Zika Virus Risk Research Articles

Impact of FDA's HCT/P ZIKV Recommendations on Cord Blood Unit Eligibility and Utilization in a Large Public Cord Blood Bank.

Cord blood units (CBUs) that are ineligible for licensure due to incomplete compliance with FDA recommendations may be used for hematopoietic stem cell transplantation under urgent medical need and an Investigational Drug Application. The largest reason for CBU donor ineligibility is Zika virus (ZIKV) risk. The study's objective was to analyze the impact of current FDA recommendations for ZIKA risk on a large public cord blood bank and propose updated recommendations. We performed a retrospective analysis of Carolinas Cord Blood Bank (CCBB), an FDA licensed public CBB, using data from January 1, 2016 to November 21, 2023 and compared FDA recommendations for transfusion transmitted infections (TTI) for blood products and relevant communicable disease agents or diseases for human cell, tissue, or cellular or tissue-based products (HCT/Ps). CCBB: 9057 (84.3% licensed) CBUs were banked. 984/1682 (58.5%) of unlicensed CBUs had ZIKV risk. 22.0% of CBUs with ZIKV risk were from Hispanic parents, compared to 16.1% of all units. 31 of IND CBUs (11 due to ZIKV risk without reported ZIKV transmission) were safely infused. FDA Guidance: HCT/P ZIKV, HIV, and vCJD recommendations have not been updated since 2018 in contrast to FDA removal of ZIKV as a relevant TTI in 2021 and updating HIV and vCJD guidance related to TTI in 2023 and 2022, respectively. The FDA should consider new data to revise the HCT/P donor eligibility recommendations, which will increase the number of eligible HCT/P donors, and potentially improve access to therapies for a more diverse patient population.

Viral diseases affecting the skin

AbstractThis chapter delves into the complex world of viral exanthems, focusing on their diagnostic challenges and distinctive features, with updated presentations and pearls. From Roseola Infantum's atypical fever‐rash presentation to Rubeola's resurgence, it underscores the importance of prompt diagnosis. Rubella, frequently confused with measles, demands heightened suspicion, especially in adults and pregnant patients. Hand, Foot, and Mouth Disease's diverse manifestations warrant accurate differentiation. The discussion extends to Parvovirus B19, Varicella‐Zoster Virus, Epstein‐Barr Virus, and HIV Primary Infection. The resurgence of Mpox, Zika Virus's risks during pregnancy, and the rare but life‐threatening Eczema Herpeticum are explored. Gianotti‐Crosti Syndrome, Unilateral Laterothoracic Exanthem, and other viral conditions complete the landscape. In summary, this chapter offers a comprehensive understanding of viral exanthems, enabling clinicians to distinguish and manage these dermatological challenges. Accurate identification is crucial for providing specialized therapy to a minority of cases and supportive care to the majority. Vigilance, thorough examination, and a nuanced understanding of viral presentations are essential in navigating this intricate landscape.

Abstract 27 Limitations of Current Human Cell, Tissue, and Cellular-based Product Donor Eligibility Guidance: Analyzing the Impact on a Large Public Cord Blood Bank

