Congenital Zika Syndrome: Genetic Avenues for Diagnosis and Therapy, Possible Management and Long-Term Outcomes.

Giuseppe Gullo,Antonio Simone Laganà,Marco Scaglione,Marco Noventa,Arianna Riva,Gaspare Cucinella,Anna Franca Cavaliere,Giovanni Buzzaccarini,Davide Coldebella,Giulia Spagnol,Simona Zaami,Fabrizio Signore

doi:10.3390/jcm11051351

Abstract

Zika virus (ZIKV) was discovered in Uganda in 1947 and was originally isolated only in Africa and Asia. After a spike of microcephaly cases in Brazil, research has closely focused on different aspects of congenital ZIKV infection. In this review, we evaluated many aspects of the disease in order to build its natural history, with a focus on the long-term clinical and neuro-radiological outcomes in children. The authors have conducted a wide-ranging search spanning the 2012–2021 period from databases PubMed, PubMed Central, Web of Science, Medline, Scopus. Different sections reflect different points of congenital ZIKV infection syndrome: pathogenesis, prenatal diagnosis, clinical signs, neuroimaging and long-term developmental outcomes. It emerged that pathogenesis has not been fully clarified and that the clinical signs are not only limited to microcephaly. Given the current absence of treatments, we proposed schemes to optimize diagnostic protocols in endemic countries. It is essential to know the key aspects of this disease to guarantee early diagnosis, even in less severe cases, and an adequate management of the main chronic problems. Considering the relatively recent discovery of this congenital infectious syndrome, further studies and updated long-term follow-up are needed to further improve management strategies for this disease.

Highlights

Zika virus (ZIKV) is a single-stranded ribonucleic acid (RNA) flavivirus transmitted by arthropod vectors, in particular, Aedes aegypti and Aedes albopictus
The impact of congenital Zika virus infection on the brain of children has been investigated by several authors through autopsy findings in fetuses and children who died shortly after birth
RT-polymerase chain reaction essay (PCR) on these tissues led to isolation of the viral genome [57]

Summary

Introduction

ZIKV is a single-stranded ribonucleic acid (RNA) flavivirus transmitted by arthropod vectors, in particular, Aedes aegypti (or yellow fever mosquito, responsible for the transmission of Dengue and Chikungunya) and Aedes albopictus (or Asian tiger mosquito, responsible for the transmission of Chikungunya and West Nile virus). The virus replicates in the insect’s epithelial cells and, eventually, in the salivary glands. ZIKV infection used to be considered a tropical disease, but global interest has increased since 2015 due to an epidemic of neonatal microcephaly in Brazil. The infection has been shown to be transmissible sexually and through transfusions [1]. Another important aspect is that the vector Aedes aegypti varies seasonally in the United

Methods

Results

Conclusion