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Zika Full Fetal Brain Seq Washington DC ex-Guatemala


niman

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LOCUS       KU870645               10798 bp    RNA     linear   VRL 22-MAR-2016
DEFINITION  Zika virus isolate FB-GWUH-2016, complete genome.
ACCESSION   KU870645
VERSION     KU870645.1  GI:1006593136
KEYWORDS    .
SOURCE      Zika virus
  ORGANISM  Zika virus
            Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA
            stage; Flaviviridae; Flavivirus.
REFERENCE   1  (bases 1 to 10798)
  AUTHORS   Driggers,R.W., Ho,C.-Y., Korhonen,E.M., Kuivanen,S.,
            Jaaskelainen,A.J., Smura,T., Rosenberg,A., Hill,A., DeBiasi,R.,
            Vezina,G., Timofeev,J., Rodriguez,F.J., Levanov,L., Razak,J.,
            Iyengar,P., Hennenfent,A., Kennedy,R., Lanciotti,R., du Plessis,A.
            and Vapalahti,O.
  TITLE     Zika virus infection with prolonged maternal viremia and fetal
            brain abnormalities
  JOURNAL   Unpublished
REFERENCE   2  (bases 1 to 10798)
  AUTHORS   Smura,T., Korhonen,E., Kuivanen,S. and Vapalahti,O.
  TITLE     Direct Submission
  JOURNAL   Submitted (05-MAR-2016) Department of Virology, University of
            Helsinki, Haartmaninkatu 3, Helsinki 00280, Finland
FEATURES             Location/Qualifiers
     source          1..10798
                     /organism="Zika virus"
                     /mol_type="genomic RNA"
                     /isolate="FB-GWUH-2016"
                     /isolation_source="fetal brain"
                     /host="Homo sapiens"
                     /db_xref="taxon:64320"
                     /country="USA"
                     /collection_date="02-Feb-2016"
                     /note="putative country of infection: Guatemala;
                     passage details: SK-N-SH"
     CDS             100..10371
                     /note="contains structural and non-structural proteins"
                     /codon_start=1
                     /product="polyprotein"
                     /protein_id="AMQ48986.1"
                     /db_xref="GI:1006593137"
                     /translation="MKNPKKKSGGFRIVNMLKRGVARVSPFGGLKRLPAGLLLGHGPI
                     RMVLAILAFLRFTAIKPSLGLINRWGSVGKKEAMEIIKKFKKDLAAMLRIINARKEKK
                     RRGADTSVGIVGLLLTTAMAAEVTRRGSAYYMYLDRNDAGEAISFPTTLGMNKCYIQI
                     MDLGHMCDATMSYECPMLDEGVEPDDVDCWCNTTSTWVVYGTCHHKKGEARRSRRAVT
                     LPSHSTRKLQTRSQTWLESREYTKHLIRVENWILRNPGFALAAAAIAWLLGSSTSQKV
                     IYLVMILLIAPAYSIRCIGVSNRDFVEGMSGGTWVDVVLEHGGCVTVMAQDKPTVDIE