IntroductionCord blood (CB) is considered a human cell, tissue, and cellular-based product (HCT/P) by the U.S. Food and Drug Administration (FDA) and is licensed through a Biological Licensing Application (BLA). Cord blood units (CBUs) require less precise donor tissue matching than other stem cell sources, which increases their availability for racial/ethnic minorities. However, a small percentage of banked CBUs are used for transplants. Updating FDA donor eligibility guidance may expand licensed CBU supply and cord blood bank (CBB) sustainability.ObjectiveThe objectives of this study were to analyze the impact of Zika virus (ZIKV) donor screening recommendations on the licensing status of banked CBUs and to propose updated policy recommendations.MethodsA retrospective analysis of Carolinas Cord Blood Bank (CCBB) data (from January 2016 to May 2022) was performed to describe CBU eligibility and shipment status. Qualitative comparisons of FDA guidance to reduce the risk of relevant communicable diseases were completed for blood versus HCT/P.Results CCBB: 8,877 banked CBUs from 2016-2022 (85.3% licensed; 14.7% unlicensed) (Table 1). 4,361 (49.1%) of CBUs were from Caucasian donors and 1,349 (15.2%) were from African American donors. 689 (52.7%) CBUs were unlicensed due to ZIKV risk. The number of CBUs with ZIKV risk banked annually has decreased significantly since 2020, with 174 ZIKV-risk CBUs in 2020 versus 63 in 2021. 26 unlicensed CBUs collected in 2016 or later have been infused versus 210 licensed CBUs. 7 unlicensed, infused CBUs had identified ZIKV risk. No ZIKV transmission was reported from these transplants. FDA Guidance: HCT/P ZIKV recommendations have not been updated since 2018 despite FDA removal of ZIKV from the relevant transfusion-transmitted infections in 2021. Recommendations for minimizing transfusion-transmission risk of human immunodeficiency virus (HIV) and variant Creutzfeldt-Jakob disease (vCJD) were updated in 2020 and 2022, respectively, to increase blood supply. New vCJD guidance eliminated geographic risk-related donor restrictions.Table 1.Characteristics of CBUs banked at CCBB January 2016 to May 2022CBU StatusNumber of Units (%)Banked8,877 (100%) Banked, licensed7,569 (85.3%) Banked, unlicensed1,308 (14.7%) Banked with ZIKV risk (travel-related donor deferral)689 (7.8%) Banked with Hepatitis B core antibody positive82 (<1.0%)Infused236/8,877 (2.7%) Infused, licensed210 (89.0 %) Infused, unlicensed26 (11.0%) Infused, Caucasian donor134 (56.8%) Infused, African American donor28 (11.9%) Infused, unlicensed with ZIKV risk7/26 (26.9%) Infused, unlicensed with Hepatitis B core antibody positive3/26 (11.5%)DiscussionGuidance for reducing disease transmission for blood and blood components have recently been updated to increase blood supply. The FDA must consider new data to revise the HCT/P donor screening recommendations. Adopting these changes will increase the number of HCT/P donors, the quantity of licensed CBUs, and potentially improve access to cellular therapies for a more diverse patient population.

Assessing the risk of spread of Zika virus under current and future climate scenarios

Zika virus (ZIKV) may cause severe microcephaly in newborn babies and Guillain-Barré syndrome in some adults. In recent decades, its range has expanded in 86 countries. There are two ecologically and evolutionarily district cycles: urban cycle and sylvatic cycle. This work aimed to estimate the urban and sylvatic cycle areas of ZIKV throughout the world. The occurrence records of vectors, non-human primate hosts, and ZIKV were collected. We chose historical climate data, predicted vectors distribution, human population density, and elevation data as the variables to fit the maximum entropy model (MaxEnt). Current risk area and future prediction were performed with global climate models (GCMs) and shared socioeconomic pathways (SSPs). Predicting the ZIKV risk area would help tailor related control strategies. The results indicated that 16.6% of the world’s landmass (except Antarctica) is a risk area in the urban cycle. Approximately 6.22 billion people (78.69% of the global population) live in the risk area, with the vast majority in South Asia, tropical Africa, South America, North America, and countries around the Mediterranean Sea. Future climate change decreases the risk area of ZIKV. This study also suggested that the sylvatic cycle happened between the Tropic of Cancer and the Tropic of Capricorn. The overlap region of the urban and sylvatic cycles could be hotpots that ZIKV spill from the sylvatic to the urban cycle. It is indicated that long-term passenger screening, mosquito surveillance, and control are necessary.

Perceived Risk of Mosquito-Borne Arboviruses in the Continental United States.

