Male-to-Female Sexual Transmission of Zika Virus—United States, January–April 2016

Russell, Kate; Hills, Susan L.; Oster, Alexandra M.; Porse, Charsey Cole; Danyluk, Gregory; Cone, Marshall; Brooks, Richard; Scotland, Sarah; Schiffman, Elizabeth; Fredette, Carolyn; White, Jennifer L.; Ellingson, Katherine; Hubbard, Allison; Cohn, Amanda C.; Fischer, Marc; Mead, Paul S.; Powers, Ann M.; Brooks, John T.

doi:10.1093/cid/ciw692

Cited by 111 publications

(71 citation statements)

References 14 publications

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“…The duration of infectiousness to mosquitoes ranges from 4–7 days (16). After this phase, women recover (R), but men remain infectious to their female partners (J) for an additional 15–180 days (17). Immunological protection is conferred upon recovery or via vaccination (V) and is assumed to be robust, consistent with other flaviviruses (18,19).…”

Section: Methodsmentioning

confidence: 99%

Evaluating Vaccination Strategies for Zika Virus in the Americas

Durham

Fitzpatrick

Ndeffo-Mbah

et al. 2018

Annals of Internal Medicine

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Background Mosquito-borne and sexually-transmitted Zika virus infection has become widespread across Central and South America as well as in the Caribbean. Over 30 Zika vaccine candidates are under active development. Objective To quantify the impact of Zika vaccine prioritization of females aged 9–49, followed by males aged 9–49, on the incidence of prenatal Zika infections. Design We developed a compartmental model of Zika transmission between mosquitoes and humans calibrated to empirical estimates of country-specific mosquito density. Mosquitoes were stratified into susceptible, exposed, or infected classes; humans were stratified into susceptible, exposed, infected, recovered, or vaccinated classes. We further incorporated age-specific rates of fertility, Zika sexual transmission, and country-specific demographics. Setting 34 countries or territories in the Americas with documented Zika outbreaks. Target population Males and females aged 9–49. Interventions Age- and gender-targeted immunization using a Zika vaccine with efficacy ranging from 60–90%. Measurements Annual prenatal Zika infections Results For a base-case vaccine efficacy of 75% and vaccination coverage of 90%, immunizing females aged 9–49, the WHO target population, would reduce the incidence of prenatal infections by at least 94%, depending on the country-specific Zika attack rate. In regions where an outbreak is not expected for at least ten years, vaccination of females aged 15–29 is more efficient than vaccinating women over 30 years. Limitations Population-level modeling may not capture all local and neighborhood-level heterogeneity in mosquito abundance or Zika incidence. Conclusions A Zika vaccine of moderate to high efficacy has the potential of virtually eliminating prenatal infections through a combination of direct protection and transmission reduction. Efficiency of age-specific Zika vaccination targeting depends on timing of future outbreaks. Funding National Institutes of Health

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Section: Methodsmentioning

confidence: 99%

Evaluating Vaccination Strategies for Zika Virus in the Americas

Durham

Fitzpatrick

Ndeffo-Mbah

et al. 2018

Annals of Internal Medicine

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“…Zika virus is primarily transmitted through the bite of an infected Aedes species mosquito, however it can also be spread via sexual transmission (1, 2) and vertically--from an infected pregnant woman (3, 4). …”

Section: Introductionmentioning

confidence: 99%

Serial Head and Brain Imaging of 17 Fetuses With Confirmed Zika Virus Infection in Colombia, South America

Parra‐Saavedra

Reefhuis

Piraquive

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To evaluate fetal ultrasound and magnetic resonance imaging findings among a series of pregnant women with confirmed Zika virus infection to evaluate the signs of congenital Zika syndrome with respect to timing of infection. Methods Retrospective case series of pregnant women referred to two perinatal clinics in Barranquilla and Ibagué, Colombia with findings consistent with congenital Zika syndrome and Zika virus infection confirmed in maternal, fetal, or infant samples. Serial ultrasound measurements, fetal magnetic resonance imaging results, laboratory results, and perinatal outcomes were evaluated. Results We describe 17 cases of confirmed prenatal maternal Zika virus infection with adverse fetal outcomes. Among the 14 symptomatic women, the median gestational age for maternal Zika virus symptoms was 10 weeks (range 7–14). The median time between Zika virus symptom onset and microcephaly (head circumference less than 3 standard deviations below the mean) was 18 weeks (range 15–24). The earliest fetal head circumference measurement consistent with microcephaly diagnosis was at 24 weeks of gestation. The earliest sign of congenital Zika syndrome was talipes equinovarus, which in two patients was noted first at 19 weeks. Common findings on fetal magnetic resonance imaging were microcephaly, ventriculomegaly, polymicrogyria, and calcifications. Conclusion Our analysis suggests a period of at least 15 weeks between maternal Zika virus infection in pregnancy and development of microcephaly, and highlights the importance of serial and detailed neuroimaging.

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“…ZIKV sequences have been detected in the semen 62 days after the onset of symptoms. The data available hint the possible transmission of the virus through vaginal and oral sex (Hills et al, 2016; Russell et al, 2016). Nonetheless, transmission role of other biological fluid, such as pre-ejaculation semen, and saliva transmission cannot be ruled out (Cowper’s gland).…”

Section: Non-mosquito Transmissionmentioning

confidence: 99%

Zika Virus: An Emerging Worldwide Threat

et al. 2017

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ZIKA virus (ZIKV) poses a severe threat to the world. Recent outbreaks of ZIKV after 2007 along with its quick transmission have made this virus a matter of international concern. The virus shows symptoms that are similar to those caused in the wake of dengue virus (DENV) and other flaviviruses, which makes it difficult to discern the viral infection. Diagnosis is further complicated as the virus cross-reacts with antibodies of other viruses. Currently, molecular diagnosis of the virus is being performed by RT-PCR and IgM-captured enzyme-linked immunosorbent assay (MAC-ELISA). The real brunt of the virus is, however, borne by children and adults alike. Case studies of the ZIKV outbreaks in the French Polynesia and other places have suggested that there is a close link between the ZIKV and Gullian-Barre syndrome (GBS). The GBS has closely followed in areas facing ZIKV outbreaks. Although solid evidence is yet to emerge, clinical data integration has revealed a large number of ZIKV patients having GBS. Moreover, the amniotic fluids, blood cord, and miscarriage tissues of mothers have been detected with ZIKV, which indicates that the virus either gets transferred from mother to fetus or seeks direct entry in the fetus, causing microcephaly and other brain anomalies in the newborn babies. Studies on mice have confirmed the link between the ZIKV infection during pregnancy and microcephaly in babies. Reports have highlighted the sexual transmission of the ZIKV, as it has been detected in the semen and saliva of affected persons. The intensity with which the ZIKA is spreading can collapse the health sector of several countries, which are poor. A comprehensive strategy is a need of an hour to combat this virus so as to prevent its transmission and avert the looming threat. At the same time, more research on the cure of the ZIKV is imperative.

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Male-to-Female Sexual Transmission of Zika Virus—United States, January–April 2016

Cited by 111 publications

References 14 publications

Evaluating Vaccination Strategies for Zika Virus in the Americas

Evaluating Vaccination Strategies for Zika Virus in the Americas

Serial Head and Brain Imaging of 17 Fetuses With Confirmed Zika Virus Infection in Colombia, South America

Zika Virus: An Emerging Worldwide Threat

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