                     LVTTTVSNMAEVRSYCYEASISDMASDSRCPTQGEAYLDKQSDTQYVCKRTLVDRGWG
                     NGCGLFGKGSLVTCAKFACSKKMTGKSIQPENLEYRIMLSVHGSQHSGMIVNDTGHET
                     DENRAKVEITPNSPRAEATLGGFGSLGLDCEPRTGLDFSDLYYLTMNNKHWLVHKEWF
                     HDIPLPWHAGADTGTPHWNNKEALVEFKDAHAKRQTVVVLGSQEGAVHTALAGALEAE
                     MDGAKGRLSSGHLKCRLKMDKLRLKGVSYSLCTAAFTFTKIPAETLHGTVTVEVQYAG
                     TDGPCKVPAQMAVDMQTLTPVGRLITANPVITESTENSKMMLELDPPFGDSYIVIGIG
                     EKKITHHWHRSGSTIGKAFEATVRGAKRMAVLGDTAWDFGSVGGALNSLGKGIHQIFG
                     AAFKSLFGGMSWFSQILIGTLLMWLGLNTKNGSISLMCLALGGVLIFLSTAVSADVGC
                     SVDFSKKETRCGTGVFVYNDVEAWRDRYKYHPDSPRRLAAAVKQAWEDGICGISSVSR
                     MENIMWRSVEGELNAILEENGVQLTVVVGSVKNPMWRAPQRLPVPVNELPHGWKAWGK
                     SYFVRAAKTNNSFVVDGDTLKECPLKHRAWNSFLVEDHGFGVFHTSVWLKVREDYSLE
                     CDPAVIGTAVKGKEAVHSDLGYWIESEKNDTWRLKRAHLIEMKTCEWPQSHTLWTDGI
                     EESDLIIPKSLAGPLSHHNTREGYRTQMKGPWHSEELEIRFEECPGTKVHVEETCGTR
                     GPSLRSTTASGRVIEEWCCRECTMPPLSFRAKDGCWYGMEIRPRKEPESNLVRSMVTA
                     GSTDHMDHFSLGVLVILLMVQEGLKKRMTTKIIISTSMAVLVAMILGGFSMSDLAKLA
                     ILMGATFAEMNTGGDVAHLALIAAFKVRPALLVSFIFRANWTPRESMLLALASCLLQT
                     AISALEGDLMVLINGFALAWLAIRAMVVPRTDNITLAILAALTPLARGTLLVAWRAGL
                     ATCGGFMLLSLKGKGSVKKNLPFVMALGLTAVRLVDPINVVGLLLLTRSGKRSWPPSE
                     VLTAVGLICALAGGFAKADIEMAGPVAAVGLLIVSYVVSGKSVDMYIERAGDITWEKD
                     AEVTGNSPRLDVALDESGDFSLVEDDGPPMREIILKVVLMTICGMNPIAIPFAAGAWY
                     VYVKTGKRSGALWDVPAPKEVKKGETTDGVYRVMTRRLLGSTQVGVGVMQEGVFHTMW
                     HVTKGSALRSGEGRLDPYWGDVKQDLVSYCGPWKLDAAWDGHSEVQLLAVPPGERARN
                     IQTLPGIFKTKDGDIGAVALDYPAGTSGSPILDKCGRVIGLYGNGVVIKNGSYVSAIT
                     QGRREEETPVECFEPSMLKKKQLTVLDLHPGAGKTRRVLPEIVREAIKTRLRTVILAP
                     TRVVAAEMEEALRGLPVRYMTTAVNVTHSGTEIVDLMCHATFTSRLLQPIRVPNYNLY
                     IMDEAHFTDPSSIAARGYISTRVEMGEAAAIFMTATPPGTRDAFPDSNSPIMDTEVEV
                     PERAWSSGFDWVTDHSGKTVWFVPSVRNGNEIAACLTKAGKRVIQLSRKTFETEFQKT
                     KHQEWDFVVTTDISEMGANFKADRVIDSRRCLKPVILDGERVILAGPMPVTHASAAQR
                     RGRIGRNPNKPGDEYLYGGGCAETDEDHAHWLEARMLLDNIYLQDGLIASLYRPEADK
                     VAAIEGEFKLRTEQRKTFVELMKRGDLPVWLAYQVASAGITYTDRRWCFDGATNNTIL
                     EDSVPAEVWTRHGEKRVLKPRWMDARVCSDHAALKSFKEFAAGKRGAAFGVMEALGTL
                     PGHMTERFQEAIDNLAVLMRAETGSRPYKAAAAQLPETLETIMLLGLLGTVSLGIFFV
                     LMRNKGIGKMGFGMVTLGASAWLMWLSEIEPARIACVLIVVFLLLVVLIPEPEKQRSP
