Repurposing clinical drugs is a promising strategy to discover drugs against Zika virus infection / 医学前沿

Zika virus (ZIKV) is an emerging pathogen associated with neurological complications, such as Guillain-Barré syndrome in adults and microcephaly in fetuses and newborns. This mosquito-borne flavivirus causes important social and sanitary problems owing to its rapid dissemination. However, the development of antivirals against ZIKV is lagging. Although various strategies have been used to study anti-ZIKV agents, approved drugs or vaccines for the treatment (or prevention) of ZIKV infections are currently unavailable. Repurposing clinically approved drugs could be an effective approach to quickly respond to an emergency outbreak of ZIKV infections. The well-established safety profiles and optimal dosage of these clinically approved drugs could provide an economical, safe, and efficacious approach to address ZIKV infections. This review focuses on the recent research and development of agents against ZIKV infection by repurposing clinical drugs. Their characteristics, targets, and potential use in anti-ZIKV therapy are presented. This review provides an update and some successful strategies in the search for anti-ZIKV agents are given.

Observation on the role of miR-16-5p in the replication of Zika virus / 中国输血杂志

【Objective】 To investigate the role of non-coding microRNA miR-16-5p in ZIKV replication and the underlying mechanism. 【Methods】 1×105/mL HeLa cells were seeded in 24-well plate and infected with ZIKV(MOI=5). RNAs were harvested, and miR-16-5p expression levels were measured by qRT-PCR at 24, 48 and 72 hour post infection, respectively. HeLa cells were transfected with 20nM miR-16-5p mimic and infected with ZIKV(MOI=5) at 24h post transfection. RNAs were extracted and ZIKV RNA and several inflammation factors expression were tested using qRT-PCR at 48h post infection. HeLa cells were co-transfected with 1μg NFκB-luc and 10ng pRL-TK with 20nM miR-16-5p mimic, and then infected with ZIKV(MOI=5) for 24h before the luciferase expression was tested at 48h post infection. HeLa cells were transfected with 20nM miR-16-5p mimic and infected with ZIKV(MOI=5) at 24h post transfection, and cell apoptosis was assayed through flow cytometry. 【Results】 Compared with uninfected control, miR-16-5p expression was significantly decreased at 24h, 48h and 72h following ZIKV infection. MiR-16-5p over-expression inhibited ZIKV replication, while upregulated NFκB activity and inflammation factors expression compared with the negative mimic-transfected cells. MiR-16-5p overexpression also promoted HeLa cell apoptosis. 【Conclusion】 ZIKV infection downregulated intracellular miR-16-5p expression. Overexpression of miR-16-5p suppressed ZIKV infection. MiR-16-5p inhibited ZIKV replication and promoted cell apoptosis probably by activating NFκB pathway and stimulating inflammation factors expression.

Effect of hsa_circ_0001613 on Zika virus replication: Preliminary study / 中国输血杂志

【Objective】 To investigate the effect of transfusion-transmitted Zika virus (ZIKV) on the expression of non-coding circular RNA (hsa_circ_0001613) and the role of hsa_circ_0001613 in Zika virus replication. 【Methods】 Human adenocarcinomic alveolar basal epithelial cells (A549) were seeded on a 12-well plate at 1.8×105/ well and infected with ZIKV at 0.05 MOI. The Total RNAs were isolated every day for 5 days after infection, and the relative expression level of hsa_circ_0001613 was detected by qRT-PCR. In addition, 10nM siRNA-hsa_circ_0001613 was transfected into 2×105/ well A549 cells to specifically knock down the expression level of hsa_circ_0001613. 24h later, the cells were infected with ZIKV (MOI=0.05). Total RNAs were isolated at day 1-5 post-infection, proteins were extracted 96h post-infection. ZIKV replication, relative host antiviral gene expression, and interferon stimulated response element (ISRE) activity were tested using qRT-PCR, western blot and dual luciferase assay, respectively. 【Results】 The relative expression of hsa_circ_0001613 decreased significantly after 1-5 days of ZIKV infection. Knockdown of hsa_circ_0001613 inhibited ZIKV replication. Meanwhile, hsa_circ_0001613 knockdown significantly upregulated IFN-α/β and its downstream interferon-stimulated genes (ISGs) expression, also increased ISRE activity. 【Conclusion】 ZIKV infection significantly suppressed hsa_circ_0001613 expression in A4549 cells. Preliminary study indicated that hsa_circ_0001613 knockdown inhibited ZIKV replication possibly through activating type-Ⅰ IFN signaling pathway as showed by increased ISGs expression and ISRE activity.

