Zika Virus Disease Outbreak Research Articles

A Pilot Seroprevalence Study Suggests Silent Zika virus Transmission in Bhopal Region of Central India.

Several sporadic cases and outbreaks of Zika virus disease have been reported from different states of India. This paper explored the possibility of any ongoing transmission of Zika virus (ZIKV) in the Bhopal region of Central India, where the last outbreak of this disease was reported in 2018. We screened a group of 75 febrile patients who had already tested negative for the locally endemic causes of fever like dengue, chikungunya, enteric fever, malaria, and scrub typhus and two groups of asymptomatic healthy individuals represented by blood donors (n = 75) and antenatal mothers (n = 75). We tested blood samples of febrile patients for ZIKV RNA using real-time polymerase chain reaction (PCR), and for the healthy individuals, we determined anti-zika immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assay. ZIKV RNA was not detected in any of the 75 samples tested by real-time PCR assay. Among the voluntary blood donors and antenatal mothers, a total of 10 (15.38%) and 5 (6.66%) individuals were found to be seropositive for anti-ZIKV IgG antibodies, respectively. The seropositive group was found to have higher age 33.06 (±10.83) years as compared to seronegative individuals 26.60 (±5.12) years (P = 0.037). This study, which is the first survey of seroprevalence of anti-Zika antibodies from India, reports an overall seropositivity rate of 10% for anti-Zika antibodies among the healthy population, suggesting an ongoing, low level, silent transmission of ZIKV in the local community.

Zika, Nipah and Kala-azar: Emerging lethal infectious diseases amid COVID-19 as an escalating public health threat in South India

As of 6 June 2022, a sum 25,782 of active cases and 524,701 deaths due to Coronavirus disease-19 (COVID-19) have been recorded in India. Stewing in the flares of the pandemic, Kerala is entwined in the wrath of multiple emerging infectious diseases.India, a home to 1.3 billion people, recently faced a devastating second wave of COVID-19 during May of 2021, with a ruckus of chronic shortage of medicine, oxygen supplies, ventilators, besides, being challenged by secondary infections and chronic health ailments. The state of Kerala, alone contributes to 50% COVID-19 caseload, besides, recent simultaneous outbreaks of Zika Virus Disease (ZVD), Nipah Virus Disease (NiVD) and Kala-azar (black fever) on July 8, September 5 and 8, 2021 respectively. Syndemicity and a high case fatality rates of these highly contagious diseases coupled with post infection sequelae, overwhelm the already fragile healthcare system. Thus, these lethal infectious diseases along with an anticipated third wave of COVID-19 pose a serious public health threat in and around South India. With this narrative review, we aim to discuss the challenges that the emergence of intersecting outbreaks of Zika, Nipah, Kala-azar presents with, in the nation, amidst the global pandemic of COVID-19 and provide recommendations so as to help alleviate the situation.The syndemicity of COVID-19 with other infectious diseases, calls for adequate surveillance and monitoring of diseases’ outbreaks. To avoid the worst situations like pandemic, the health ministry, public and private health stakeholders in India should strengthen the public healthcare delivery system and providence of quick medical facilities to control the rate of mortality and morbidity during outbreaks.

Knowledge and Attitude toward Zika Virus Disease among Pregnant Women in Iloilo City, Philippines

The recent outbreak of Zika Virus Disease (ZVD) has caused global and local public health concerns especially among pregnant women and women of reproductive age. A descriptive-correlational survey was conducted to determine the knowledge and attitude toward ZVD among pregnant women in Iloilo City. Using a validated self-completion questionnaire, a total of 102 women seeking prenatal consultation in District Health Centers in Iloilo City were conveniently chosen as study participants. Descriptive and non-parametric inferential statistical tools were employed to analyze the data. Results indicated that the most common sources of information about ZVD were the television and radio. Majority of pregnant women had low level of knowledge but had positive attitude toward ZVD. Only a few knew that the disease can spread through sexual contact. While many pregnant women felt that ZVD is a serious disease that can cause serious problems to their babies, only a little more than half believed that they are susceptible of acquiring the disease. A significant relationship was found between knowledge about ZVD and attitude toward the disease. The findings suggest that public health intervention programs must address knowledge gaps and focus on correcting misconceptions to raise awareness and promote favorable attitude toward ZVD.

