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Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 1/2017

01-01-2017 | Neurological Infections (J Lyons, Section Editor)

Zika Virus Disease and Associated Neurologic Complications

Authors: Lindsey M. Duca, J. David Beckham, Kenneth L. Tyler, Daniel M. Pastula

Published in: Current Infectious Disease Reports | Issue 1/2017

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Abstract

Purpose of Review

The purpose of this article is to review what is currently known about Zika virus (ZIKV) disease and associated neurologic complications.

Recent Findings

ZIKV is a mosquito-borne or sexually transmitted flavivirus rapidly spreading throughout the Americas. While ZIKV infection is usually asymptomatic, it may cause a non-specific illness with fever, rash, myalgia, headache, and/or non-purulent conjunctivitis. Additionally, ZIKV has been associated with a number of neurologic complications including microcephaly and other birth defects, Guillain-Barré syndrome, meningoencephalitis, myelitis, and various ophthalmologic abnormalities.

Summary

Treatment for ZIKV disease is supportive. Those in ZIKV endemic areas should protect themselves from mosquito bites by wearing insect repellent, wearing long-sleeved shirts and pants when outdoors, and/or using air conditioning or window screens when indoors. Furthermore, unprotected sexual intercourse should be temporarily avoided by those who recently traveled to endemic areas. Suspected ZIKV disease cases should be reported to local, state, or territorial health departments.
Literature
1.
Dick GWA, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952;46:509–20.CrossRefPubMed
2.
3.
Moore DL, Causey OR, Carey DE, Reddy S, Cooke AR, Akinkugbe FM, et al. Arthropod-borne viral infections of man in Nigeria, 1964–1970. Ann Trop Med Parasitol. 1975;69:49–64.CrossRefPubMed
4.
Fagbami AH. Zika virus infections in Nigeria: virological and seroepidemiological investigations in Oyo State. J Hyg (Lond). 1979;83:213–9.CrossRef
5.
Filipe AR, Martins CM, Rocha H. Laboratory infection with Zika virus after vaccination against yellow fever. Arch Für Ges Virusforsch. 1973;43:315–9.CrossRef
6.
Olson JG, Ksiazek TG, Suhandiman, Triwibowo. Zika virus, a cause of fever in Central Java, Indonesia. Trans R Soc Trop Med Hyg. 1981;75:389–93.CrossRefPubMed
7.
Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009;360:2536–43.CrossRefPubMed
8.
• Musso D, Nilles EJ, Cao-Lormeau VM. Rapid spread of emerging Zika virus in the Pacific area. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2014;20:O595–6. Description of ZIKV spread throughout the Pacific.
9.
Oehler E, Watrin L, Larre P, Leparc-Goffart I, Lastere S, Valour F, et al. Zika virus infection complicated by Guillain-Barre syndrome—case report, French Polynesia, December 2013. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2014;19.
10.
• Campos GS, Bandeira AC, Sardi SI. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis. 2015;21:1885–6. First reports of ZIKV transmission in Brazil.CrossRefPubMedPubMedCentral
11.
• Zanluca C, de Melo VCA, Mosimann ALP, Santos GIVD, Santos CNDD, Luz K. First report of autochthonous transmission of Zika virus in Brazil. Mem Inst Oswaldo Cruz. 2015;110:569–72. First reports of ZIKV transmission in Brazil.CrossRefPubMedPubMedCentral
12.
13.
14.
15.
16.
17.
18.
Foy BD, Kobylinski KC, Chilson Foy JL, Blitvich BJ, Travassos da Rosa A, Haddow AD, et al. Probable non-vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis. 2011;17:880–2.CrossRefPubMedPubMedCentral
19.
Hills SL, Russell K, Hennessey M, Williams C, Oster AM, Fischer M, et al. Transmission of Zika virus through sexual contact with travelers to areas of ongoing transmission - continental United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:215–6.CrossRefPubMed
20.
21.
Deckard DT, Chung WM, Brooks JT, Smith JC, Woldai S, Hennessey M, et al. Male-to-male sexual transmission of Zika virus—Texas, January 2016. MMWR Morb Mortal Wkly Rep. 2016;65:372–4.CrossRefPubMed
22.
D’Ortenzio E, Matheron S, Yazdanpanah Y, de Lamballerie X, Hubert B, Piorkowski G, et al. Evidence of sexual transmission of Zika virus. N Engl J Med. 2016;374:2195–8.CrossRefPubMed
