Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy

Sotelo, Julio; Sotelo, Andre B.; Sotelo, Fabio J.B.; Doi, André Mario; Pinho, João Renato Rebello; Oliveira, Rita de Cássia da Silva; Bezerra, Alanna M.P.S.; Deutsch, Alice D’Agostini; Villas-Boas, Lucy Santos; Félix, Alvina Clara; Romano, Camila Malta; Machado, Clarisse Martins; Mendes-Corrêa, Maria Cássia; Santana, Rúbia Anita Ferraz; Menezes, Fernando Gatti de; Mangueira, Cristóvão Luis Pitangueira

doi:10.3201/eid2305.161538

Cited by 60 publications

(95 citation statements)

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“…ZIKV RNA was not detected in breast milk samples collected from three other women included in the case series at 4 days or longer post‐onset of symptoms . Finally, in a case report, ZIKV RNA was found in colostrum at 14 days and milk samples at 23 and 32 days after onset, and infectious ZIKV particles were found on culturing the day 14 colostrum sample and the day 32 milk sample …”

Section: Resultsmentioning

confidence: 85%

“…Ten studies were identified that described detection of flavivirus genomic material (ZIKV, DENV, and WNV) in human milk (Table ). Five articles (three case reports and two case series) described six cases in which ZIKV ribonucleic acid (RNA) was detected in human milk, including four in which ZIKV was cultured . In one case series (n = 2), reverse‐transcription polymerase chain reaction (RT‐PCR) testing revealed ZIKV RNA in human milk samples collected 5 days after maternal symptom onset, but cell cultures were negative for infectious virus in both cases .…”

Section: Resultsmentioning

confidence: 99%

“…The reports included in this review provide limited evidence of the possible transmission of certain flaviviruses through human and animal milk. The presence of viral RNA in human milk was confirmed for DENV, WNV, and ZIKV, and was found to be potentially infectious in five of 20 cases (4 ZIKV, 1 DENV) . For ZIKV specifically, infectious virus was detected as late as 32 days post‐onset of maternal illness .…”

Section: Commentmentioning

confidence: 88%

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Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review

Mann

Haddad

Williams

et al. 2018

Paediatric Perinatal Epid

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Section: Resultsmentioning

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Commentmentioning

confidence: 88%

See 1 more Smart Citation

Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review

Mann

Haddad

Williams

et al. 2018

Paediatric Perinatal Epid

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show abstract

“…Five countries in the Americas have reported sexually transmitted ZIKV cases [5]. ZIKV can be transmitted in utero to the unborn fetus but there are reports of ZIKV being found in breastmilk [10].…”

Section: Introductionmentioning

confidence: 99%

Zika virus knowledge and attitudes in Ecuador

Casapulla

Aidoo-Frimpong

Basta³

et al. 2018

AIMS Public Health

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Since its discovery in 1947 in Uganda, ZIKV has spread to 61 countries with a total of 229,238 confirmed human cases worldwide. Specifically, Ecuador has recorded 3,058 confirmed cases and 7 confirmed cases of congenital syndrome associated with ZIKV. Using the Health Belief Model (HBM), this pilot study was conducted to assess Zika virus-related knowledge and attitudes among adults in Ecuador. The survey data were collected in public places in rural and urban areas of Ecuador in May 2016. Seven items measured ZIKV knowledge and 23 items measured attitudes toward ZIKV. A total of 181 Ecuadorians participated in this study. The average age of the sample was 33.4. With respect to ZIKV knowledge, the majority of the participants had heard of ZIKV (n = 162, 89.5%). More males reported first hearing of ZIKV on the internet (p = 0.02), more rural individuals reported knowing someone diagnosed with ZIKV (p = 0.02), more primary school educated individuals reported hearing about ZIKV first from their doctor/nurse (p = 0.03), and more high school graduates correctly identified that ZIKV could be transmitted from mother to child (p = 0.03). As for the HBM constructs, there was a statistically significant difference between gender and cues to action (p = 0.04), with males having a statistically significant lower mean on the cues to action items compared to females. There were also statistically significant differences between those categorized as having “adequate” knowledge compared to “low” knowledge on the benefits construct (p = 0.04) and the perceived severity construct (p = 0.03). There is a clear need for education about the transmission and prevention of ZIKV. High levels of self-efficacy for prevention behaviors for ZIKV combined with low perceived barriers in this community set the stage for effective educational interventions or health promotion campaigns that can ameliorate the knowledge deficits surrounding transmission and prevention.

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“…Unlike most flaviviruses, which are known to cause acute infections that are cleared by the host immune response, ZIKV’s persistence in body fluids ( e.g. , semen, saliva, serum, and breast milk) (Paz-Bailey et al, 2017; Sotelo et al, 2017) for weeks to months after the onset of symptoms and its long-term infection of tissues such as the testis (Govero et al, 2016; Ma et al, 2016) suggest a need and opportunity for pharmacological interventions that can help to eliminate the virus from immune-privileged sites, limit damage to tissues and organs where ZIKV persists, and/or limit non-classical modes of ZIKV transmission ( e.g. , sexual or breastfeeding).…”

Section: Introductionmentioning

confidence: 99%

Antiviral activity of N-(4-hydroxyphenyl) retinamide (4-HPR) against Zika virus

Pitts

Wispelaere

et al. 2017

Antiviral Research

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The rapid spread of Zika virus (ZIKV) in recent years has highlighted the severe diseases associated with ZIKV infection, such as Guillain-Barré syndrome in adults and microcephaly in newborns; yet no vaccines or antivirals currently exist to prevent or treat ZIKV infection. We and others have previously identified N-(4-hydroxyphenyl) retinamide (fenretinide or 4-HPR) as an antiviral compound that inhibits dengue virus 2 (DV2) and other flaviviruses by limiting the steady-state accumulation of viral RNA. Here we show that 4-HPR potently inhibits ZIKV in mammalian cell culture and significantly reduces both serum viremia and brain viral burden in a murine model of ZIKV infection. Consistent with previous observations with dengue virus, this antiviral activity is associated with a significant reduction in the steady-state abundance of viral genomic RNA. We show this reduction is due to a major decrease in the rate of viral RNA synthesis, though not via direct inhibition of the activity of the viral replicase. These results establish 4-HPR’s mode of action against DV and ZIKV and, taken with previous clinical trials that established 4-HPR’s safety and tolerability, illustrate the potential utility of 4-HPR as an agent for treatment of ZIKV infection.

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Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy

Abstract: We detected Zika virus in breast milk of a woman in Brazil infected with the virus during the 36th week of pregnancy. Virus was detected 33 days after onset of signs and symptoms and 9 days after delivery. No abnormalities were found during fetal assessment or after birth of the infant.

Cited by 60 publications

References 10 publications

Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review

Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review

Zika virus knowledge and attitudes in Ecuador

Antiviral activity of N-(4-hydroxyphenyl) retinamide (4-HPR) against Zika virus

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