Zika virus infection and transfusion safety / 中国输血杂志

Zika virus(ZIKV) is an arbovirus transmitted mainly by mosquitoes. ZIKV infection usually causes mild self-limiting disease, and most of the infected patients only developed relatively mild symptoms which were often easily overlooked. However, serious damage of the central nervous system is observed in a few of the infected patients, and microcephaly of embryos and fetuses in pregnant women infected by ZIKV has attracted wide attention in recent years. Although there is a high proportion of asymptomatic infection and a high incidence of viremia, ZIKV has not been included in the routine pathogen screening before blood donation in China yet, and there is a risk of transmission through blood transfusion. This article briefly introduces the biological characteristics, epidemic characteristics, and pathogenic mechanisms of ZIKV,, and discusses ZIKV infection and the safety of blood transfusion.

Inhibition of Brazilian ZIKV strain replication in primary human placental chorionic cells and cervical cells treated with nitazoxanide

ABSTRACT Zika virus (ZIKV) infection during pregnancy is associated with a congenital syndrome. Although the virus can be detected in human placental tissue and sexual transmission has been verified, it is not clear how the virus reaches the fetus. Despite the emerging severity caused by ZIKV infection, no specific prophylactic and/or therapeutic treatment is available. The aim of the present study was to evaluate the effectiveness antiviral of nitazoxanide (NTZ) in two important congenital transmission targets: (i) a primary culture of human placental chorionic cells, and (ii) human cervical epithelial cells (C33-A) infected with Brazilian ZIKV strain. Initially, NTZ activity was screened in ZIKV infected Vero cells under different treatment regimens with non-toxic drug concentrations for 48 h. Antiviral effect was found only when the treatment was carried out after the viral inoculum. A strong effect against the dengue virus serotype 2 (DENV-2) was also observed suggesting the possibility of treating other Flaviviruses. Additionally, it was shown that the treatment did not reduce the production of infectious viruses in insect cells (C6/36) infected with ZIKV, indicating that the activity of this drug is also related to host factors. Importantly, we demonstrated that NTZ treatment in chorionic and cervical cells caused a reduction of infected cells in a dose-dependent manner and decreased viral loads in up to 2 logs. Pre-clinical in vitro testing evidenced excellent therapeutic response of infected chorionic and cervical cells and point to future NTZ activity investigation in ZIKV congenital transmission models with the perspective of possible repurposing of NTZ to treat Zika fever, especially in pregnant women.

Characterization of placental infection by zika virus in humans: A review of the literature / Caracterização da infecção placentária pelo vírus zika em humanos: Uma revisão da literatura