23.
Mansuy JM, Dutertre M, Mengelle C, Fourcade C, Marchou B, Delobel P, et al. Zika virus: high infectious viral load in semen, a new sexually transmitted pathogen? Lancet Infect Dis. 2016;16:405.CrossRefPubMed
24.
25.
Barzon L, Pacenti M, Franchin E, Lavezzo E, Trevisan M, Sgarabotto D, et al. Infection dynamics in a traveller with persistent shedding of Zika virus RNA in semen for six months after returning from Haiti to Italy, January 2016. Euro Surveill. 2016;21:32.
26.
27.
Venturi G, Zammarchi L, Fortuna C, Remoli ME, Benedetti E, Fiorentini C, et al. An autochthonous case of Zika due to possible sexual transmission, Florence, Italy, 2014. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2016;21.
28.
Fréour T, Mirallié S, Hubert B, Splingart C, Barrière P, Maquart M, et al. Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2016;21.
29.
• Brooks JT, Friedman A, Kachur RE, LaFlam M, Peters PJ, Jamieson DJ. Update: interim guidance for prevention of sexual transmission of Zika virus - United States, July 2016. MMWR Morb Mortal Wkly Rep. 2016;65:745–7. Guidelines to prevent ZIKV sexual transmission.CrossRefPubMed
30.
Brooks RB, Carlos MP, Myers RA, White MG, Bobo-Lenoci T, Aplan D, et al. Likely sexual transmission of Zika virus from a man with no symptoms of infection - Maryland, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:915–6.CrossRefPubMed
31.
Musso D, Nhan T, Robin E, Roche C, Bierlaire D, Zisou K, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2014;19.
32.
Kuehnert MJ, Basavaraju SV, Moseley RR, Pate LL, Galel SA, Williamson PC, et al. Screening of blood donations for Zika virus infection—Puerto Rico, April 3-June 11, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:627–8.CrossRefPubMed
33.
Barjas-Castro ML, Angerami RN, Cunha MS, Suzuki A, Nogueira JS, Rocco IM, et al. Probable transfusion-transmitted Zika virus in Brazil. Transfusion (Paris). 2016;56:1684–8.CrossRef
34.
35.
Jouannic JM, Friszer S, Leparc-Goffart I, Garel C, Eyrolle-Guignot D. Zika virus infection in French Polynesia. Lancet Lond Engl. 2016;387:1051–2.CrossRef
36.
Calvet G, Aguiar RS, Melo ASO, Sampaio SA, de Filippis I, Fabri A, et al. Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study. Lancet Infect Dis. 2016;16:653–60.CrossRefPubMed
37.
Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis B. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2016;47:6–7.CrossRef
38.
Meaney-Delman D, Hills SL, Williams C, Galang RR, Iyengar P, Hennenfent AK, et al. Zika virus infection among U.S. pregnant travelers—August 2015-February 2016. MMWR Morb Mortal Wkly Rep. 2016;65:211–4.CrossRefPubMed
39.••
Martines RB, Bhatnagar J, Keating MK, Silva-Flannery L, Muehlenbachs A, Gary J, et al. Notes from the Field: evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses—Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:159–60. Case series with pathologic evidence of fetal ZIKV infection.CrossRefPubMed
40.
Van der Eijk AA, Van Genderen PJ, Verdijk RM, Reusken CB, Mögling R, Van Kampen JJA, et al. Miscarriage associated with Zika virus infection. N Engl J Med. 2016;375:1002–4.CrossRefPubMed
41.
Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2014;19.
42.
Dupont-Rouzeyrol M, Biron A, O’Connor O, Huguon E, Descloux E. Infectious Zika viral particles in breastmilk. Lancet Lond Engl. 2016;387:1051.CrossRef
43.
44.
45.
46.
• Sharp TM, Muñoz-Jordán J, Perez-Padilla J, Bello-Pagán MI, Rivera A, Pastula DM, et al. Zika virus infection associated with severe thrombocytopenia. Clin Infect Dis Off Publ Infect Dis Soc Am. 2016. doi:10.​1093/​cid/​ciw476. Case reports of severe thrombocytopenia associated with ZIKV infection.
47.
Karimi O, Goorhuis A, Schinkel J, Codrington J, Vreden SGS, Vermaat JS, et al. Thrombocytopenia and subcutaneous bleedings in a patient with Zika virus infection. Lancet Lond Engl. 2016;387:939–40.CrossRef
48.
• Hennessey M, Fischer M, Staples JE. Zika virus spreads to new areas—region of the Americas, May 2015-January 2016. MMWR Morb Mortal Wkly Rep. 2016;65:55–8. Description of ZIKV spread throughout the Americas.CrossRefPubMed
49.
