Genetic evidence of Zika virus in mother's breast milk and body fluids of a newborn with severe congenital defects

Giovanetti, Marta; Jesus, Jaqueline Góes de; Maia, Maricelia Lima; Junior, Javier; Castro-Amarante, Maria Fernanda de; Viana, Paloma; Barreto, Fernanda Khouri; Cerqueira, Erenilde Marques de; Santos, Nicole; Falcão, Melissa Barreto; Costa, M.C. Machado; Faiçal, Adriana Virgínia Barros; Melo, Armindo; Amorim, L. Santos; Siqueira, Isadora Cristina de; Macarenhas, D.L.; Filippis, Ana María Bispo de; Faria, Nieli Rodrigues da Costa; Xavier, Joilson; Alcântara, Luiz Carlos Júnior

doi:10.1016/j.cmi.2018.06.008

Cited by 16 publications

(28 citation statements)

References 5 publications

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“…Reports have shown that ZIKV RNA is present in several body fluids, including urine, blood, saliva, breast milk and secretions from the vaginal tract [ 7 , 8 , 9 , 10 ], being cleared early from serum but still detected in whole blood, saliva and urine for more than two weeks after symptoms onset [ 11 , 12 , 13 , 14 ]. ZIKV can also replicate and persist in the male reproductive system and ZIKV RNA has been detected within semen for up to 6 months after initial infection in the male reproductive system (MRS) [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Persistence and Intra-Host Genetic Evolution of Zika Virus Infection in Symptomatic Adults: A Special View in the Male Reproductive System

Oliveira

Durigon

Mendes

et al. 2018

Viruses

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We followed the presence of Zika virus (ZIKV) in four healthy adults (two men and two women), for periods ranging from 78 to 298 days post symptom onset. The patients were evaluated regarding the presence of the virus in different body fluids (blood, saliva, urine and semen), development of immune responses (including antibodies, cytokines and chemokines), and virus genetic variation within samples collected from semen and urine during the infection course. The analysis was focused primarily on the two male patients who shed the virus for up to 158 days after the initial symptoms. ZIKV particles were detected in the spermatozoa cytoplasm and flagella, in immature sperm cells and could also be isolated from semen in cell culture, confirming that the virus is able to preserve integrity and infectivity during replication in the male reproductive system (MRS). Despite the damage caused by ZIKV infection within the MRS, our data showed that ZIKV infection did not result in infertility at least in one of the male patients. This patient was able to conceive a child after the infection. We also detected alterations in the male genital cytokine milieu, which could play an important role in the replication and transmission of the virus which could considerably increase the risk of ZIKV sexual spread. In addition, full genome ZIKV sequences were obtained from several samples (mainly semen), which allowed us to monitor the evolution of the virus within a patient during the infection course. We observed genetic changes over time in consensus sequences and lower frequency intra-host single nucleotide variants (iSNV), that suggested independent compartmentalization of ZIKV populations in the reproductive and urinary systems. Altogether, the present observations confirm the risks associated with the long-term replication and shedding of ZIKV in the MRS and help to elucidate patterns of intra-host genetic evolution during long term replication of the virus.

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Section: Introductionmentioning

confidence: 99%

Persistence and Intra-Host Genetic Evolution of Zika Virus Infection in Symptomatic Adults: A Special View in the Male Reproductive System

Oliveira

Durigon

Mendes

et al. 2018

Viruses

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“…As previously stated, these articles were not eligible, but they also did not describe any nutrition or feeding‐related findings and their effect on infant outcomes and nor the effect of support for primary caregivers on infant outcomes. The case reports we identified were clinical and laboratory studies related to testing breast milk of infected mothers for ZIKV in French Polynesia [30], New Caledonia [31] and Brazil [32].…”

Section: Resultsmentioning

confidence: 99%

Feeding modifications and additional primary caregiver support for infants exposed to Zika virus or diagnosed with congenital Zika syndrome: a rapid review of the evidence

Martínez

Pardo-Hernández

Palacios

2020

Tropical Med Int Health

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Objective Infants exposed to Zika virus (ZIKV) or diagnosed with congenital Zika syndrome (CZVS) may present dysphagia, regurgitation and other feeding difficulties. They may require special feeding practices to minimise the risk of mortality, morbidity and developmental problems. Improving knowledge, skills and behaviours of caregivers may preserve health, maximise development and promote quality of life among affected infants. We reviewed intervention studies of modified feeding practices and additional primary caregiver support to improve outcomes among infants 0 to 12 months of age exposed to ZIKV or diagnosed with CZVS. Methods Rapid review and meta‐analysis. We searched PubMed/MEDLINE and contacted experts. The search is current to 18 July 2020. We planned a meta‐analysis using fixed‐effect models; if unfeasible, we intended to summarise studies narratively. We planned to assess risk of bias of included studies and quality of evidence using Cochrane guidance. Results We identified 42 records for title and abstract screening; 14 were eligible for full‐text assessment. Among these, no intervention studies were found. Eight observational studies reported on the nutritional status, feeding practices and outcomes among infants affected by ZIKV or diagnosed with CZVS. They are presented and discussed to provide a basis for future research. Conclusions While no intervention studies were found, evidence from eight observational studies highlights the need for early nutrition interventions and caregiver support among infants affected by ZIKV or diagnosed with CZSV. More research is needed to assess whether modifications of feeding practices and provision of additional primary caregiver support will impact outcomes of interest.

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“…Human case reports have confirmed the presence of ZIKV in breast milk and its transmission to newborns (13,167). In addition, the presence of ZIKV was also evidenced in breast milk, as well as in the serum and urine of a newborn with congenital defects whose mother was infected early during pregnancy (169).…”

Section: Postnatal Zikv Infectionmentioning

confidence: 87%

Maternal-Fetal Interplay in Zika Virus Infection and Adverse Perinatal Outcomes

et al. 2020

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During pregnancy, the organization of complex tolerance mechanisms occurs to assure non-rejection of the semiallogeneic fetus. Pregnancy is a period of vulnerability to some viral infections, mainly during the first and second trimesters, that may cause congenital damage to the fetus. Recently, Zika virus (ZIKV) infection has gained great notoriety due to the occurrence of congenital ZIKV syndrome, characterized by fetal microcephaly, which results from the ability of ZIKV to infect placental cells and neural precursors in the fetus. Importantly, in addition to the congenital effects, studies have shown that perinatal ZIKV infection causes a number of disorders, including maculopapular rash, conjunctivitis, and arthralgia. In this paper, we contextualize the immunological aspects involved in the maternal-fetal interface and vulnerability to ZIKV infection, especially the alterations resulting in perinatal outcomes. This highlights the need to develop protective maternal vaccine strategies or interventions that are capable of preventing fetal or even neonatal infection.

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Genetic evidence of Zika virus in mother's breast milk and body fluids of a newborn with severe congenital defects

Cited by 16 publications

References 5 publications

Persistence and Intra-Host Genetic Evolution of Zika Virus Infection in Symptomatic Adults: A Special View in the Male Reproductive System

Persistence and Intra-Host Genetic Evolution of Zika Virus Infection in Symptomatic Adults: A Special View in the Male Reproductive System

Feeding modifications and additional primary caregiver support for infants exposed to Zika virus or diagnosed with congenital Zika syndrome: a rapid review of the evidence

Maternal-Fetal Interplay in Zika Virus Infection and Adverse Perinatal Outcomes

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