Urological profile of children with microcephaly and congenital zika syndrome

An outbreak of Zika virus disease, a self-limiting arbovirus infection involving skin rash and fever, occurred in Brazil in 2015 and was followed by an increase in newborns with microcephaly and brain malformations. Although two recent studies reported neurogenic bladder in children with microcephaly and congenital Zika syndrome (CZS), urologic evaluation is not yet routine. To investigate the urological profile of children with microcephaly and CZS. A descriptive, cross-sectional study conducted with children with microcephaly undergoing clinical, laboratory, urodynamic and ultrasonographic evaluation at a center for childhood urinary disorders in Salvador, Bahia, Brazil. Thirty-three children were evaluated. Mean age was 40.3±3.2 months (range 35-47 months). Twenty-one (63.6%) were female. None urinated voluntarily. Urine stream was continuous in 22 (66.7%) and intermittent in 3 (9.1%), with no information in 8 cases (24.2%). Abdominal straining during voiding was absent in 27 (81.8%) and present in 3 (9.1%), with no information in 3 cases (9.1%). Upper urinary tract dilatation was not detected in any of the 27 ultrasounds performed. Twenty-two urine cultures were performed, with no cases of bacterial growth. Renal function was normal in all cases (mean creatinine 0.41±0.1mg/dl, range 0.29-0.79mg/dl and urea 20±7mg/dl, 6-36mg/dl). Mean maximum bladder capacity was lower than expected for age: 46.4±25.6mL range 15-110mL versus 135.2±6.6mL, 125.5-153mL, respectively (p<0.0001). Sixteen patients (59.2%) had immature and reflex bladder, 3 (11.1%) had neurogenic bladder with small bladder compliance, 5 (18.5%) had neurogenic bladder and detrusor overactivity and 1 (3.7%) had normal bladder capacity and compliance, but urinated with abdominal straining and a significant residue. Urodynamic evaluation was normal in only two children (7.4%). Most children evaluated had immature and reflex bladder, with no repercussions on the upper urinary tract. Literature on urological complications in children with microcephaly is sparse; however, the present results differ from cases of neurogenic bladder in children with neural tube closure defects. Microcephaly in CZS involves a neurological and urodynamic pattern very similar to that found in children with cerebral palsy. Study limitations include the absence of a control group and neurological data with which to correlate these findings. Neurogenic bladder in children with CZS-associated microcephaly was much less common than recently reported. Most patients had no kidney abnormalities, but small bladder capacity and reflex bladder, with non-significant post-void residual urine.

Zika Virus Disease in Colombia — Preliminary Report

BackgroundColombia began official surveillance for Zika virus disease (ZVD) in August 2015. In October 2015, an outbreak of ZVD was declared after laboratory-confirmed disease was identified in nine patients.MethodsUsing the national population-based surveillance system, we assessed patients with clinical symptoms of ZVD from August 9, 2015, to April 2, 2016. Laboratory test results and pregnancy outcomes were evaluated for a subgroup of pregnant women. Concurrently, we investigated reports of microcephaly for evidence of congenital ZVD.ResultsBy April 2, 2016, there were 65,726 cases of ZVD reported in Colombia, of which 2485 (4%) were confirmed by means of reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. The overall reported incidence of ZVD among female patients was twice that in male patients. A total of 11,944 pregnant women with ZVD were reported in Colombia, with 1484 (12%) of these cases confirmed on RT-PCR assay. In a subgroup of 1850 pregnant women, more than 90% of women who were reportedly infected during the third trimester had given birth, and no infants with apparent abnormalities, including microcephaly, have been identified. A majority of the women who contracted ZVD in the first or second trimester were still pregnant at the time of this report. Among the cases of microcephaly investigated from January 2016 through April 2016, four patients had laboratory evidence of congenital ZVD; all were born to asymptomatic mothers who were not included in the ZVD surveillance system.ConclusionsPreliminary surveillance data in Colombia suggest that maternal infection with the Zika virus during the third trimester of pregnancy is not linked to structural abnormalities in the fetus. However, the monitoring of the effect of ZVD on pregnant women in Colombia is ongoing. (Funded by Colombian Instituto Nacional de Salud and the Centers for Disease Control and Prevention.)

Detection of a Locally-Acquired Zika Virus Outbreak in Hidalgo County, Texas through Increased Antenatal Testing in a High-Risk Area.

