

Cited by 13 publications

References 42 publications

Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure

Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure

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

Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure

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