All fields are required.

Close Appointment form

Publications

icon
What we know and what we don’t know about perinatal Zika virus infection: A systematic review

By Soriano-Arandes A, Rivero-Calle I, Nastouli E, et al.

Zika virus (ZIKV) infection has caused the most challenging worldwide infectious epidemic outbreak in recent months. ZIKV causes microcephaly and other congenital malformations. There is a need to perform updated systematic reviews on ZIKV infection periodically because this epidemic is bringing up new evidence with extraordinary speed.

 

Published in: Expert Review of Anti-infective Therapy Vol. 0, Iss. ja, 2018

icon
Evidence for Mother-to-Child Transmission of Zika Virus Through Breast Milk

By Gabriela M Blohm, John A Lednicky, Marilianna Márquez, Sarah K White, Julia C Loeb, Carlos A Pacheco, David J Nolan, Taylor Paisie, Marco Salemi, Alfonso J Rodríguez-Morales, J Glenn Morris, Juliet R C Pulliam, Alberto E Paniz-Mondolfi

Zikavirus (ZIKV) is an emerging viral pathogen that continues to spread throughout different regions of the world. Herein we report a case that provides further evidence that ZIKV transmission can occur through breastfeeding by providing a detailed clinical, genomic, and virological case-based description.

Published in: Clinical Infectious Diseases, cix968 https://doi.org/10.1093/cid/cix968 

icon
Meningo-encephalo-myelitis in Children during the Zika Virus Epidemic in Grenada

By Nelson B, Melbourne-Chambers R, Christie CDC

Zika Virus is neurotropic. We report two children from the Caribbean island of Grenada, a three-year-old with acute neuro-inflammation who had intractable seizures, meningo-encephalitis, CSF pleocytosis and Zika IgM positive acute serology and a four-year-old with acute demyelinating encephalomyelitis manifesting as generalized seizures, optic neuritis, diffuse cerebral dysfunction, encephalopathy, impaired speech and ataxia who also had CSF pleocytosis as well as Zika IgM and dengue IgM positive acute serologies. Both cases occurred during the 2016 Zika and Dengue fever epidemic in Grenada. Both children recovered completely. The etiologic role of the Zika and Dengue arboviruses is discussed.

Published in: West Indian Med J. Published Online: December 20, 2017 (doi:10.7727/wimj.2017.227) 

icon
Behavioral, climatic, and environmental risk factors for Zika and Chikungunya virus infections in Rio de Janeiro, Brazil

By Fuller TL, Calvet G, Genaro Estevam C, et al. 

The burden of arboviruses in the Americas is high and may result in long-term sequelae with infants disabled by Zika virus infection (ZIKV) and arthritis caused by infection with Chikungunya virus (CHIKV). We aimed to identify environmental drivers of arbovirus epidemics to predict where the next epidemics will occur and prioritize municipalities for vector control and eventual vaccination. We screened sera and urine samples (n = 10,459) from residents of 48 municipalities in the state of Rio de Janeiro for CHIKV, dengue virus (DENV), and ZIKV by molecular PCR diagnostics. Further, we assessed the spatial pattern of arbovirus incidence at the municipal and neighborhood scales and the timing of epidemics and major rainfall events. Lab-confirmed cases included 1,717 infections with ZIKV (43.8%) and 2,170 with CHIKV (55.4%) and only 29 (<1%) with DENV. ZIKV incidence was greater in neighborhoods with little access to municipal water infrastructure (r = -0.47, p = 1.2×10-8). CHIKV incidence was weakly correlated with urbanization (r = 0.2, p = 0.02). Rains began in October 2015 and were followed one month later by the largest wave of ZIKV epidemic. ZIKV cases markedly declined in February 2016, which coincided with the start of a CHIKV outbreak. Rainfall predicted ZIKV and CHIKV with a lead time of 3 weeks each time. The association between rainfall and epidemics reflects vector ecology as the larval stages of Aedes aegypti require pools of water to develop. The temporal dynamics of ZIKV and CHIKV may be explained by the shorter incubation period of the viruses in the mosquito vector; 2 days for CHIKV versus 10 days for ZIKV.

Published in: PLoS One. 2017;12(11):e0188002.

Read the publication
icon
Neurologic Complications Associated With the Zika Virus in Brazilian Adults

By da Silva IRF, Frontera JA, Bispo de Filippis AM, Nascimento OJMD

Importance:  There are no prospective cohort studies assessing the incidence and spectrum of neurologic manifestations secondary to Zika virus (ZIKV) infection in adults.

Objective:  To evaluate the rates of acute ZIKV infection among patients hospitalized with Guillain-Barré syndrome (GBS), meningoencephalitis, or transverse myelitis.

Published in: JAMA Neurol. 2017;74(10):1190–1198. doi:10.1001/jamaneurol.2017.1703

icon
Rapid antigen tests for dengue virus serotypes and Zika virus in patient serum

By Bosch I, de Puig H, Hiley M, et al.

