Sunday, March 6, 2016

Zika virus: scientists a step closer to establishing microcephaly link

lthough not a concrete link to microcephaly, study shows that Zika can infect cells similar to those involved in brain development and disrupt cell growth.




Scientists examining the link between the Zika virus and microcephaly in babies have discovered that the virus can infect cells similar to those involved in brain development.
Published in Stem Cell Stem the study, led by scientists at Johns Hopkins University and Florida State University, reveals that when lab-grown neuronal cells are exposed to the Zika virus, it infects the cells and is able to produce a large number of copies of itself. The researchers also found that the virus was able to disrupt pathways within the cells and limit their growth.



However, the scientists are quick to point out that their results do not prove that the mosquito-borne virus is leading to abnormal brain development of babies in the womb. “We don’t have the direct evidence to show that this will link the Zika virus to microcephaly,” said Dr Zhexing Wen, a co-author of the paper from Johns Hopkins University.
In order to probe the effect of the virus on neuronal cells, the scientists took human skin cells and “reprogrammed” them into pluripotent stem cells, which were then encouraged to grow into cells known as human cortical neural progenitor cells (human NPCs). These cells are similar to those that lead to the development of the cortex - the region of the brain that is typically underdeveloped in babies born with microcephaly.
The cells were then exposed to Zika virus. After 56 hours 65- 90% of the cells were infected with Zika; the virus was also found to be able to reproduce in large numbers within infected cells. What’s more, the Zika virus was found to interfere with cell processes and to increase cell death.
“This study hasn’t directly proved that the Zika virus causes microcephaly,” said Wen. “But it is telling that the human NPCs are very susceptible to the Zika virus and the Zika virus can cause the disruption of the human NPC growth and this may potentially correlate to the disrupted brain development in the foetus.”
While the Zika virus has previously been found to infect a range of human cells types, the latest study reveals that human NPCs showed a greater susceptibility to infection than some other cell types, including human embryonic stem cells. “We also want to know why the human NPCs are quite specific for the infection,” Wen adds.
There are, however, many more questions. “Maybe different strains of the Zika virus have different effects or maybe different people in different areas of the world may have a different response to the same Zika virus,” says Wen. But he believes the technique used by the team could help to provide answers. “We can test this out with the human NPC system,” he says.
Wen adds the team now want to use the human NPC system to screen for drugs that could prevent or eradicate infection by the Zika virus.
Responding to the paper, Prof Jonathan Ball from the University of Nottingham urges caution in interpreting the study’s findings. “There are still a number of unknowns,” he says. “It isn’t clear if the virus growing in the laboratory in these artificially generated nerve cells behaves the same way as it would in a human. We are complex organisms and lots of factors can affect how a virus infection pans out.”
However, he does believe the findings are a step towards probing the impact of Zika on the human body. “These are really interesting findings and go some way to understand how Zika virus might be causing the serious conditions that it is associated with,” he adds. “But we must remember, at the moment Zika and the link to microcephaly and Guillain-Barré [a neurological condition that can cause temporary paralysis] are only associations, and we need to know what is really happening in natural infection. Unfortunately we don’t have all of the tools to be able to do this work and the necessary experiments are tricky to do.”



Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, believes such in vitro research builds on a range of studies exploring the link between the Zika virus and microcephaly. “It’s all accumulating complementary evidence,” he says.
“It is important to understand and definitively prove - or not - the direct causal relationship between infections during pregnancy and microcephaly. As the weeks and months go by there is more and more evidence that is becoming almost compelling that there is a direct causal link,” he told the Guardian.
“I think it is reasonable to make the assumption that sooner or later we will find definitive proof that Zika is related to microcephaly,” he adds. “Then we have a compelling need to protect pregnant women and women of childbearing age who will become pregnant.”
While there is currently no vaccine available to combat the virus, Fauci says that several are under development, with phase one trials for the first vaccine scheduled to begin towards the end of the summer. “Barring any unforeseen glitches I would think we would start that in September,” he says. “By the end of 2016, early 2017 we will know if it is safe in normal people.” 
However finding out if it works could take time. “Everything is going to depend on the state of the epidemic because if [it] dies down it might take a couple of years to show that the vaccine works,” says Fauci. “If the epidemic is raging as it is now in early 2017, we may actually know whether it works by the end of 2017.”