Hidalgo County (HC), located along the Texas–Mexico border, was listed as a high-risk county for Zika virus (ZIKV) in 2017 by the Texas Department of State Health Services, based on its historical presence of Dengue. Due to its subtropical climate, active binational travel, and population of low socioeconomic status, Hidalgo County focused on disease detection activities for the prevention of further transmission. Therefore, Hidalgo County Health and Human Services enacted public health surveillance, reviewed laboratory results, and conducted epidemiological investigations from 2016 to 2018. In 2017, Hidalgo County experienced a locally-acquired outbreak of Zika virus disease, resulting in the highest local mosquito-borne acquisition case count for the year within the United States. This resulted in Hidalgo County reviewing epidemiological data for disease detection and risk areas. With the data review, key outcomes of testing were identified. This included the importance of both RT-PCR and IgM-ELISA/PRNT testing methods. In addition, increased antenatal testing and surveillance also recognized the need of improved disease identification and testing among the general population, especially during localized outbreaks.

Community health workers reveal COVID-19 disaster in Brazil

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Using information theory to optimise epidemic models for real-time prediction and estimation.

The effective reproduction number, Rt, is a key time-varying prognostic for the growth rate of any infectious disease epidemic. Significant changes in Rt can forewarn about new transmissions within a population or predict the efficacy of interventions. Inferring Rt reliably and in real-time from observed time-series of infected (demographic) data is an important problem in population dynamics. The renewal or branching process model is a popular solution that has been applied to Ebola and Zika virus disease outbreaks, among others, and is currently being used to investigate the ongoing COVID-19 pandemic. This model estimates Rt using a heuristically chosen piecewise function. While this facilitates real-time detection of statistically significant Rt changes, inference is highly sensitive to the function choice. Improperly chosen piecewise models might ignore meaningful changes or over-interpret noise-induced ones, yet produce visually reasonable estimates. No principled piecewise selection scheme exists. We develop a practical yet rigorous scheme using the accumulated prediction error (APE) metric from information theory, which deems the model capable of describing the observed data using the fewest bits as most justified. We derive exact posterior prediction distributions for infected population size and integrate these within an APE framework to obtain an exact and reliable method for identifying the piecewise function best supported by available epidemic data. We find that this choice optimises short-term prediction accuracy and can rapidly detect salient fluctuations in Rt, and hence the infected population growth rate, in real-time over the course of an unfolding epidemic. Moreover, we emphasise the need for formal selection by exposing how common heuristic choices, which seem sensible, can be misleading. Our APE-based method is easily computed and broadly applicable to statistically similar models found in phylogenetics and macroevolution, for example. Our results explore the relationships among estimate precision, forecast reliability and model complexity.

#30 Congenital microcephaly in Southern Brazil during the Zika virus disease outbreak

#30 Congenital microcephaly in Southern Brazil during the Zika virus disease outbreak

Knowledge and attitude regarding Zika virus disease among junior residents of a tertiary care hospital in Delhi, India

Introduction: Zika virus disease (ZVD) is a mosquito-borne arbovirus infection caused by Zika virus, a Flavivirus from the Flaviviridae family spread via a type of mosquito called Aedes mosquito, namely Aedes aegypti and Aedes albopictus which is also responsible for spreading diseases such as dengue, chikungunya, and yellow fever. Outbreaks of ZVD have been recorded in Africa, the Americas, Asia, and the Pacific. Materials and Methods: A cross-sectional study with complete enumeration was carried out among non-PG junior residents (JRs) of a tertiary care hospital of Delhi. Those who agreed to fill the questionnaire were included in the study after written consent. A self-administered, pretested, semistructured questionnaire, consisted of three sections, is used. Results: 125 (72.7%) participants had heard about ZVD, and almost 61% of participants believed A. aegypti to be the vector for transmission of ZVD. More than 80% of participants believed that ZVD outbreak is possible in India. The various reasons they quoted for the outbreak were environmental factors (50%), travel and immigration (16.3%), unawareness and unpreparedness (11.5%), host factors (9.6%), agent factors (6.4%), and easy transmission (4.7%). Approximately 90% of the study participants who have heard of ZVD knew that travel to the endemic area should be postponed. Participants with high level of knowledge according to knowledge score think that ZVD outbreak is possible in India in the future and they tried to gain more knowledge about ZVD. The results were found to be statistically significant. Conclusion: It can be concluded that the low knowledge among JR area is worrisome and a great deal of importance needs to be paid because health-care providers should be able to identify and screen potential patients to prevent further progression of this disease.