Abstract Objective The aim of the current review is to present a systematic evaluation of reported human placental findings in cases of zika virus (ZIKV) infection. Data sources We reviewed the EMBASE, PUBMED, and SCIELO databases until June 2019, without language restrictions. Selection of studies The search terms placenta AND zika virus were used. The inclusion criteria of the studies were studies that reported placental findings in humans. Experimental studies, reviews, notes or editorials were excluded. A total of 436 studies were retrieved; after duplicate exclusion, 243 articles had their titles screened, and 128 had their abstract read; of those, 32 were included in the final analysis (18 case reports, 10 case series, and 4 cohorts) Data collection We collected data concerning the author, year of publication, study design, number of participants, number of placental samples, onset of symptoms, perinatal outcomes, and main findings on histological analysis. Data synthesis The placental pathologic findings were described as mild and nonspecific, similar to those of other placental infections, including chronic placentitis, chronic villitis, increased Hofbauer cells, irregular fibrin deposits, increased mononuclear cells in the villus stroma, villous immaturity, edema, hypervascularization, stromal fibrosis, calcification, and focal necrosis of syncytiotrophoblasts. Conclusion Zika infection presents unspecific placental findings, similar to other infections in the toxoplasmosis, other agents, rubella, cytomegalovirus, and herpes (TORCH)group. Characterizing and standardizing placental findings after zika virus infection is key to understanding the mechanisms of congenital diseases.

Resumo Objetivo O objetivo desta revisão é apresentar uma avaliação sistemática dos achados relacionados à infecção por zika vírus (ZIKV) na placenta humana. Fontes de dados As bases de dados EMBASE, PUBMED, e SCIELO foram pesquisadas, até junho de 2019, sem qualquer restrição de língua. Seleção dos estudos Os termos placenta E zika virus foram utilizados na busca. Foram incluídos estudos que reportassem achados placentários de infecção em seres humanos, enquanto estudos experimentais, revisões, notas e editoriais foram excluídos. Um total de 436 estudos foram identificados, e 243 tiveram seus títulos lidos após a exclusão de duplicatas. Cento e vinte e oito artigos tiveram seus resumos avaliados, dos quais 32 foram incluídos na análise final (18 relatos de caso, 10 séries de casos, e 4 estudos de coorte). Dados obtidos Foram pesquisados dados relativos ao autor, ano da publicação, desenho do estudo, número de participantes, número de amostras de placenta, início dos sintomas, desfechos perinatais, e principais achados histológicos. Síntese dos dados Os principais achados placentários descritos foram leves e inespecíficos, similares a outras infecções placentárias, incluindo infecção placentária crônica, vilosite crônica, aumento das células de Hofbauer, depósitos irregulares de fibrina, aumento das células mononucleares no estroma viloso, imaturidade vilosa, edema, hipervascularização, fibrose estromal, calcificação, e necrose focal dos sincicitrofoblastos. Conclusão Infecções por ZIKV têm achados placentários inespecíficos, similares aos de outras infecções do grupo toxoplasmose, rubéola, citomegalovírus e herpes (TORCH). Caracterizar e padronizar os achados placentários após infecção por ZIKV é fundamental para entender o mecanismo das infecções congênitas.

Prevalence and causes of congenital microcephaly in the absence of a Zika virus outbreak in southern Brazil / Prevalência e causas da microcefalia congênita sem a presença do surto do vírus Zika no Sul do Brasil

Abstract Objective: The aim of this study was to identify the causes of congenital microcephaly in Rio Grande do Sul, a state in southern Brazil, where no ZIKV outbreak was detected, from December 2015 to December 2016, which was the period when ZIKV infection was at its peak in northeast Brazil. Methods: This was a cross-sectional study where all notifications of congenital microcephaly in the state of Rio Grande do Sul were included for analysis. Evaluation of cases followed the guidelines of the Brazilian Ministry of Health. Dysmorphological and neurological evaluations were performed by a specialized team, and genetic tests and neuroimaging were performed when clinically indicated. STORCH infections were diagnosed using standard tests. ZIKV infection was diagnosed through maternal serum RT-PCR and/or neuroimaging associated with clinical/epidemiological criteria. Results: From 153 744 registered live births in the study period, 148 cases were notified, but 90 (60.8%) of those were later excluded as "non-confirmed" microcephaly. In the 58 confirmed cases of microcephaly (prevalence = 3.8/10 000 live births), congenital infections (syphilis, toxoplasmosis, cytomegalovirus, and ZIKV) constituted the predominant etiology (50.0%), followed by isolated CNS (15.5%), and genetic syndromes (10.3%). Congenital ZIKV syndrome (CZS) with typical phenotype was diagnosed in three cases (5.2% of all confirmed microcephaly cases or 10.4% of all congenital infections). Conclusion: In Rio Grande do Sul, where no outbreak of ZIKV infection was recorded, congenital infections were the leading cause of congenital microcephaly, and the attributable risk for CZS in the etiology of microcephaly was 5.2%.