Schuler-Faccini L, Ribeiro EM, Feitosa IML, Horovitz DDG, Cavalcanti DP, Pessoa A, et al. Possible association between Zika virus infection and microcephaly—Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:59–62.CrossRefPubMed
50.
51.
Cauchemez S, Besnard M, Bompard P, Dub T, Guillemette-Artur P, Eyrolle-Guignot D, et al. Association between Zika virus and microcephaly in French Polynesia, 2013–15: a retrospective study. Lancet Lond Engl. 2016;387:2125–32.CrossRef
52.
Brasil P, Pereira JP, Raja Gabaglia C, Damasceno L, Wakimoto M, Ribeiro Nogueira RM, et al. Zika virus infection in pregnant women in Rio de Janeiro—preliminary report. N Engl J Med. 2016. doi:10.​1056/​NEJMoa1602412.PubMed
53.
Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, et al. Zika virus associated with microcephaly. N Engl J Med. 2016;374:951–8.CrossRefPubMed
54.
França GVA, Schuler-Faccini L, Oliveira WK, Henriques CMP, Carmo EH, Pedi VD, et al. Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation. Lancet Lond Engl. 2016;388:891–7.CrossRef
55.
Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WTGH, Do Carmo GMI, Henriques CMP, Coelho GE, et al. Increase in reported prevalence of microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy—Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:242–7.CrossRefPubMed
56.
Sarno M, Sacramento GA, Khouri R, Do Rosário MS, Costa F, Archanjo G, et al. Zika virus infection and stillbirths: a case of hydrops fetalis, hydranencephaly and fetal demise. PLoS Negl Trop Dis. 2016;10:e0004517.CrossRefPubMedPubMedCentral
57.
Driggers RW, Ho CY, Korhonen EM, Kuivanen S, Jääskeläinen AJ, Smura T, et al. Zika virus infection with prolonged maternal viremia and fetal brain abnormalities. N Engl J Med. 2016;374:2142–51.CrossRefPubMed
58.
• Hazin AN, Poretti A, Turchi Martelli CM, Huisman TA, Microcephaly Epidemic Research Group, Di Cavalcanti Souza Cruz D, et al. Computed tomographic findings in microcephaly associated with Zika virus. N Engl J Med. 2016;374:2193–5. Radiographic findings in fetal ZIKV infection.CrossRefPubMed
59.
• Martines RB, Bhatnagar J, de Oliveira Ramos AM, Davi HPF, Iglezias SD, Kanamura CT, et al. Pathology of congenital Zika syndrome in Brazil: a case series. Lancet Lond Engl. 2016;388:898–904. Case series with pathologic evidence of fetal ZIKV infection.CrossRef
60.
•• Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects—reviewing the evidence for causality. N Engl J Med. 2016;374:1981–7. Causal relationship established between microcephaly and Zika virus infection.CrossRefPubMed
61.
• De Fatima Vasco Aragao M, Van der Linden V, Brainer-Lima AM, Coeli RR, Rocha MA, Sobral da Silva P, et al. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study. BMJ. 2016;353:i1901. Radiographic findings in fetal ZIKV infection.CrossRefPubMedPubMedCentral
62.
• Soares de Oliveira-Szejnfeld P, Levine D, de Oliveira Melo AS, Amorim MMR, Batista AGM, Chimelli L, et al. Congenital brain abnormalities and Zika virus: what the radiologist can expect to see prenatally and postnatally. Radiology. 2016. doi:10.​1148/​radiol.​2016161584. Radiographic findings in fetal ZIKV infection.PubMed
63.
• Tang H, Hammack C, Ogden SC, Wen Z, Qian X, Li Y, et al. Zika virus infects human cortical neural progenitors and attenuates their growth. Cell Stem Cell. 2016;18:587–90. Laboratory evidence of ZIKV tropism for neural stem cells.CrossRefPubMed
64.
• Garcez PP, Loiola EC, Madeiro da Costa R, Higa LM, Trindade P, Delvecchio R, et al. Zika virus impairs growth in human neurospheres and brain organoids. Science. 2016;352:816–8. Laboratory evidence of ZIKV tropism for neural stem cells.CrossRefPubMed
65.
• Brault JB, Khou C, Basset J, Coquand L, Fraisier V, Frenkiel MP, et al. Comparative analysis between flaviviruses reveals specific neural stem cell tropism for Zika virus in the mouse developing neocortex. EBioMedicine. 2016;10:71–6. Laboratory evidence of ZIKV tropism for neural stem cells.CrossRefPubMedPubMedCentral
66.
•• Russell K, Oliver SE, Lewis L, Barfield WD, Cragan J, Meaney-Delman D, et al. Update: interim guidance for the evaluation and management of infants with possible congenital Zika virus infection—United States, August 2016. MMWR Morb Mortal Wkly Rep. 2016;65:870–8. Evaluation and management of congenital ZIKV disease.CrossRefPubMed
67.
