First case of confirmed congenital Zika syndrome in continental Africa

Sassetti, Madalena; Zé-Zé, Líbia; Franco, J. Lorenzo; Cunha, José da; Junior, Antonio Luiz Gomes; Tomé, Ana; Alves, Maria João

doi:10.1093/trstmh/try074

Cited by 30 publications

(35 citation statements)

References 15 publications

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“…Both cases (one of which is clinically reported here) have strong serological evidence for maternal ZIKV exposure and brain abnormalities consistent with congenital Zika syndrome. 11,22 Further, both confirmed microcephaly cases were born a few months after the date of sampling of PCR-confirmed ZIKV infections in Angola. A time lag of ~5 months between ZIKV incidence and occurrence of microcephaly cases has been observed elsewhere.…”

Section: Discussionmentioning

confidence: 95%

“…Details of this case, a short (193 nt) fragment of the ZIKV NS1 gene from the neonate, and ethical permissions are described elsewhere. 11 Virus genome sequencing of that strain was attempted using the methods described above, at the Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal.…”

Section: Zikv Genome Sequencingmentioning

confidence: 99%

“…The three Angolan ZIKV sequences differ from each other at 34 nucleotide sites. Three of these variable sites cause amino acid changes: Y135H (in sample Z3), Y3038H and D3344E (both in sample PoHuZV_634939, isolated from a microcephaly patient 11 ). Neither of the two amino acid changes observed in strain PoHuZV_634939 are seen in either of the two most closely related ZIKV genomes obtained from infants born with microcephaly in Brazil (GenBank accession numbers KU729217, KU527068).…”

Section: Sequencing and Genetic Analysis Of Zikvmentioning

confidence: 99%

“…We tested available serum samples for ZIKV and used portable sequencing technology to generate three Asian lineage ZIKV genome sequences from individuals infected in Angola, including one individual born with microcephaly. 11 Phylogenetic analyses reconstruct the timings and geographic origin of the Angolan ZIKV outbreak. We corroborate our conclusions using multiple data sources, including the climatic suitability of the Aedes mosquito vector, international data on ZIKV incidence and airline passenger numbers.…”

Section: Introductionmentioning

confidence: 99%

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Emergence of the Zika virus Asian lineage in Angola

Hill

Vasconcelos

Neto

et al. 2019

Preprint

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Background: Zika virus (ZIKV) infections and suspected microcephaly cases have been recently reported in Angola, but no data are available on the origins, epidemiology, and diversity of the virus. Methods: Serum samples from 54 suspected ZIKV cases, 76 suspected microcephaly cases, and 24 mothers of infants with suspected microcephaly were received by the Angolan Ministry of Health. Computed tomographic brain imaging and serological assays (PRNT) were conducted on one microcephalic infant. All sera were tested for ZIKV by RT-qPCR. 349 samples from HIV+ patients and 336 samples from patients suspected of chikungunya virus or dengue virus infection were also tested. Portable sequencing was used to generate Angolan ZIKV genome sequences, including from a ZIKV+ neonate with microcephaly born in Portugal to an Angolan resident. Genetic and mobility data were analysed to investigate the date of introduction and geographic origin of ZIKV in Angola. Findings: Four autochthonous cases were ZIKV positive via RT-qPCR, with all positive samples collected between December 2016 and June 2017. Viral genomes were generated for two of these cases, and from the neonate with microcephaly identified in Portugal. Genetic analyses and other data indicate that ZIKV was introduced to Angola from Brazil between July 2015 and June 2016. This introduction likely initiated local ZIKV circulation in Angola that continued until June 2017. The scanned microcephaly case showed brain abnormalities consistent with congenital Zika syndrome and serological evidence for maternal ZIKV infection. Interpretation: Our analyses confirm the autochthonous transmission of the ZIKV Asian lineage in continental Africa. Conducting ZIKV surveillance throughout Africa is critical in the light of presented evidence for autochthonous ZIKV transmission in Angola, and associated microcephaly cases. Funding: Royal Society, Wellcome Trust, CNPq, CAPES, ERC, Oxford Martin School, Global Challenges Research Fund, Africa Oxford, and John Fell Fund.