The United States experienced local transmission of West Nile Virus (WNV) for the first time in 1999, and Zika Virus (ZIKV) in 2016. These introductions captured the public’s attention in varying degrees. The research presented here analyzes the disproportional perception of ZIKV risk compared to WNV transmission risk, by the public and vector control personnel. The risk perception of vector control was measured through purposive sampled interviews (24 interviews in 13 states; May 2020–June 2021), while the public’s perception was estimated from news publications (January 2000–December 2020), and Google searches (January 2004–December 2020). Over time, we observed a decrease in the frequency of press reporting and Google searches of both viruses with decreasing annual peaks in the summer. The highest peak of ZIKV news, and searches, surpassed that of WNV. We observed clear differences in the contents of the headlines for both viruses. We propose that the main reason in risk perception differences between the viruses were psychological. Zika infections (mosquito-borne and sexually transmitted) can result in devastating symptoms in fetuses and newborns, observations that frequently appeared in ZIKV-related headlines. Our results highlight the likely influence the news media has on risk perception and the need for public health agencies to play active roles in the conversation, helping disseminate timely and accurate information. Understanding the factors that shape risk perceptions of vector-borne diseases will hopefully lead to better use of resources by providing better guidance.

Persistence of Zika virus RNA in the epididymis of the murine male reproductive tract

Zika virus (ZIKV) can infect developing fetuses in utero and cause severe congenital defects independent of route of maternal infection. Infected men can shed ZIKV RNA in semen for over six months. Whether prolonged viral RNA shedding in semen indicates a persistent infection in the male reproductive tract is unknown. We hypothesized that if ZIKV establishes a persistent infection in the male reproductive tract (MRT), then immunosuppressant treatment should stimulate ZIKV replication and seminal shedding. Male mice were infected with ZIKV and immunosuppressed when they shed viral RNA but not infectious virus in ejaculates. Following immunosuppression, we did not detect infectious virus in ejaculates. However, we did detect ZIKV positive and negative sense RNA in the epididymal lumens of mice treated with cyclophosphamide, suggesting that ZIKV persists in the epididymis. This study provides insight into the mechanisms behind ZIKV sexual transmission, which may inform public health decisions regarding ZIKV risks.

A review of models applied to the geographic spread of Zika virus.

In recent years, Zika virus (ZIKV) has expanded its geographic range and in 2015–2016 caused a substantial epidemic linked to a surge in developmental and neurological complications in newborns. Mathematical models are powerful tools for assessing ZIKV spread and can reveal important information for preventing future outbreaks. We reviewed the literature and retrieved modelling studies that were developed to understand the spatial epidemiology of ZIKV spread and risk. We classified studies by type, scale, aim and applications and discussed their characteristics, strengths and limitations. We examined the main objectives of these models and evaluated the effectiveness of integrating epidemiological and phylogeographic data, along with socioenvironmental risk factors that are known to contribute to vector–human transmission. We also assessed the promising application of human mobility data as a real-time indicator of ZIKV spread. Lastly, we summarised model validation methods used in studies to ensure accuracy in models and modelled outcomes. Models are helpful for understanding ZIKV spread and their characteristics should be carefully considered when developing future modelling studies to improve arbovirus surveillance.

Experimental infections with Zika virus strains reveal high vector competence of Aedes albopictus and Aedes aegypti populations from Gabon (Central Africa) for the African virus lineage

ABSTRACT The two main Zika virus (ZIKV) vectors, Aedes albopictus and Aedes aegypti (invasive and native species, respectively), are present in Gabon (Central Africa). The aim of this study was to determine the entomological ZIKV risk associated with these mosquito species in Gabon by evaluating their vector competence for an African (i.e. representative of the endemic strains circulating in sub-Saharan Africa) and two Asian (i.e. representatives of exogenous epidemic strains that could be introduced) ZIKV strains. The transmission efficiency of one Ae. aegypti and two Ae. albopictus field-collected populations from Libreville and Franceville was assayed at day 7, 14 and 21 after experimental oral infection. The two mosquito species could transmit all three ZIKV strains already at day 7 post-infection, but transmission efficiency was higher for the African strain than the non-African strains (>60% versus <14%; incubation period of 14–21 days). The two mosquito species exhibited comparable vector competence for ZIKV, although the amount of viral particles (African strain) in saliva was significantly higher in Ae. albopictus than Ae. aegypti at day 14 post-infection. These findings suggest that overall, ZIKV risk in Gabon is mainly related to virus strains that circulate endemically across sub-Saharan Africa, although the transmission of non-African strains remain possible in case of introduction. Due to its high infestation indexes and ecological/geographical ranges, this risk appears mainly associated with Ae. albopictus. Vector surveillance and control methods against this invasive mosquito must be strengthened in the region to limit the risk of future outbreaks.