Resumo: Objetivo: Identificar as causas da microcefalia congênita no Rio Grande do Sul, Região Sul do Brasil, onde não foi detectado surto de ZIKV, de dezembro de 2015 a dezembro de 2016. Esse foi o período em que a infecção por ZIKV estava em seu auge no Nordeste do Brasil. Métodos: Este é um estudo transversal no qual todas as notificações de microcefalia congênita no estado do Rio Grande do Sul foram incluídas para análise. A avaliação dos casos seguiu as orientações do Ministério da Saúde. A avaliação dismorfológica e neurológica foi feita por uma equipe especializada e os testes genéticos e as neuroimagens foram feitos quando indicado clinicamente. As infecções STORCH (Sífilis, Toxoplasmose, Rubéola, Citomegalovírus e Herpes simples) foram diagnosticadas utilizando testes padrão. A infecção por ZIKV foi diagnosticada por meio da transcriptase reversa seguida de reação em cadeia da polimerase (RT-PCR) no soro materno e/ou neuroimagem associada a critérios clínicos/epidemiológicos. Resultados: De 153.744 nascidos vivos registrados no período do estudo, 148 bebês foram casos notificados, porém 90 (60,8%) casos foram excluídos posteriormente como microcefalia "não confirmada". Nos 58 casos confirmados de microcefalia (prevalência = 3,8/10.000 nascidos vivos), as infecções congênitas (sífilis, toxoplasmose, citomegalovírus e ZIKV) constituíram a etiologia predominante (50,0%), seguidas de doenças ligadas ao SNC isolado (15,5%) e síndromes genéticas (10,3%). A síndrome congênita do ZIKV (SCZ) com fenótipo típico foi diagnosticada em três casos (5,2% de todos os casos confirmados de microcefalia ou 10,4% de todas as infecções congênitas). Conclusão: No Rio Grande do Sul, Brasil, onde não foi registrado surto de infecção por ZIKV, a principal causa de microcefalia congênita foram infecções congênitas e o risco atribuível para SCZ na etiologia de microcefalia foi de 5,2%.

Study of B cell epitope conserved region of the Zika virus envelope glycoprotein to develop multi-strain vaccine

A Zika virus (ZIKV) infection causes severe clinical manifestations, both in newborn baby and adult. It was consideredas the public health emergency by the World Health Organization in 2016. Until now, there is no approved drug orvaccine for the treatment or prevention of multi-strain ZIKV infection. The present work attempts to identify theB cell epitope conserved region of ZIKV envelope glycoprotein through an intensive in silico study. A total of 363ZIKV strains was retrieved from the National Center of Biotechnology Information (NCBI) database, then aligned toobtain the conserved region of ZIKV glycoprotein. The interaction between the conserved region with Axl receptortyrosine kinase, a ZIKV receptor on the host cell, has been evaluated through molecular docking approach. TheB cell epitope was identified using the immune epitope database (IEDB) web server. This study revealed that theconserved region of ZIKV envelope glycoprotein interacts with Asp9, Glu12, Glu40, Asp177, Glu243, and Glu245of Axl receptor. Two sequences in ZIKV envelope glycoprotein, “ISDSDSRCPTQGEALKQSDTQY” (22-mer) and“SQHSGMGETDERAKVETPNSPRAEATL” (27-mer), are identified as B cell epitopes. Further studies are necessaryto confirm their possibility as the potential ZIKV multi-strain vaccine in the future.