Sunday, February 28, 2016

France records first sexually transmitted case of Zika in Europe

Europe’s first case of the sexually transmitted Zika virus has been recorded in France, where a woman has been infected after her partner returned from Brazil.
France’s minister for social affairs, health and women’s rights, Marisol Touraine, said the woman was not pregnant, therefore at low risk of any complications, and was recovering well.
Experts believe babies born to mothers infected with Zika while pregnant are susceptible to microcephaly, a congenital condition that causes abnormally small heads and hampers brain development.
Touraine, who was on a visit to French Guiana, said the case was recorded in the Paris area. “She showed classic signs of the disease,” an official said. “She was not hospitalised and is doing well.”
The World Health Organisation (WHO) says up to 46 countries have reported some level of evidence of Zika infection and that 130 countries are home to theAedes aegypti mosquito that carries the virus, meaning the eventual spread of the disease could be widespread and rapid.
Denmark, Germany and Britain have all reported cases of the disease in tourists returning from affected areas. Zika virus is not deemed a notifiable disease by the EU and so countries are not required to report cases to the European Centre for Disease Prevention and Control, so the accuracy of reporting of cases is variable.
The case in Paris is the first publicly reported case of transmission in Europe, where the spread of the disease is lessened because mosquitos are inactive in winter.
However, the WHO warned earlier this month that European nations should prepare for the possibility that the disease will spread in the warmer months.
“Every European country in which Aedes mosquitos are present can be at risk for the spread of Zika virus disease,” WHO Europe chief Zsuzsanna Jakab said a fortnight ago. “With the onset of spring and summer, the risk that Zika virus will spread increases.”
The mosquito that transmits the virus is not found in the UK, and Public Health England has said that if a person acquires Zika abroad and becomes ill on their return to Britain, any public health risk to the wider population is negligible.
A total of eight cases has been diagnosed in UK travellers since 2014 in tourists travelling from countries including Barbados, Colombia, Venezuela, Guyana and Mexico. Almost all cases of Zika are acquired via mosquito bites, and only a small number of cases have been recorded as sexually transmitted.
Brazil has been the hardest-hit country, with 1.5m cases of active Zika transmission.
There is currently no cure or vaccine against Zika and the majority of people infected have no symptoms. For those who do feel unwell, typical symptoms include fever, joint pain, red eyes or conjunctivitis, headaches and sometimes an itchy rash.

Monday, February 22, 2016

Brazil: Navy informs school kids how to avoid Zika virus

Sailors from the Brazilian Navy informed pupils of the Mariza de Azevedo Catarino primary school of the dangers of the Zika virus in the Sao Jaoao de Meriti neighbourhood of Rio de Janeiro on Saturday.

 The information campaign is part of a massive mobilisation of the Brazilian armed forces to combat the proliferation of the Zika virus. "Making children conscious of the Zika virus means they can bring that message home, they can share it with with parents, relatives and friends. This multiplies the impact of our campaign," explained Navy personnel Captain Cordeiro.

 

Zika virus: Brazilian scientists decipher its genome, agency says. (CNN)

(CNN)Brazilian scientists in Rio de Janeiro have obtained the genome sequence of the Zika virus and found the disease is indeed related to the incidence of microcephaly, which causes babies to be born with small heads and impaired cognition, that country's official news agency said Saturday.
The scientists were able to identify "the full order of the virus's genetic data, a significant step towards understanding how Zika behaves in the human body and how to develop a vaccine as well as new tests," Agencia Brasil reported.
The researchers at Federal University of Rio de Janeiro's molecular virology lab analyzed the virus taken from the amniotic fluid of pregnant women, and the scientists also isolated the virus in the brains of fetuses with microcephaly who died in Paraiba state in northeastern Brazil right after birth, the agency said.
"What we know now may help us understand why the virus has chosen children's brain cells over those of adults --the pregnant women," Professor Renato Santana told the outlet.
Brazil's Health Ministry believes the virus infected most of women who gave birth to babies with "microcephaly or changes in the central nervous system suggesting congenital infection," the agency said.

    Possibility of other malformations

    Brazilian scientists are also considering the possibility that the Zika virus may be capable of causing other types of malformation, the media report said.
    Meanwhile, Colombia has seen an increase in the number of Zika cases, which now number more than 37,000, health authorities there said Saturday.
    There are 6,356 pregnant women who are among the total number of Zika cases, now standing at 37,011, Colombia's National Institute of Health said in a statement.
    At least 30,148 cases have been confirmed through clinical and laboratory tests. Last week, there were 5,456 new reported cases, according to the Colombian NIH.
    The Brazilian Ministry of Health estimated that country's number of Zika cases as between 497,593 and almost 1.5 million, but that has ceased counting cases of the Zika virus, according to the World Health Organization.