                     QDNQMAIIIMVAVGLLGLITANELGWLERTKSDLSHLMGRREEGATIGFSMDIDLRPA
                     SAWAIYAALTTFITPAVQHAVTTSYNNYSLMAMATQAGVLFGMGKGMPFYAWDFGVPL
                     LMIGCYSQLTPLTLIVAIILLVAHYMYLIPGLQAAAARAAQKRTAAGIMKNPVVDGIV
                     VTDIDTMTIDPQVEKKMGQVLLIAVAVSSAILSRTAWGWGEAGALITAATSTLWEGSP
                     NKYWNSSTATSLCNIFRGSYLAGASLIYTVTRNAGLVKRRGGGTGETLGEKWKARLNQ
                     MSALEFYSYKKSGITEVCREEARRALKDGVATGGHAVSRGSAKLRWLVERGYLQPYGK
                     VIDLGCGRGGWSYYAATIRKVQEVKGYTKGGPGHEEPVLVQSYGWNIVRLKSGVDVFH
                     MAAEPCDTLLCDIGESSSSPEVEETRTLRVLSMVGDWLEKRPGAFCIKVLCPYTSTMM
                     ETLERLQRRYGGGLVRVPLSRNSTHEMYWVSGAKSNTIKSVSTTSQLLLGRMDGPRRP
                     VKYEEDVNLGSGTRAVVSCAEAPNMKIIGNRIERIRSEHAETWFFDENHPYRTWAYHG
                     SYEAPTQGSASSLINGVVRLLSKPWDVVTGVTGIAMTDTTPYGQQRVFKEKVDTRVPD
                     PQEGTRQVMSMVSSWLWKELGKHKRPRVCTKEEFINKVRSNAALGAIFEEEKEWKTAV
                     EAVNDPRFWALVDKEREHHLRGECQSCVYNMMGKREKKQGEFGKAKGSRAIWYMWLGA
                     RFLEFEALGFLNEDHWMGRENSGGGVEGLGLQRLGYVLEEMSCIPGGRMYADDTAGWD
                     TRISRFDLENEALITNQMEKGHRALALAIIKYTYQNKVVKVLRPAEKGKTVMDIISRQ
                     DQRGSGQVVTYALNTFTNLVVQLIRNMEAEEVLEMQDLWLLRRSEKVTNWLQSNGWDR
                     LKRMAVSGDDCVVKPIDDRFAHALRFLNDMGKVRKDTQEWKPSTGWDNWEEVPFCSHH
                     FNKLHLKDGRSIVVPCRHQDELIGRARVSPGAGWSIRETACLAKSYAQMWQLLYFHRR
                     DLRLMANAICSSVPVDWVPTGRTTWSIHGKGEWMTTEDMLVVWNRVWIEENDHMEDKT
                     PVTKWTDIPYLGKREDLWCGSLIGHRPRTTWAENIKNTVNMVRRIIGDEEKYMDYLST
                     QVRYLGEEGSTPGVL"
ORIGIN      
        1 ctgtgtgtga atcagactgc gacagttcga gtttgaagcg aaagctagca acagtatcaa
       61 caggttttat tttggatttg gaaacgagag tttctggtca tgaaaaaccc aaaaaagaaa
      121 tccggaggat tccggattgt caatatgcta aaacgcggag tagcccgtgt gagccccttt
      181 gggggcttga agaggctgcc agccggactt ctgctgggtc atgggcccat caggatggtc
      241 ttggcgattc tagccttttt gagattcacg gcaatcaagc catcactggg tctcatcaat
      301 agatggggtt cagtggggaa aaaagaggct atggaaataa taaagaagtt caagaaagat
      361 ctggctgcca tgttgagaat aatcaatgct aggaaggaga agaagagacg aggcgcagat
      421 actagtgtcg gaattgttgg cctcctgctg accacagcta tggcagcgga ggtcactaga
      481 cgtgggagtg catactatat gtacttggac agaaacgatg ctggggaggc catatctttt
      541 ccaaccacat tggggatgaa taagtgttat atacagatca tggatcttgg acacatgtgt
      601 gatgccacca tgagctatga gtgccctatg ctggatgagg gggtggaacc agatgacgtc
      661 gattgttggt gcaacacgac gtcaacttgg gttgtgtacg gaacctgcca tcacaaaaaa