Generation of human monoclonal antibody Fab fragment to Zika Virus by Phage Display Technology / 中华实验和临床病毒学杂志

Objective@#In this study, phage display technology was used to construct the human anti-Zika virus(ZIKV), phage antibody library and to obtain and express the monoclonal antibody. The aim was to master the preparation and expression of human phage antibody library screening method for highly specific antibodies.@*Methods@#The whole blood samples of Zika patients were collected and the lymphocytes were isolated. The RT-PCR method was used to amplify the antibody light chain and heavy chain Fab gene from lymphocyte Ig mRNA. The pComb3H system was used to construct the gene with genetic diversity Preparation of human anti-ZIKV phage antibody library. The purified antibody library was screened by using the purified ZIKV and the obtained ZIKV E protein antigen.@*Results@#The monoclonal antibody Fab fragment gene was successfully obtained for the ZIKV E protein antigen. The gene can be efficiently expressed in Escherichia coli.@*Conclusions@#According to the sequence analysis, this study showed that the monoclonal antibody was a new human genetically engineered antibody against ZIKV, which laid the foundation for the early diagnosis of ZIKV, and obtain a specific monoclonal antibody to ZIKV for human treatment of ZIKV infection.

Rapid Whole-genome Sequencing of Zika Viruses using Direct RNA Sequencing

Zika virus (ZIKV) is one of the pathogens which is transmitted world widely, but there are no effective drugs and vaccines. Whole genome sequencing (WGS) of viruses could be applied to viral pathogen characterization, diagnosis, molecular surveillance, and even finding novel pathogens. We established an improved method using direct RNA sequencing with Nanopore technology to obtain WGS of ZIKV, after adding poly (A) tails to viral RNA. This established method does not require specific primers, complimentary DNA (cDNA) synthesis, and polymerase chain reaction (PCR)-based enrichment, resulting in the reduction of biases as well as of the ability to find novel RNA viruses. Nanopore technology also allows to read long sequences. It makes WGS easier and faster with long-read assembly. In this study, we obtained WGS of two strains of ZIKV following the established protocol. The sequenced reads resulted in 99% and 100% genome coverage with 63.5X and 21,136X, for the ZIKV PRVABC59 and MR 766 strains, respectively. The sequence identities of the ZIKV PRVABC59 and MR 766 strains for each reference genomes were 98.76% and 99.72%, respectively. We also found that the maximum length of reads was 10,311 bp which is almost the whole genome size of ZIKV. These long-reads could make overall structure of whole genome easily, and WGS faster and easier. The protocol in this study could provide rapid and efficient WGS that could be applied to study the biology of RNA viruses including identification, characterization, and global surveillance.

Knowledge, perceptions and practices regarding Zika virus of university students in northern Colombia (Santa Marta, 2016) / Conocimientos, percepciones y prácticas sobre el virus del Zika en estudiantes universitarios del norte de Colombia (Santa Marta, 2016)

This study focuses on the knowledge, perceptions and practices of 171 university students regarding Zika virus and its vector in Santa Marta (Colombia) in 2016. A survey was conducted, and the answers about causative agent and mode of transmission were classified into three levels of knowledge. Altogether, 32.1% of the students stated that they had suffered from Zika. A total of 60% stated that they knew what the disease was; however, only 29.2% knew what the causative agent was, and 45.6% knew the mode of transmission. Regarding the level of knowledge, only 14.6% knew the causative agent and the mode of transmission (Level 2). In general, the students recognize the symptoms of Zika virus, and 53.8% of them consider Zika to be very serious. More than half of them believe that they, the community, and the government are responsible for controlling the vector. Even though more than half the students know the most important strategies to control the vector, they do not apply them; the reasons for this might be their everyday habits, the lack of organization in their communities, a deficient public health system, and climate change. It is recommended to implement permanent strategies for vector control that take into account the sociocultural characteristics of at-risk populations.