Communicating the risk of contracting Zika virus to low income underserved pregnant Latinas: A clinic-based study.

Frequent travel between the Southern border states in the USA, Mexico, and Latin American countries increases the risk of the Zika virus (ZIKV) spread. Patient education on virus transmission is fundamental in decreasing the number of imported cases, particularly among pregnant women. The study used cross-sectional methodology to investigate information sources and knowledge concerning the ZIKV virus among 300 under-served pregnant Latinas recruited from prenatal care clinics in the North Texas region. Bivariate and multiple logistic regression models were used to investigate associations between the primary outcomes and patient characteristics. Physicians, nurses, and families are the major sources for pregnancy information, while media/internet (65%) and physician/nurse (33%) are the main sources for ZIKV information. Less than one-half of the mothers reported that their physician/nurse did not discuss safe sexual practices or inquired about their sexual practices. A considerable proportion of women from the community clinic were neither warned nor queried about travel to ZIKV risk countries. There is an overall understanding of Zika virus transmission, symptoms, complications, and recommended guidelines. Younger age and single mother status are risk factors for lack of ZIKV knowledge. Foreign-born mothers are 2.5-3.0 times more likely to have knowledge on disease transmission, symptoms, and microcephaly condition. While, younger mothers (18-24) are less likely to have knowledge of ZIKV infection symptoms (fever, rash and pink eye) and transmission of infection via unprotected sexual (vaginal, anal, or oral) behavior, compared to older mothers. Interventions are needed to heighten the knowledge of ZIKV, particularly among women of reproductive age and their male partners in the community health care setting. Our study underscores the need for health care providers to be trained in delivering messages to enhance risk perception during health emergencies to vulnerable and underserved families (lower economic background, language ability, and culture). During health emergencies, clinics must disseminate crucial information via multi modalities to ensure messages reach the targeted patients.

Warming temperatures could expose more than 1.3billion new people to Zika virus risk by 2050.

In the aftermath of the 2015 pandemic of Zika virus (ZIKV), concerns over links between climate change and emerging arboviruses have become more pressing. Given the potential that much of the world might remain at risk from the virus, we used a previously established temperature‐dependent transmission model for ZIKV to project climate change impacts on transmission suitability risk by mid‐century (a generation into the future). Based on these model predictions, in the worst‐case scenario, over 1.3 billion new people could face suitable transmission temperatures for ZIKV by 2050. The next generation will face substantially increased ZIKV transmission temperature suitability in North America and Europe, where naïve populations might be particularly vulnerable. Mitigating climate change even to moderate emissions scenarios could significantly reduce global expansion of climates suitable for ZIKV transmission, potentially protecting around 200 million people. Given these suitability risk projections, we suggest an increased priority on research establishing the immune history of vulnerable populations, modeling when and where the next ZIKV outbreak might occur, evaluating the efficacy of conventional and novel intervention measures, and increasing surveillance efforts to prevent further expansion of ZIKV.

Contraceptive Counseling in the Zika Era: Primary Care Providers’ Perspective [07J

INTRODUCTION: The 2015 Zika virus (ZIKV) outbreak emphasized the imperative for contraceptive counseling for at-risk populations such as Latinx women. This study assessed primary care providers’ knowledge, perception of risk, and approach to contraceptive counseling in response to ZIKV. METHODS: We performed a sequential mixed-methods, cross-sectional study with a survey and semi-structured interview. From 06/2018 to 08/2018 we recruited primary care providers from a federally qualified health organization in the Salt Lake City area that provides preventive care to non-pregnant Latinx women of reproductive age. The survey assessed demographics, contraceptive and ZIKV knowledge, and CDC ZIKV guideline adherence. The Health Belief Model informed our interview guide on contraceptive and ZIKV counseling. We performed descriptive analyses on survey data and analyzed qualitative data for dominant themes. RESULTS: Twenty-two of 40 (57%) providers participated. Twelve (55%) are family medicine physicians, seven are physician assistants (32%), and three are nurse practitioners (14%); 53% are women, and 96% identify as white. On contraceptive and ZIKV knowledge questions, providers averaged 69% and 81% correct respectively. Sixty-five percent reported CDC ZIKV guideline adherence. Qualitative themes include conditional ZIKV risk, neonatal-related severity of ZIKV, specific cues to action for counseling about ZIKV and contraception, and omission of the ZIKV risk to non-pregnant women who may become pregnant. CONCLUSION: Primary care providers perceive the risk of ZIKV; however, their knowledge, guideline adherence, and perception of risk do not translate into ZIKV-aware counseling. Our results demonstrate the need for action plans that ensure practice changes in response to emerging infectious diseases.