    A problem around the world

    The U.S. Centers for Disease Control and Prevention now counts 27 countries or territories in South and North America with active transmission of the Zika virus. Zika has also been circulating in the Cape Verde islands off Africa and the Pacific islands of Samoa and Tonga.
    In January, the head of the World Health Organization recently said Zika virus was "spreading explosively" in the Americas, with another official estimating 3 million to 4 million infections in the region over a 12-month period.
    "The level of concern is high, as is the level of uncertainty," Dr. Margaret Chan, WHO's director-general, told her organization's executive board members then. "We need to get some answers quickly."

    Thursday, February 18, 2016

    Rate My Hospital Zika virus vaccine trials at least 18 months away , WHO says

    Experimental vaccines to protect against Zika virus are at least 18 months away from large-scale trials, an official with the World Health Organization said Friday.

    To date, about 15 companies or groups have expressed an interest in Zika vaccines and most have just started the work, Marie-Paule Kieny, WHO assistant director-general for health systems and innovation, told reporters.
    Concerns focus on pregnant women and those of childbearing age because of the suspected association between Zika virus infection and microcephaly or abnormally small heads. 
    Brazil has experienced a surge in microcephaly and an epidemic of Zika virus infections. Researchers are closely following pregnant women elsewhere in Latin America, as well as French Polynesia and Cape Verde.
    "In a few weeks or months we will see how many of these women will deliver a child with microcephaly and this will make things much clearer," Kieny said. 
    Studies are being carried out on medicines and other therapies that could prevent infection, as is done for malaria, Kieny said. "This seems for the moment a more viable and faster option than a curative treatment."
    Improved diagnostic tests are also critical. Kieny said new test kits were being developed and could be available in weeks.

    Better diagnostics

    Scientists who aim to better understand how infectious the virus is in bodily fluids also need better diagnostics. 
    The second report of Zika virus found in semen was published by British researchers in the May issue of Emerging Infectious Diseases. The man had symptoms in 2014 after returning from the Cook Islands, and his semen tested positive for the virus 62 days after his illness began. It's not clear if he would have been able to infect a sexual partner so long afterwards.  
    On Thursday, Venezuelan President Nicolas Maduro said at least three people in his country have died due to complications related to the mosquito-borne Zika virus. He added that 68 people have been hospitalized with complications confirmed to be related to the virus.
    Kieny said WHO hasn't received any primary information from Venezuela yet.
    "We haven't seen any report of death of adults directly linked to viral infection, so it could be that this is Guillain Barré in persons known to be infected with Zika virus," Kieny said. 
    In Guillain Barré, the nervous system is attacked and paralysis can result. In patients with the immune-associated disease, doctors treat the syndrome itself rather than Zika infection.
    Today WHO also suggested pregnant women "consider delaying travel" to Zika-affected areas.
    In the affected countries, mosquito control is paramount. For example, Jamaica's new public service announcement shows how to remove stagnant water where mosquitoes breed.
    WHO is also assessing new ways to reduce mosquito populations. 

    Zika virus and pregnancy: What women need to know !

    The rapidly spreading Zika virus and its suspected link to babies being born with abnormally small heads have understandably raised anxieties among pregnant women throughout the Americas.
    The virus, which is primarily spread to humans through the bites of infected mosquitoes, is actively spreading in over two dozen countries. In the continental U.S., there have been at least 79 cases of travel-acquired Zika reported and onesexually-transmitted case in Texas, according state and local health officials. There have been no reports yet of mosquitoes spreading the illness from person to person in the states.
    Symptoms of Zika include fever, joint pain, rash, and conjunctivitis, but 4 out of 5 people won't have any symptoms at all and may not know they're infected. The greatest risk appears to be to unborn babies whose mothers are infected during pregnancy. There is no vaccine for Zika and no specific treatment.
    Though U.S. health officials say they do not expect a large-scale Zika outbreak here, many pregnant women or women hoping to conceive in the near future are left with questions about what it could mean for the health and safety of their unborn children.
    Here's what pregnant women should know about Zika virus.
    What are the risks to pregnant women and their unborn children?
    Health officials say there's strong evidence to link Zika to a surge in cases of babies born in Brazil in recent months with abnormally small heads, a condition calledmicrocephaly, which can lead to mental retardation and other complications. Microcephaly can be caused by a number of other factors, including chromosomal abnormalities, decreased oxygen to the fetal brain, severe malnutrition, and fetal infections during pregnancy.