Este estudio analiza el nivel de conocimiento, percepciones y prácticas de 171 estudiantes universitarios sobre el virus del Zika y su vector en Santa Marta (Colombia) en 2016. Se aplicó una encuesta y las respuestas sobre el agente causativo y el modo de transmisión se clasificaron en tres niveles de conocimiento. Se encontró que el 32,1% de los estudiantes manifiestan haber sufrido Zika. Un 60% afirmó que conocían la enfermedad, sin embargo, solo el 29,2% conocía el agente causal y el 45,6% el modo de transmisión. Sólo el 14,6% conocía el agente causal y el modo de transmisión (Nivel 2). En general, los estudiantes reconocen los síntomas del Zika. Para el 53,8% es una enfermedad muy grave y más de la mitad considera que ellos, la comunidad y el gobierno son responsables de controlar el vector. Aunque más de la mitad de los estudiantes conocen las estrategias más importantes para controlar el vector, no las practican; esto puede explicarse debido a sus prácticas cotidianas, falta de organización comunitaria, deficiencia en el sistema de salud pública y el cambio climático. Se recomienda implementar estrategias permanentes de control de vectores que consideren las características socioculturales de las poblaciones en riesgo.

Risk of Zika virus transmission by blood donations in Brazil

ABSTRACT Background: Zika, a disease caused by Zika virus infections, has recently emerged and caused outbreaks in many parts of the world. The clinical manifestations of Zika are usually mild, mostly presenting as an exanthematic febrile disease, but on some occasions, it might be associated with microcephaly after intrauterine infection, and Guillain-Barré Syndrome. Zika virus is primarily transmitted by mosquito bites, but other means of transmission have been described, and potential risk for blood transmission has been reported in French Polynesia and Brazil. Methods: To investigate the risk of Zika virus infection after a blood transfusion in an area of Brazil where a possible transmission by a platelet concentrate has been described. Using a mini-pool format, 1857 blood donations were evaluated by real-time reverse transcriptase polymerase chain reaction designed to detect Zika virus RNA. Results: After testing samples individually from positive mini-pools, the prevalence of Zika virus RNA was only 0.16%, a result probably associated to the low circulation of this virus in the study area. In addition, it was evident that the implementation of post-surveillance programs is important to detect Zika virus infections in blood donors, as the post-donation surveillance program detected two blood donors with the disease in this study. Conclusion: This study shows that the risk for Zika virus transmission by blood transfusion is real, even in regions with a low circulation of the disease, but the combination of the detection of Zika virus RNA by polymerase chain reaction and post-donation surveillance might reduce the risk of transmission by blood transfusions.

Anti-Zika virus:research advances / 国际药学研究杂志

Zika virus(ZIKV)is an arbovirus transmitted mainly through Aedes aegypti,which is associated with adult Guil-lain-Barré syndrome and microcephaly,as well as other neurological deficits in the neonate.On Feb.1,2016,the outbreak of ZIKV disease was regarded as an international public health emergency by WHO,and anti-ZIKV has become a worldwide medical chal-lenge.There are currently no vaccines and specific antiviral therapeutics available for ZIKV.In this paper,the possible pathogenesis of ZIKV and the new progress in the treatment drugs are reviewed.

Probing the Pharmacological Parameters, Molecular Docking and Quantum Computations of Plant Derived Compounds Exhibiting Strong Inhibitory Potential Against NS5 from Zika Virus