Comprehensive Profiling of Zika Virus Risk with Natural and Artificial Mitigating Strategies, United States

Zika virus is transitioning to become a long-term public health challenge, and countries should remain informed of the risk for emergence. We developed a stochastic epidemiologic model to profile risk for Zika virus emergence, including trimester-specific fetal risk across time, in all 3,208 counties in the United States, including Puerto Rico. Validation against known transmission in North America demonstrated accuracy to predict epidemic dynamics and absolute case counts across scales (R2 = 0.98). We found that, although sporadic single transmission events could occur in most US counties, outbreaks will likely be restricted to the Gulf Coast region and to late spring through autumn. Seasonal fluctuations in birth rates will confer natural population-level protection against early-trimester infections. Overall, outbreak control will be more effective and efficient than prevention, and vaccination will be most effective at >70% coverage. Our county-level risk profiles should serve as a critical resource for resource allocation.

Impact of temperature on the extrinsic incubation period of Zika virus in Aedes aegypti.

Since Zika virus (ZIKV) emerged as a global human health threat, numerous studies have pointed to Aedes aegypti as the primary vector due to its high competence and propensity to feed on humans. The majority of vector competence studies have been conducted between 26–28°C, but arboviral extrinsic incubation periods (EIPs), and therefore transmission efficiency, are known to be affected strongly by temperature. To better understand the relationship between ZIKV EIPs and temperature, we evaluated the effect of adult mosquito exposure temperature on ZIKV infection, dissemination, and transmission in Ae. aegypti at four temperatures: 18°C, 21°C, 26°C, and 30°C. Mosquitoes were exposed to viremic mice infected with a 2015 Puerto Rican ZIKV strain, and engorged mosquitoes were sorted into the four temperatures with 80% RH and constant access to 10% sucrose. ZIKV infection, dissemination, and transmission rates were assessed via RT-qPCR from individual mosquito bodies, legs and wings, and saliva, respectively, at three to five time points per temperature from three to 31 days, based on expectations from other flavivirus EIPs. The median time from ZIKV ingestion to transmission (median EIP, EIP50) at each temperature was estimated by fitting a generalized linear mixed model for each temperature. EIP50 ranged from 5.1 days at 30°C to 24.2 days at 21°C. At 26°C, EIP50 was 9.6 days. At 18°C, only 15% transmitted by day 31 so EIP50 could not be estimated. This is among the first studies to characterize the effects of temperature on ZIKV EIP in Ae. aegypti, and the first to do so based on feeding of mosquitoes on a live, viremic host. This information is critical for modeling ZIKV transmission dynamics to understand geographic and seasonal limits of ZIKV risk; it is especially relevant for determining risk in subtropical regions with established Ae. aegypti populations and relatively high rates of return travel from the tropics (e.g. California or Florida), as these regions typically experience cooler temperature ranges than tropical regions.

