Zika Virus Infection

Abstract

Background: Zika virus (ZIKV) is an emergent flavivirus, transmitted predominately by Aedes genus mosquitos that recently reached the Americas and was soon implicated in an increase in microcephaly and other serious birth defects. Purpose: This report provides updated information and recommendations on testing, screening, and care for pregnant women and infants affected by ZIKV. Methods: Current published recommendations from the Centers for Disease Control and Prevention, the World Health Organization, and the American Academy of Pediatrics were reviewed and included in this report. Results: Although largely a self-limiting disease usually without symptoms, pregnant women and their fetuses are at greatest risk. Maternal transmission of ZIKV to the fetus can lead to congenital Zika infection with potentially devastating sequelae to the infant. The available evidence suggests that infection during the first trimester of pregnancy, in which the fetus' central nervous system is being formed, is associated with higher risk of brain abnormalities and perinatal loss. Implications for Practice: Uncertainties remain about the course of the disease, and the full spectrum of effects of the virus on the developing infant is not yet understood. Infants with congenital Zika syndrome need coordinated follow-up and long-term specialty care, as well as support for the family. Implications for Research: There is no known cure for ZIKV infection and no vaccine is currently available. The full spectrum of developmental disabilities and other adverse early childhood outcomes associated with congenital ZIKV infection needs to be studied.

T cell immunity rather than antibody mediates cross-protection against Zika virus infection conferred by a live attenuated Japanese encephalitis SA14-14-2 vaccine

“…Therefore, it is inevitable that JEV and ZIKV co-circulate. The identification of ZIKV presents new challenges for prevention and control because of its severe consequences in pregnancy (Grazel and Harris-Haman 2018 ) and prompts an urgent need to clarify the mechanisms underlying such cross-protective immunity, which will inform the strategy of developing safe and effective vaccines targeting both viruses, with appropriately balanced B cell and T cell antigens.…”

Erythromycin Estolate Inhibits Zika Virus Infection by Blocking Viral Entry as a Viral Inactivator

“…The clinical dosage of Ery-Est for adults is 0.75–2 g/day according to the drug instructions, and it was reported to be safely used by pregnant women at the dosage of 1 g/day to assess whether antibiotic treatment could benefit pregnant women with heavy vaginal ureaplasma colonization [47]. Since it is considered safe in pregnant women, Ery-Est could provide a choice for ZIKV-infected gravida who are most likely to suffer serious consequences of abortion, premature birth, or having a baby with microcephaly [48,49,50,51]. Meanwhile, as the sexual transmission of ZIKV was constantly reported [52,53], Ery-Est also showed great potential to be developed into the microbicide with both anti-ZIKV and bactericidal effects, which would not only block the sexual transmission of ZIKV but would be conducive to the healthy vaginal environment.…”

Obstetric Ultrasonography to Detect Fetal Abnormalities in a Mouse Model for Zika Virus Infection

“…Currently, it is not understood how likely ZIKV infection during pregnancy results in infection and damage to the fetus. So far, the first trimester of human pregnancy is considered as the time period in which the fetuses are most vulnerable to ZIKV infection and the development CZS [34][35][36]. After confirmed or possible ZIKV infections in pregnant women, the Center for Disease Control and Prevention (CDC) recommends repeated fetal ultrasound to monitor for possible fetal malformation especially in the head regions.…”