Abstract
Most viruses use several entry sites and modes of transmission to infect their host (parenteral, sexual, respiratory, oro-fecal, transplacental, transcutaneous, etc.). Some of them are known to be essentially transmitted via arthropod bites (mosquitoes, ticks, phlebotomes, sandflies, etc.), and are thus named arthropod-borne viruses, or arboviruses. During the last decades, several arboviruses have emerged or re-emerged in different countries in the form of notable outbreaks, resulting in a growing interest from scientific and medical communities as well as an increase in epidemiological studies. These studies have highlighted the existence of other modes of transmission. Among them, mother-to-child transmission (MTCT) during breastfeeding was highlighted for the vaccine strain of yellow fever virus (YFV) and Zika virus (ZIKV), and suggested for other arboviruses such as Chikungunya virus (CHIKV), dengue virus (DENV), and West Nile virus (WNV). In this review, we summarize all epidemiological and clinical clues that suggest the existence of breastfeeding as a neglected route for MTCT of arboviruses and we decipher some of the mechanisms that chronologically occur during MTCT via breastfeeding by focusing on ZIKV transmission process.
Highlights
Arboviruses, Breastfeeding, and Milk-Borne VirusesIn 1881, Carlos Finlay was the first to hypothesize that a virus, especially yellow fever virus (YFV), was able to be transmitted by mosquitoes [1]
Several arboviruses have been detected in breast milk of infected mothers, raising alarm concerning the risk of transmission of arboviruses to newborns during breastfeeding [15–25]
We demonstrated that primary human mammary epithelial cells are permissive to a productive Zika virus (ZIKV) infection, suggesting that the human mammary epithelium could be the source for viral particles detected in the breast milk of infected mothers
Summary
In 1881, Carlos Finlay was the first to hypothesize that a virus, especially yellow fever virus (YFV), was able to be transmitted by mosquitoes [1]. In opposition to the prenatal link of the mother–fetus dyad ensured by blood exchanges through the placenta, the post-natal link between the mother and her newborn(s) during breastfeeding is not systematic. This cultural practice is heterogeneously distributed across the world: according to UNICEF, 20% of children who live in high income countries never receive breast milk, against only 4% in low and middle income countries. Three viruses were recognized to be efficiently transmitted from mother to child during breastfeeding in humans, resulting in a chronic infection in the newborn: cytomegalovirus (CMV), human immunodeficiency virus type 1. Several arboviruses have been detected in breast milk of infected mothers, raising alarm concerning the risk of transmission of arboviruses to newborns during breastfeeding [15–25]
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