Serological Survey of Zika Virus in Humans and Animals in Dejiang Prefecture, Guizhou Province, China

ObjectiveThe current outbreak of Zika virus (ZIKV) poses a severe threat to human health. Two ZIKV strains were isolated from mosquitoes collected from the Dejiang prefecture in China in 2016, which was the first isolation of ZIKV in nature in China. MethodsIn this study, serum samples were collected from 366 healthy individuals and 104 animals from Dejiang prefecture in 2017, and the plaque reduction neutralization test (PRNT) was used to evaluate the seroprevalence of ZIKV. ResultsNone of the 366 residents from whom the samples were collected were seropositive for ZIKV. None of the 11 pigs from whom the samples were collected were seropositive for ZIKV, while 1 of 63 (1.59%) chickens and 2 of 30 (6.67%) sheep were seropositive for ZIKV. ConclusionsThe extremely low seropositivity rate of ZIKV antibodies in animals in the Dejiang prefecture, Guizhou province in this study indicates that ZIKV can infect animals; however, there is a low risk of ZIKV circulating in the local population.

Spatial Associations Between Land Use and Infectious Disease: Zika Virus in Colombia.

Land use boundaries represent human–physical interfaces where risk of vector-borne disease transmission is elevated. Land development practices, coupled with rural and urban land fragmentation, increases the likelihood that immunologically naïve humans will encounter infectious vectors at land use interfaces. This research consolidated land use classes from the GLC-SHARE dataset; calculated landscape metrics in linear (edge) density, proportion abundance, and patch density; and derived the incidence rate ratios of the Zika virus occurrence in Colombia, South America during 2016. Negative binomial regression was used to evaluate vector-borne disease occurrence counts in relation to Population Density, Average Elevation, Per Capita Gross Domestic Product, and each of three landscape metrics. Each kilometer of border length per square kilometer of area increase in the linear density of the Cropland and Grassland classes is associated with an increase in Zika virus risk. These spatial associations inform a risk reduction approach to rural and urban morphology and land development that emphasizes simple and compact land use geometry that decreases habitat availability for mosquito vectors of Zika virus.

Awareness, Knowledge, and Travel-Related Risk Factors for Zika Virus Among Latinas Attending a Federally Qualified Health Center in Rural North Carolina.

BACKGROUND The Zika virus (ZIKV) epidemic that began in 2015 presented a risk for ZIKV infection among persons who traveled to ZIKV-affected countries. Latinas in North Carolina and their sexual partners may be exposed to ZIKV when traveling to these regions.METHODS We administered a cross-sectional survey, measuring ZIKV risk and knowledge, to a convenience sample of 262 reproductive-age Latinas attending a Federally Qualified Health Center in rural North Carolina. We described ZIKV risk and knowledge in the sample, and compared responses between those who were pregnant or recently pregnant, and those who were not pregnant. We further identified factors associated with 1) awareness of ZIKV and 2) high knowledge of ZIKV sequelae and prevention among those who were aware of ZIKV, using log-binomial regression.RESULTS Two-thirds of participants had ever heard of ZIKV, which was positively associated with educational attainment. Most participants aware of ZIKV had moderate/high knowledge of ZIKV transmission (92.5%) and symptoms (73.2%), but knowledge of preventing sexual and congenital transmission was limited. Travel was infrequent among pregnant or recently pregnant participants (5.4%) and their partners (7.1%). Despite low risk for ZIKV infection, participants were willing to practice ZIKV prevention.LIMITATIONS Our study is limited by a lack of generalizability to Latinas in other regions of the country, self-reporting bias, and lack of survey validation as an indicator of English language proficiency.CONCLUSIONS Providers should identify patients likely to become pregnant and travel to high-risk areas, inquire about partner travel history, and offer culturally appropriate ZIKV risk counseling.

Identifying high risk areas of Zika virus infection by meteorological factors in Colombia