    reviously, Brazil saw about 150 cases of microcephaly each year. But since October, coinciding with the rise of Zika, the country has reported 5,079 suspected cases.
    On Wednesday, the Ministry of Health released updated numbers reporting 4,443 suspected and confirmed cases of microcephaly. Of that total, 508 cases have been confirmed, while 3,935 are still being investigated, according to officials.
    Last week, the ministry said 41 of the confirmed microcephaly cases were linked to Zika.
    Evidence supporting the link includes traces of Zika virus found in samples of blood and fetal tissue, including the brains of babies in Brazil who died of microcephaly.
    However, experts say more research needs to be done to prove cause and effect and further understand the connection.
    "There's a lot we don't know. Can we say every mother who has Zika virus will have a baby with microcephaly? No. We don't know why this baby gets microcephaly and that baby doesn't," Dr. Oluwatosin Goje, an Infectious Disease OB/GYN at the Cleveland Clinic, told CBS News. Indeed, many women in Brazil went on to have healthy babies despite the outbreak.
    Zika has also been linked to miscarriages. Last week, the CDC reported that two U.S. women who had contracted the virus while traveling abroad miscarried after returning home. Zika virus was found in their placentas.
    "With infections in general during pregnancy, there's a risk of miscarriage," Goje explained. "Other infections that can cause miscarriage include toxoplasmosis, rubella, and cytomegalovirus, and many times depending on how early the infection is contracted, some people may have a miscarriage. One of the things that researchers are studying is the suspicion that having contracted the Zika virus in the first trimester may be more detrimental compared to the second or third trimester, so that might explain the miscarriages in some people."
    What's the risk of travel to Zika-affected areas?
    The CDC has issued a travel advisory urging women who are pregnant or thinking of becoming pregnant to avoid travel to places where Zika is actively spreading.
    These areas include:
    • In Latin America: Bolivia, Brazil, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Suriname and Venezuela.
    • In the Caribbean: Barbados, Curacao, the Dominican Republic, Guadeloupe, Haiti, Jamaica, Martinique, St. Martin, Puerto Rico, the U.S. Virgin Islands.
    • Cape Verde, off the coast of western Africa.
    • American Samoa, Samoa and Tonga in the South Pacific.
    "We're not saying postpone travel indefinitely, but at least hold off on spring and summer travel plans to these areas until the CDC knows more about the virus," Goje said.
    If travel is necessary, health officials recommend taking extra precautions to avoid mosquito bites, including wearing long-sleeve shirts and long pants, staying indoors with air conditioning or protective screens, and using Environmental Protection Agency (EPA)-registered insect repellents, such as those containing DEET, Picaridin or a combination.
    What kind of testing is available in the U.S.?
    Goje said a handful of her own patients and many others referred to her by colleagues have recently travelled to areas where Zika is spreading. Among these women, anxieties are running high.
    "Most patients are concerned and they want to know more, especially about microcephaly," she said.
    A blood test is available for pregnant women who have recently traveled to Zika-affected areas, whether they are showing symptoms of illness or not. However, because there is no commercial diagnostic test available, all samples must go through the CDC and results can take weeks to come back.
    While the test can be administered at any point during pregnancy, it is best to see a doctor as soon as possible, as the virus clears the blood system in about a week.
    Pregnant women who think they may be infected and are experiencing symptoms like fever, joint pain, rash, and conjunctivitis should seek medical attention immediately.
    Goje said efforts are being made to make Zika testing more widely available at state level.
    As far as microcephaly, the condition can usually be picked up in an ultrasound between 18 and 20 weeks, Goje said, "but this isn't set in stone." Some cases may be missed this early on and won't be detected until the late second trimester or early third trimester. "So if a patient has traveled to an area where Zika transmission is ongoing, it's important to get an ultrasound between 18 and 20 weeks, but it's also important to get follow-up ultrasounds," Goje said.
    What should I know about Zika and sexual transmission?
    There have been several cases of Zika virus being transmitted through sexual contact with an infected person, including a case in Texas earlier this month.
    According to the CDC, Zika may be present in semen for up to 10 weeks after the onset of illness, but it is unknown if the virus can persist in semen for longer than that or if infected men who never develop symptoms can transmit Zika to their sex partners.
    Health officials recommend that pregnant women should abstain from sex with men who live in or have traveled to a Zika-affected area, or consistently and correctly use condoms to reduce the risk of sexual transmission.
    Men who have been in Zika-affected areas should also consider abstinence or condom use during sexual contact with non-pregnant partners, the CDC advises.
    Should women who want to get pregnant in the future be worried?
    According to the CDC, Zika virus normally clears from a person's bloodstream after about a week, and there is no evidence that it poses a risk of birth defects for future pregnancies.
    Women thinking about becoming pregnant now who have recently traveled to an area where Zika transmission is ongoing should consult with their doctor.
    Will Zika spread in the U.S.?
    To date, there have been no cases of local transmission of Zika virus by mosquitoes in the continental United States, but experts warn it could happen.
    The Aedes aegypti mosquito -- the species that spreads Zika -- is primarily found in southern states, so as more infected travelers return home, mosquitoes here could bite them, pick up the virus, and transmit it to others. The mosquitoes are active in a wider area of the country in warmer months, so the risk could increase in spring and summer.
    However, while experts say that some local transmission is probably inevitable, they do not anticipate widespread outbreaks here.