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Section: Discussionmentioning

confidence: 95%

Section: Zikv Genome Sequencingmentioning

confidence: 99%

Section: Sequencing and Genetic Analysis Of Zikvmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Emergence of the Zika virus Asian lineage in Angola

Hill

Vasconcelos

Neto

et al. 2019

Preprint

Self Cite

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“…It remains unknown when the next outbreak of ZIKV will occur, yet we know through past devastating epidemics, in which thousands of women and children were affected by this virus that we still have an urgent need for effective therapies against ZIKV infection [11], [50], [51]. Despite current potential protection from herd and self-immunity, environmental factors, and host-vector-virus interactions that keep ZIKV in the low incidence figures [1], [52], [53], [54], [55], preventing ZIKV and other arbovirus infections should be a priority. In recent years, many compounds have been proposed as potential anti-ZIKV agents following in vitro results [24], [25], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65].…”

Section: Discussionmentioning

confidence: 99%

The antiparasitic drug atovaquone inhibits arbovirus replication through the depletion of intracellular nucleotides.

Kottkamp

Jesus

Grande

et al. 2018

Preprint

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Arthropod-borne viruses represent a significant public health threat worldwide yet there are few antiviral therapies or prophylaxis targeting these pathogens. In particular, the development of novel antivirals for high-risk populations such as pregnant women is essential to prevent devastating disease such as that which was experienced with the recent outbreak of Zika virus (ZIKV) in the Americas. One potential avenue to identify new and pregnancy friendly antiviral compounds is to repurpose well-known and widely used FDA approved drugs. In this study, we addressed the antiviral role of atovaquone, a FDA Pregnancy Category C drug and pyrimidine biosynthesis inhibitor used for the prevention and treatment of parasitic infections. We found that atovaquone was able to inhibit ZIKV and chikungunya virus virion production in human cells and that this antiviral effect occurred early during infection at the initial steps of viral RNA replication. Moreover, we were able to complement viral replication and virion production with the addition of exogenous pyrimidine nucleosides indicating that atovaquone is functioning through the inhibition of the pyrimidine biosynthesis pathway to inhibit viral replication. Finally, using an ex vivo human placental tissue model, we found that atovaquone could limit ZIKV infection in a dose-dependent manner providing evidence that atovaquone may function as an antiviral in humans. Taken together, these studies suggest that atovaquone could be a broad-spectrum antiviral drug and a potential attractive candidate for the prophylaxis or treatment of arbovirus infection in vulnerable populations, such as pregnant women.

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Obstetric and perinatal outcomes in cases of congenital Zika syndrome

Melo

Tavares²,

Costa³

et al. 2020

Prenatal Diagnosis

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Objective: To describe obstetric and perinatal outcomes in cases of congenital Zika syndrome (CZS). Methods: A dual prospective and retrospective cohort study involving 102 pairs of mothers and fetuses/children with CZS whose infection was confirmed by testing for the Zika virus in amniotic fluid, umbilical cord blood, and fragments from the placenta of the newborn infant (confirmed CZS), or by intrauterine imaging tests (neurosonography), and/or postnatal computed tomography (presumed CZS). Results: Suspicion of CZS was investigated by ultrasonography during pregnancy in 52.9% of cases. The principal prenatal imaging findings were ventriculomegaly (43.1%) and microcephaly (42.2%). Median gestational age at delivery was 39 weeks, with 15.7% being premature. Mean head circumference at birth was 30.0 ± 2.3 cm, with 66% of cases being classified as having microcephaly. Arthrogryposis was found in 10 cases (9.8%). There were no fetal deaths; however, nine neonatal deaths were recorded, and three autopsies were performed. Conclusion: Neonatal mortality was high, almost 10%. Regarding the abnormalities of CZS, microcephaly, although common, was not present in all cases and intracranial findings need to be taken into consideration for diagnosis. Therefore, ultrasound screening during pregnancy should be systematized and expanded in endemic zones.

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First case of confirmed congenital Zika syndrome in continental Africa

Abstract: To our knowledge this is the first report that shows the circulation of the Asian lineage in Angola and the first report of a congenital Zika syndrome in continental Africa.

Cited by 30 publications

References 15 publications

Emergence of the Zika virus Asian lineage in Angola

Emergence of the Zika virus Asian lineage in Angola

The antiparasitic drug atovaquone inhibits arbovirus replication through the depletion of intracellular nucleotides.

Obstetric and perinatal outcomes in cases of congenital Zika syndrome

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