BackgroundSeveral Zika virus (ZIKV) outbreaks have occurred since October 2015. Because there is no effective treatment for ZIKV infection, developing an effective surveillance and warning system is currently a high priority to prevent ZIKV infection. Despite Aedes mosquitos having been known to spread ZIKV, the calculation approach is diverse, and only applied to local areas. This study used meteorological measurements to monitor ZIKV infection due to the high correlation between climate change and Aedes mosquitos and the convenience to obtain meteorological data from weather monitoring stations.MethodsThis study applied the Bayesian structured additive regression modeling approach to include spatial interactive terms with meteorological factors and a geospatial function in a zero-inflated Poisson model. The study area contained 32 administrative departments in Colombia from October 2015 to December 2017. Weekly ZIKV infection cases and daily meteorological measurements were collected. Mapping techniques were adopted to visualize spatial findings. A series of model selections determined the best combinations of meteorological factors in the same model.ResultsWhen multiple meteorological factors are considered in the same model, both total rainfall and average temperature can best assess the geographic disparities of ZIKV infection. Meanwhile, a 1-in. increase in rainfall is associated with an increase in the logarithm of relative risk (logRR) of ZIKV infection of at most 1.66 (95% credible interval [CI] = 1.09, 2.15) as well as a 1 °F increase in average temperature is significantly associated with at most 0.79 (95% CI = 0.12, 1.22) increase in the logRR of ZIKV. Moreover, after controlling rainfall and average temperature, an independent geospatial function in the model results in two departments with an excessive ZIKV risk which may be explained by unobserved factors other than total rainfall and average temperature.ConclusionOur study found that meteorological factors are significantly associated with ZIKV infection across departments. The study determined both total rainfall and average temperature as the best meteorological factors to identify high risk departments of ZIKV infection. These findings can help governmental agencies monitor at risk areas according to meteorological measurements, and develop preventions in those at risk areas in priority.

Understanding U.S. Adults' Zika Virus Risk Perceptions and Mitigation Behaviors to Improve Technology-Supported Risk Communication.

Understanding public risk perceptions, and how these affect behavior, is critical to public health's ability to leverage technology for risk communications. However, little is known about Zika virus risk perceptions. We addressed this gap by analyzing nationally representative (U.S.) survey data. Our results suggest that a minority of U.S. adults perceive Zika to be a major threat (13%), and only about 15% have taken protective actions. Our findings have implications for improving technology-supported risk communication.

Zika virus in Vietnam, Laos, and Cambodia: are there health risks for travelers?

Vietnam, Laos, and Cambodia have reported first cases of Zika virus (ZIKV) infection since 2010 (Cambodia) and 2016 (Vietnam and Laos). One case of ZIKV-related microcephaly was recognized among a hundred infected cases in these areas, raising a great concern about the health risk related to this virus infection. At least 5 cases of ZIKV infection among travelers to Vietnam, Laos, and Cambodia were recorded. It is noticeable that ZIKV in these areas can cause birth defects. This work aims to discuss the current epidemics of ZIKV in Vietnam, Laos, and Cambodia and update the infection risk of ZIKV for travelers to these areas.

Risk Perception of Zika Virus Infection Among Vulnerable Women in Rio de Janeiro

Introduction:The Zika virus (ZIKV) infection outbreak in Brazil surged in late 2014, peaking in 2015. The most affected region was the northeast, but Rio de Janeiro was especially affected in poor, vulnerable, low-income communities with inadequate sanitation and water. Most cases of the ZIKV-related neurologic syndrome, microcephaly, were detected among newborns coming from this environment.Aim:To identify risk perception and consequences of ZIKV infection for pregnant women in a vulnerable community in Rio de Janeiro.Methods:Forty women who frequented a primary health care center (PHC) in a ZIKV-prone area of Rio de Janeiro were interviewed based on an open-ended questionnaire on ZIKV infection and risk. No censorship regarding age or other demographic characteristics was applied. Interviews were transcribed and analyzed according to analytical categories stemming from the literature and prior work. Preliminary analysis focused on risks for pregnant women and other groups.Results:Absolute number of responses reflect density of issues within all responses. Age range was 15-60 years. Several women identified microcephaly as a consequence of ZIKV infection for newborns, but many respondents did not cite any health problem associated with ZIKA in pregnancy. Although some cited pregnant women and children as most vulnerable, people living in or near insalubrious environments, such as the elderly, and those with low immunity were more cited. Information was mostly obtained from health professionals and television. Many confused origin and symptoms of ZIKV infection with other arbovirus infections.Discussion:This vulnerable group of women, who continuously attend a PHC in the area, have had community experience with the disease and its consequences, showed surprisingly little knowledge as to the risks of ZIKV infection for pregnant women. Results may indicate that the health system has still not achieved adequate risk communication for at-risk women for ZIKV infection in Rio de Janeiro.