Zika Virus: A Review of Literature.

Zika virus (ZIKV) is an arthropod-borne virus that was first isolated in 1947. Since then, multiple outbreaks of ZIKV have been reported in different countries. It is transmitted mostly by Aedes mosquitoes, and the symptoms of fever, joint pain, red eyes, headache, and maculopapular rash closely resemble chikungunya and dengue. The most severe complications of ZIKV infection include the risk of microcephaly and other congenital brain anomalies in infected pregnant women. It is a condition that can be easily prevented with proper education. In this review, we focussed on different aspects of the recent outbreaks of Zika virus disease, including its epidemiological background, transmission routes, presentation, as well as diagnosis and prevention.

Real-Time Evolution of Zika Virus Disease Outbreak, Roatán, Honduras.

A Zika virus disease outbreak occurred in Roatán, Honduras, during September 2015–July 2016. Blood samples and clinical information were obtained from 183 patients given a clinical diagnosis of suspected dengue virus infection. A total of 79 patients were positive for Zika virus, 13 for chikungunya virus, and 6 for dengue virus.

Rapid spread of an ongoing outbreak of Zika virus disease in pregnant women in a Mexican hospital

In the first nine weeks of implementation of a Zika Virus Preparedness Plan in a Mexican Public Hospital, we cared for 221 pregnant women with any signal or symptom suggesting Zika virus infection and 99 (44.8%) patients were found to be positive for Zika virus.The median age of patients was 25.3 years (range 13–49). Symptoms in PCR-positive patients were rash (91.4%) followed by headache (53.1%), myalgia (46.9%), arthralgia (45.7%), pruritus (35.8%), retroocular pain (29.6%), conjunctivitis (21%), and fever (21%). The women's epidemiologic exposure history indicates local transmission and a community outbreak.

Outbreak of Zika virus disease

Outbreak of Zika virus disease

Zika virus disease outbreak in Brazil: Existing challenges and role of young people in containing the infection

Zika virus disease outbreak in Brazil: Existing challenges and role of young people in containing the infection

Preliminary Report of Microcephaly Potentially Associated with Zika Virus Infection During Pregnancy - Colombia, January-November 2016.

In Colombia, approximately 105,000 suspected cases of Zika virus disease (diagnosed based on clinical symptoms, regardless of laboratory confirmation) were reported during August 9, 2015-November 12, 2016, including nearly 20,000 in pregnant women (1,2). Zika virus infection during pregnancy is a known cause of microcephaly and serious congenital brain abnormalities and has been associated with other birth defects related to central nervous system damage (3). Colombia's Instituto Nacional de Salud (INS) maintains national surveillance for birth defects, including microcephaly and other central nervous system defects. This report provides preliminary information on cases of congenital microcephaly identified in Colombia during epidemiologic weeks 5-45 (January 31-November 12) in 2016. During this period, 476 cases of microcephaly were reported, compared with 110 cases reported during the same period in 2015. The temporal association between reported Zika virus infections and the occurrence of microcephaly, with the peak number of reported microcephaly cases occurring approximately 24 weeks after the peak of the Zika virus disease outbreak, provides evidence suggesting that the period of highest risk is during the first trimester of pregnancy and early in the second trimester of pregnancy. Microcephaly prevalence increased more than fourfold overall during the study period, from 2.1 per 10,000 live births in 2015 to 9.6 in 2016. Ongoing population-based birth defects surveillance is essential for monitoring the impact of Zika virus infection during pregnancy on birth defects prevalence and measuring the success in preventing Zika virus infection and its consequences, including microcephaly.

Early Findings of Zika Virus Infection Epidemiology and Birth Outcomes in Colombia

Colombia began official surveillance for Zika virus disease (ZVD) in August 2015 and declared the country's first ZVD outbreak in October 2015. This