ABSTRACT Zika virus (ZIKV) is known for microcephaly and neurological disease in humans and the nonstructural proteins of ZIKV play a fundamental role in the viral replication. Among the seven nonstructural proteins, NS5 is the most conserved and largest protein. Two major functional domains of NS5 i.e. methyltransferase (MTase) and RNA-dependent RNA polymerase (RdRp) are imperative for the virus life cycle and survival. The present study explicates the inhibitory action of phytochemicals from medicinal plants against NS5 from ZIKV, leading to the identification of potential inhibitors. The crystal structure of the protein is retrieved from RCSB protein data bank. A total of 2035 phytochemicals from 505 various medicinal plants are analysed for their pharmacological properties and pharmacokinetics. Compounds having effective drug-likeness are docked against the protein and further analysed using density functional theory approach. Among the 2035 phytochemicals, 13 are selected as potential inhibitors against MTase having high binding affinities and 17 compounds are selected for RdRp. HOMO and LUMO energies are calculated for the docked compounds within and outside binding pockets of MTase and RdRp, adapting the B3LYP hybrid exchange-correlation functional with def2-SV(P) basis set. Physicochemical properties such as ionization energy, electronic chemical potential, electronegativity, electron affinity, molecular softness, molecular hardness and electrophilicity index have also been analysed for selected phytochemicals. Based upon the results, it is concluded that the selected phytochemicals are highly competent to impede the replication of the virus by inhibiting the ZIKV-NS5.

Sensitivity of RT-PCR method in samples shown to be positive for Zika virus by RT-qPCR in vector competence studies

Abstract Tissue samples from mosquitoes artificially infected with Zika virus and shown to be positive by RT-qPCR were reexamined by RT-PCR. Using these samples we compared the two methods employed in virus RNA detection for vector competence studies. Results demonstrated that, albeit useful, RT-PCR gave false negatives with low viral loads (< 106 RNA copies/ml).

Function and structure analysis of premembrane and envelope proteins of Zika virus / 中国人兽共患病学报

The premembrane and envelope proteins (prM-E),which contains the mainly protective antigen related with virulence and tropism,are the primary structural protein of flavivirus.However,prM-E in ZIKV is rarely understood.We have analyzed the structure and biological effects of prM-E in ZIKV by bionformatics methods.The prM-E proteins virus-like particles of dengue virus was introduced in the present.Then,the prM-E proteins virus like particles of ZIKV was prospected.

Síndrome de guillain-barré e infección por virus zika en ciudad bolívar, venezuela (2015- 2016) / Guillain-barre syndrome and infection by ZIKA virus in Ciudad Bolívar, Venezuela (2015-2016)

El Virus ZIKA se extendió por muchos países y se vinculó a Sindrome de Guillain Barre en una alta proporción de pacientes. Objetivos: determinar el comportamiento clínicoepidemiológico de Síndrome de Guillain Barré (SGB) e infección por ZIKV en el Hospital Ruíz y Páez, Ciudad Bolívar, Estado Bolívar, Venezuela, en 2015-2016. Métodos: estudio descriptivo, prospectivo, diseño longitudinal. La muestra correspondió a 30 pacientes ingresados con diagnóstico de SGB e infección por ZIKV. Resultados: Los síntomas principales fueron: debilidad muscular progresiva (66.67%), parestesias (40.00%) y parálisis (26.67%). El 40.00% refirió infección previa por ZIKV; Se realizaron pruebas serológicas al 100% de los pacientes y en 93.33% se encontró hiperproteinorraquia; De acuerdo a los criterios de Brighton se estableció que todos los pacientes en estudio eran casos de SGB (nivel de certeza tipo 2) Al menos 63.33% eran nivel de certeza tipo 1, al tener los reportes electrofisiológicos. Todos, cumplían con los criterios de Asbury & Cornblath (1990) para diagnóstico de SGB. Evolución: recibió plasmaféresis el 46,66% de la muestra y 83.33% egresó por mejoría. Conclusión: Los resultados expuestos establecen clara vinculación ZIKV-SGB(AU)

ZIKA virus has extended to many countries and was the cause of Guillain-Barre Syndrome in a high proportion of the patients. Objectives: to determinate the clinical and epidemiological behavior of this combination in the Hospital Ruíz y Páez, Ciudad Bolívar, Venezuela. Methods: this was a descriptive, prospective, longitudinal study. The sample was of 30 patients admitted with Guillain-Barre´s Syndrome (GBS) and ZIKA Virus infection. Results: the major symptoms were: progressive muscular weakness 66.67%, paresthesias 40.00% and paralysis 26.67%. 40.00% had presented previous ZIKV. In 93.33% high contents in CSF were found. Serologic studies were realized in all patients: positive ZIKV IgM was present in 73.33% and IgG in 26.67% positiva para ZIKV. Due to their clinical conditions, 36.67% wwere admitted to the ICU. Following Brighton´s criteria and Asbury & Cornblath, all had the diagnosis of GBS. Evolutión: plasmapheresis was used in 46,66% and 83.33% improved and left the hospital. Conclusion: In this study there was a clear evidence of ZIKV infection in patients con GBS(AU)