Van der Linden V, Filho ELR, Lins OG, Van der Linden A, de Fátima Viana Vasco Aragão M, Brainer-Lima AM, et al. Congenital Zika syndrome with arthrogryposis: retrospective case series study. BMJ. 2016;354:i3899.CrossRefPubMedPubMedCentral
68.
69.
70.
•• Cao-Lormeau VM, Blake A, Mons S, Lastère S, Roche C, Vanhomwegen J, et al. Guillain-Barré syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet Lond Engl. 2016;387:1531–9. Case–control study linking ZIKV infection with Guillain-Barré syndrome.CrossRef
71.
Brasil P, Sequeira PC, Freitas AD, Zogbi HE, Calvet GA, de Souza RV, et al. Guillain-Barré syndrome associated with Zika virus infection. Lancet Lond Engl. 2016;387:1482.CrossRef
72.
Kassavetis P, Joseph J-MB, Francois R, Perloff MD, Berkowitz AL. Zika virus-associated Guillain-Barré syndrome variant in Haiti. Neurology. 2016;87:336–7.CrossRefPubMed
73.
Rozé B, Najioullah F, Fergé JL, Apetse K, Brouste Y, Cesaire R, et al. Zika virus detection in urine from patients with Guillain-Barré syndrome on Martinique, January 2016. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2016;21.
74.
•• Dirlikov E, Major CG, Mayshack M, Medina N, Matos D, Ryff KR, et al. Guillain-Barré syndrome during ongoing Zika virus transmission—Puerto Rico, January 1–July 31, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:910–4. Recent prospective Zika virus-Guillain Barré syndrome surveillance system from Puerto Rico.CrossRefPubMed
75.
76.
Styczynski AR, Malta J, Krow-Lucal E, Percio J, Nobrega M, Vargas A, et al. Guillain-Barré syndrome outbreak—Bahia State, Brazil, 2015. Epidemic Intell Serv Conf Atlanta Abstract. 2016.
77.
Mécharles S, Herrmann C, Poullain P, Tran TH, Deschamps N, Mathon G, et al. Acute myelitis due to Zika virus infection. Lancet Lond Engl. 2016;387:1481.CrossRef
78.
Carteaux G, Maquart M, Bedet A, Contou D, Brugières P, Fourati S, et al. Zika virus associated with meningoencephalitis. N Engl J Med. 2016;374:1595–6.CrossRefPubMed
79.
Rozé B, Najioullah F, Signate A, Apetse K, Brouste Y, Gourgoudou S, et al. Zika virus detection in cerebrospinal fluid from two patients with encephalopathy, Martinique, February 2016. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2016;21.
80.
81.
Ventura CV, Maia M, Ventura BV, Linden VVD, Araújo EB, Ramos RC, et al. Ophthalmological findings in infants with microcephaly and presumable intra-uterus Zika virus infection. Arq Bras Oftalmol. 2016;79:1–3.PubMed
82.
Ventura CV, Maia M, Bravo-Filho V, Góis AL, Belfort R. Zika virus in Brazil and macular atrophy in a child with microcephaly. Lancet Lond Engl. 2016;387:228.CrossRef
83.
De Paula Freitas B, De Oliveira Dias JR, Prazeres J, Sacramento GA, Ko AI, Maia M, et al. Ocular findings in infants with microcephaly associated with presumed Zika virus congenital infection in Salvador, Brazil. JAMA Ophthalmol. 2016. doi:10.​1001/​jamaopthalmol.​2016.​0267.
84.
Miranda HA, Costa MC, Frazão MAM, Simão N, Franchischini S, Moshfeghi DM. Expanded spectrum of congenital ocular findings in microcephaly with presumed Zika infection. Ophthalmology. 2016;123:1788–94.CrossRefPubMed
85.
Ventura CV, Maia M, Dias N, Ventura LO, Belfort R. Zika: neurological and ocular findings in infant without microcephaly. Lancet Lond Engl. 2016;387:2502.CrossRef
86.
Furtado JM, Espósito DL, Klein TM, Teixeira-Pinto T, da Fonseca BA. Uveitis associated with Zika virus infection. N Engl J Med. 2016;375:394–6.CrossRefPubMed
87.
88.
89.
•• Rabe IB, Staples JE, Villanueva J, Hummel KB, Johnson JA, Rose L, et al. Interim guidance for interpretation of Zika virus antibody test results. MMWR Morb Mortal Wkly Rep. 2016;65:543–6. Interpretation of ZIKV diagnostic tests.CrossRefPubMed
90.
91.
• Morrison C. DNA vaccines against Zika virus speed into clinical trials. Nat Rev Drug Discov. 2016;15:521–2. Vaccines for ZIKV disease have moved into clinical trials.CrossRefPubMed
92.
93.
Metadata
Title
Zika Virus Disease and Associated Neurologic Complications
Authors
Lindsey M. Duca
J. David Beckham
Kenneth L. Tyler
Daniel M. Pastula
Publication date
01-01-2017
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 1/2017
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0557-x

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