Zika virus and the Olympics

British Journal of MidwiferyVol. 24, No. 7 CommentZika virus and the OlympicsGeorge F WinterGeorge F WinterSearch for more papers by this authorGeorge F WinterPublished Online:11 Jul 2016https://doi.org/10.12968/bjom.2016.24.7.464AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alshammari SM, Mikler AR (2016) Modeling Disease Spread at Global Mass Gatherings: Data Requirements and Challenges. In: Boonkrong SUnger HMeesad P, eds. Recent Advances in Information and Communication Technology. Part II. Springer International Publishing, Cham, Switzerland: 17–26 Crossref, Google ScholarAl Turki YA (2016) Mass Gathering Medicine New discipline to Deal with Epidemic and Infectious Diseases in the Hajj Among Muslim Pilgrimage: A Mini Review Article. J Relig Health 55(4): 1270–4 Crossref, Google ScholarAttaran A (2016) Off the Podium: Why public health concerns for global spread of Zika virus means that Rio de Janeiro's 2016 Olympic Games must not proceed. http://tinyurl.com/hsmlav2 (accessed 27 June 2016) Google ScholarBarasheed O, Rashid H, Alfelali M et al. (2014) Viral respiratory infections among Hajj pilgrims in 2013. Virol Sin 29(6): 364–71 Crossref, Google ScholarLadhani SN, O'Connor C, Kirkbride H, Brooks T, Morgan D (2016) Outbreak of Zika virus disease in the Americas and the association with microcephaly, congenital malformations and Guillain-Barré syndrome. Arch Dis Child 101(7): 600–2 Crossref, Google ScholarSinger P (1979) Practical Ethics. Cambridge University Press, Cambridge Google ScholarSoliman T, Cook AR, Coker RJ (2015) Pilgrims and MERS-CoV: what's the risk? Emerg Themes Epidemiol 12: 3. doi: https://doi.org/10.1186/s12982-015-0025-8 Crossref, Google ScholarWorld Health Organization (2009) WHO guidelines on hand hygiene in health care: first global patient safety challenge. Clean care is safer care. WHO, Geneva Google ScholarWorld Health Organiaation (2016) WHO statement on the third meeting of the International Health Regulations (2005) (IHR(2005)) Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations. http://tinyurl.com/jp9b3jt (accessed 27 June 2016) Google Scholar FiguresReferencesRelatedDetails 2 July 2016Volume 24Issue 7ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 11 July 2016 Published in print 2 July 2016 Information© MA Healthcare LimitedPDF download

Projecting Month of Birth for At-Risk Infants after Zika Virus Disease Outbreaks.

The marked increase in infants born with microcephaly in Brazil after a 2015 outbreak of Zika virus (Zika virus) disease suggests an association between maternal Zika virus infection and congenital microcephaly. To project the timing of delivery of infants born to mothers infected during early pregnancy in 1 city in Bahia State, Brazil, we incorporated data on reported Zika virus disease cases and microcephaly cases into a graphical schematic of weekly birth cohorts. We projected that these births would occur through February 2016. Applying similar projections to a hypothetical location at which Zika virus transmission started in November, we projected that full-term infants at risk for Zika virus infection would be born during April-September 2016. We also developed a modifiable spreadsheet tool that public health officials and researchers can use for their countries to plan for deliveries of infants to women who were infected with Zika virus during different pregnancy trimesters.

Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak — Puerto Rico, 2016

Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links Zika virus infection during pregnancy to adverse pregnancy and birth outcomes, including pregnancy loss, intrauterine growth restriction, eye defects, congenital brain abnormalities, and other fetal abnormalities. The virus has also been determined to be sexually transmitted. Because of the potential risks associated with Zika virus infection during pregnancy, CDC has recommended that health care providers discuss prevention of unintended pregnancy with women and couples who reside in areas of active Zika virus transmission and do not want to become pregnant. However, limitations in access to contraception in some of these areas might affect the ability to prevent an unintended pregnancy. As of March 16, 2016, the highest number of Zika virus disease cases in the United States and U.S. territories were reported from Puerto Rico. The number of cases will likely rise with increasing mosquito activity in affected areas, resulting in increased risk for transmission to pregnant women. High rates of unintended and adolescent pregnancies in Puerto Rico suggest that, in the context of this outbreak, access to contraception might need to be improved. CDC estimates that 138,000 women of reproductive age (aged 15-44 years) in Puerto Rico do not desire pregnancy and are not using one of the most effective or moderately effective contraceptive methods, and therefore might experience an unintended pregnancy. CDC and other federal and local partners are seeking to expand access to contraception for these persons. Such efforts have the potential to increase contraceptive access and use, reduce unintended pregnancies, and lead to fewer adverse pregnancy and birth outcomes associated with Zika virus infection during pregnancy. The assessment of challenges and resources related to contraceptive access in Puerto Rico might be a useful model for other areas with active transmission of Zika virus.