Infección por Virus Zika en el embarazo / Virus Zika infection in pregnancy

La infección viral por Zika se ha diseminado desde fechas recientes en las Américas. Venezuela no ha escapado a la emergente enfermedad, y al ser una población rica en población de mosquitos Aedes Aepypti y sin memoria inmunológica al virus nos hace muy susceptibles a tener una amplia distribución de la infección en muy corto tiempo, similar a lo ocurrido con otras enfermedades transmitidas por mosquitos como el Dengue y el Chikungunya. Las mujeres embarazadas tienen un potencial de infección y de transmisión materno fetal mucho mayor por los cambios fisiológicos en sus sistemas inmunológicos, y la transmisión vertical del virus implica un riesgo para que el feto tenga compromiso en su anatomía en diferentes regiones, principalmente afectando el SNC. En este trabajo se describe la problemática, métodos de diagnóstico materno y fetal de las complicaciones y resumen de protocolos sugeridos por instituciones de salud mundiales, orientadas a médicos, obstetras y otros prestadores de salud, actualizados hasta marzo del 2016. Al ser una enfermedad de aparición nueva, las publicaciones existentes a la fecha son también muy recientes, sin estudios científicos concluyentes en cuanto al verdadero riesgo que implica la infección para la embarazada, su progenie y para la población en general.

Zika virus infection has spread in the Americas in the recent years. Venezuela has not escaped this emerging disease, and as we own a rich population of Aedes mosquitoes and also people without immunological memory to the virus makes us very susceptible to a wide distribution of the infection in a very short time, similar to what happened with other diseases spread by mosquitoes such as Dengue and Chikungunya. Pregnant women have an increased potential for infection and its transmission to their offspring due to their physiological changes in the immune system, and the vertical transmission of the virus poses a risk to the fetus, who has a higher chance to be affected mainly in the CNS, as recent publications claim. In this paper we summarize the problem, diagnosis data according to Venezuela and we resume guidelines to physicians in different fields, updated until March 2016. As Zika infection is a new emerging disease, published papers are few and non-conclusive about the true risk it implies to the pregnant women, her offspring and for the general population.

Zika: As an emergent epidemic

Zika virus is a new global threat for 2016 that has been swept to almost all Americas and is now posing serious threats to the entire globe. This deadly virus is playing havoc to unborn lives because of its reported association with upsurge of fetal deformation called microcephaly and neuropathic disorders including Guillain-Barré syndrome. Till today, there is no vaccine prospect, antiviral therapy or licensed medical countermeasures to curb the teratogenic outcomes of this destructive viral infection. Diagnosis, treatment, chronicity and pathogenesis are still vague and unsettled. Therefore, this review article addresses all the aspects related to this disease to mitigate the explosive rise in Zika virus infection.

Zika: As an emergent epidemic

Zika virus is a new global threat for 2016 that has been swept to almost all Americas and is now posing serious threats to the entire globe. This deadly virus is playing havoc to unborn lives because of its reported association with upsurge of fetal deformation called microcephaly and neuropathic disorders including Guillain-Barré syndrome. Till today, there is no vaccine prospect, antiviral therapy or licensed medical countermeasures to curb the teratogenic outcomes of this destructive viral infection. Diagnosis, treatment, chronicity and pathogenesis are still vague and unsettled. Therefore, this review article addresses all the aspects related to this disease to mitigate the explosive rise in Zika virus infection.