The recent Zika virus (ZIKV) outbreak demonstrates that cost-effective clinical diagnostics are urgently needed to detect and distinguish viral infections to improve patient care. Unlike dengue virus (DENV), ZIKV infections during pregnancy correlate with severe birth defects, including microcephaly and neurological disorders. Because ZIKV and DENV are related flaviviruses, their homologous proteins and nucleic acids can cause cross-reactions and false-positive results in molecular, antigenic, and serologic diagnostics. We report the characterization of monoclonal antibody pairs that have been translated into rapid immunochromatography tests to specifically detect the viral nonstructural 1 (NS1) protein antigen and distinguish the four DENV serotypes (DENV1–4) and ZIKV without cross-reaction. To complement visual test analysis and remove user subjectivity in reading test results, we used image processing and data analysis for data capture and test result quantification. Using a 30-μl serum sample, the sensitivity and specificity values of the DENV1–4 tests and the pan-DENV test, which detects all four dengue serotypes, ranged from 0.76 to 1.00. Sensitivity/specificity for the ZIKV rapid test was 0.81/0.86, respectively, using a 150-μl serum input. Serum ZIKV NS1 protein concentrations were about 10-fold lower than corresponding DENV NS1 concentrations in infected patients; moreover, ZIKV NS1 protein was not detected in polymerase chain reaction–positive patient urine samples. Our rapid immunochromatography approach and reagents have immediate application in differential clinical diagnosis of acute ZIKV and DENV cases, and the platform can be applied toward developing rapid antigen diagnostics for emerging viruses.

Published in: Science Translational Medicine. 2017;9(409)

Read the publication
icon
Structural investigation of C6/36 and Vero cell cultures infected with a Brazilian Zika virus

By Barreto-Vieira DF, Jacome FC, da Silva MAN, et al.

Zika virus (ZIKV) is a member of the flavivirus genus, and its genome is approximately 10.8 kilobases of positive-strand RNA enclosed in a capsid and surrounded by a membrane. Studies on the replication dynamics of ZIKV are scarce, which limits the development of antiviral agents and vaccines directed against ZIKV. In this study, Aedes albopictus mosquito lineage cells (C6/36 cells) and African green monkey kidney epithelial cells (Vero cells) were inoculated with a ZIKV sample isolated from a Brazilian patient, and the infection was characterized by immunofluorescence staining, phase contrast light microscopy, transmission electron microscopy and real-time RT-PCR. The infection was observed in both cell lineages, and ZIKV particles were observed inside lysosomes, the rough endoplasmic reticulum and viroplasm-like structures. The susceptibility of C6/36 and Vero cells to ZIKV infection was demonstrated. Moreover, this study showed that part of the replicative cycle may occur within viroplasm-like structures, which has not been previously demonstrated in other flaviviruses.

Published in: PLoS One2017;12(9):e0184397.

Read the publication
icon
Zika genomics urgently need standardized and curated reference sequences

By Theys K, Libin P, Dallmeier K, et al.

In this letter, the authors address the need for curation and standardized annotation of ZIKV reference genomes in order to guide researchers and clinicians in genomic analyses and the translation of research findings.

Published in: PLoS Pathog. 2017;13(9):e1006528

 

Read the publication
icon
Neurologic Complications Associated With the Zika Virus in Brazilian Adults

By Da Silva IRF, Frontera JA, Bispo de Filippis AM, Nascimento OJMD; RIO-GBS-ZIKV Research Group. 

There are no prospective cohort studies assessing the incidence and spectrum of neurologic manifestations secondary to Zika virus (ZIKV) infection in adults. The article reports on the observational cohort study whose objective was to evaluate the rates of acute ZIKV infection among patients hospitalized with Guillain-Barré syndrome (GBS), meningoencephalitis, or transverse myelitis.

Published in: JAMA Neurol. 2017 Aug 14.

Read the publication
icon
Antibody-based assay discriminates Zika virus infection from other flaviviruses

By Balmaseda A, Stettler K, Medialdea-Carrera R, Collado D, Jin X, Zambrana JV, Jaconi S, Cameroni E, Saborio S, Rovida F, Percivalle E, Ijaz S, Dicks S, Ushiro-Lumb I, Barzon L, Siqueira PBrown DWG, Baldanti F, Tedder R, Zambon M, de Filippis AMB, Harris E, Corti D.

Zika virus (ZIKV) is a mosquito-borne flavivirus that emerged recently as a global health threat, causing a pandemic in the Americas. ZIKV infection mostly causes mild disease, but is linked to devastating congenital birth defects and Guillain-Barré syndrome in adults. The high level of cross-reactivity among flaviviruses and their cocirculation has complicated serological approaches to differentially detect ZIKV and dengue virus (DENV) infections, accentuating the urgent need for a specific and sensitive serological test. We previously generated a ZIKV nonstructural protein 1 (NS1)-specific human monoclonal antibody, which we used to develop an NS1-based competition ELISA. Well-characterized samples from RT-PCR-confirmed patients with Zika and individuals exposed to other flavivirus infections or vaccination were used in a comprehensive analysis to determine the sensitivity and specificity of the NS1 blockade-of-binding (BOB) assay, which was established in laboratories in five countries (Nicaragua, Brazil, Italy, United Kingdom, and Switzerland). Of 158 sera/plasma from RT-PCR-confirmed ZIKV infections, 145 (91.8%) yielded greater than 50% inhibition. Of 171 patients with primary or secondary DENV infections, 152 (88.9%) scored negative. When the control group was extended to patients infected by other flaviviruses, other viruses, or healthy donors (n = 540), the specificity was 95.9%. We also analyzed longitudinal samples from DENV-immune and DENV-naive ZIKV infections and found inhibition was achieved within 10 d postonset of illness and maintained over time. Thus, the Zika NS1 BOB assay is sensitive, specific, robust, simple, low-cost, and accessible, and can detect recent and past ZIKV infections for surveillance, seroprevalence studies, and intervention trials.

Published in: Proc Natl Acad Sci U S A. 2017Aug 1;114(31):8384-8389.

Read the publication