    "We have two things going for us. First, the mosquitoes are not present at all in most of the country and they're present in much lower numbers where they are present," CDC Director Dr. Thomas Frieden told "CBS Evening News."
    Experts say several other factors will help keep Zika at bay in the U.S., including less dense urban areas than South and Central America, access to air conditioning and protective screens, and overall better mosquito control.
    Still, as the weather warms and mosquitoes become more present, everyone can take steps to deter any outbreaks by eliminating standing water in places like uncovered containers and bottles, garbage cans, old tires, and flower pots, where mosquitoes like to breed, and by using insect repellent to reduce the risk of getting bitten.

    Zika virus: more than 5,000 pregnant women infected in Colombia

    More than 5,000 pregnant Colombian women have been infected with the Zika virus, the country’s health authority has said, as the outbreak continues to spread across the Americas.

    An epidemiology bulletin from Colombia’s national health institute said there were 31,555 cases of the mosquito-borne virus in the country, including 5,013 pregnant women. The virus is believed to be linked to a neurological birth defect known as microcephaly, in which babies are born with abnormally small heads and suffer incomplete brain development.
    At the end of January, the Colombian health minister, Alejandro Gaviria, reportedroughly 20,000 Zika infections, placing the country second only to Brazil in the severity of its outbreak. No figure for pregnant women was given at the time. 
    The World Health Organisation has said the virus is also suspected of being linked to the rare neurological disorder Guillain-Barré syndrome (GBS), in which the body’s immune system attacks part of the nervous system, causes gradual weakness in the legs, arms and upper body and sometimes leads to complete paralysis.
    The WHO said in a weekly report published on Saturday: “In the context of the Zika virus outbreak, Brazil, Colombia, El Salvador, Suriname and Venezuela have reported an increase of GBS.”
    It added: “The cause of the increase in GBS incidence observed in Brazil, Colombia, El Salvador and Suriname remains unknown, especially as dengue, chikungunya and Zika virus have all been circulating simultaneously in theAmericas.”
    Investigations continued to determine the cause, the WHO said, noting that there was no laboratory confirmation of Zika virus in patients with GBS in Colombiaand El Salvador.
    WHO officials said it was now critical to stop the spread of Zika.
    “There are concerns that the Zika virus may spread globally to environments where mosquitoes can live and breed,” the organisation said.
    The outbreak has already been declared a public health emergency of international concern, with US and UK health authorities warning pregnant women to avoid travelling to affected areas. All aircraft returning to the UK from affected countries are being sprayed with insecticide.
    Around 220,000 soldiers were deployed across Brazil on Saturday in a massivecampaign to raise awareness of the virus and offer advice on how to eliminate theAedes aegypti mosquito that spreads it.
    It has yet to be proven that Zika is linked to microcephaly or Guillain-Barré syndrome, but evidence is stacking up. Venezuela had reported 252 cases of Guillain-Barré occurring at the same time and place as Zika infections, the WHO said.
    “Zika virus infection was confirmed for three of the GBS cases, including one fatal case,” it said.
    Venezuela’s president, Nicolas Maduro, said on Thursday that three people had died of complications linked to the Zika virus and that suspected cases of Zika had risen to 5,221.
    Even in the best of settings, 3-5% of Guillain-Barré patients die from complications, which can include paralysis of the muscles that control breathing, blood infection, lung clots or cardiac arrest, according to the WHO.
    In French Polynesia, all 42 Guillain-Barré cases identified during the Zika virus outbreak in 2013-14 tested positive for dengue and Zika virus infection.