      721 ggtgaagcac ggagatctag aagagctgtg acgctcccct cccattccac taggaagctg
      781 caaacgcggt cgcaaacctg gttggaatca agagaataca caaagcactt gattagagtc
      841 gaaaattgga tactcaggaa ccctggcttc gcgttagcag cagctgccat cgcttggctt
      901 ttgggaagct caacgagcca aaaagtcata tatttggtca tgatactgct gattgccccg
      961 gcatacagca tcaggtgcat aggagtcagc aatagggact ttgtggaagg tatgtcaggt
     1021 gggacttggg ttgatgttgt cttggaacat ggaggttgtg tcaccgtaat ggcacaggac
     1081 aaaccgactg tcgacataga gctggttaca acaacagtca gcaacatggc ggaggtaaga
     1141 tcctactgct atgaggcatc aatatcagac atggcttcgg acagccgctg cccaacacaa
     1201 ggtgaagcct accttgacaa gcaatcagac actcaatatg tctgcaaaag aacgttagtg
     1261 gacagaggct ggggaaatgg atgtggactt tttggcaaag ggagcctggt gacatgcgct
     1321 aagtttgcat gctccaagaa aatgaccggg aagagcatcc agccagagaa tctggagtac
     1381 cggataatgc tgtcagttca tggctcccag cacagtggga tgatcgttaa tgacacagga
     1441 catgaaactg atgagaatag agcgaaggtt gagataacgc ccaattcacc aagagccgaa
     1501 gccaccctgg ggggttttgg aagcctagga cttgattgtg aaccgaggac aggccttgac
     1561 ttttcagatt tgtattactt gactatgaat aacaagcact ggttggttca caaggagtgg
     1621 ttccacgaca ttccattacc ttggcacgct ggggcagaca ccggaactcc acactggaac
     1681 aacaaagaag cactggtaga gttcaaggac gcacatgcca aaaggcaaac tgtcgtggtt
     1741 ctagggagtc aagaaggagc agttcacacg gcccttgctg gagctctgga ggctgagatg
     1801 gatggtgcaa agggaaggct gtcctctggc cacttgaaat gtcgcctgaa aatggataaa
     1861 ctcagattga agggcgtgtc atactccttg tgtaccgcag cgttcacatt caccaagatc
     1921 ccggctgaaa cactgcacgg gacagtcaca gtggaggtac agtacgcagg gacagatgga
     1981 ccttgcaagg ttccagctca gatggcggtg gacatgcaaa ctctgacccc agttgggagg
     2041 ttgataaccg ctaaccccgt aatcactgaa agcactgaga actctaagat gatgctggaa
     2101 cttgatccac catttgggga ctcttacatt gtcataggaa tcggggagaa gaagatcacc
     2161 caccactggc acaggagtgg cagcaccatt ggaaaagcat ttgaagccac tgtgagaggt
     2221 gccaagagaa tggcagtctt gggagacaca gcctgggact ttggatcagt tggaggcgct
     2281 ctcaactcat tgggcaaggg catccatcaa atttttggag cagctttcaa atcattgttt
     2341 ggaggaatgt cctggttctc acaaattctc attggaacgt tgctgatgtg gttgggtctg
     2401 aacacaaaga atggatctat ttcccttatg tgcttggcct tagggggagt gttgatcttc
     2461 ttatccacag ccgtctctgc tgatgtgggg tgctcggtgg acttctcaaa gaaggagacg
     2521 agatgcggta caggggtgtt cgtctataac gacgttgaag cctggaggga caggtacaag
     2581 taccatcctg actccccccg tagattggca gcagcagtca agcaagcctg ggaagatggt
     2641 atctgcggga tctcctctgt ttcaagaatg gaaaacatca tgtggagatc agtagaaggg
     2701 gagctcaacg caatcctgga agagaatgga gttcaactga cggtcgttgt gggatctgta
     2761 aaaaacccca tgtggagagc tccacagaga ttgcccgtgc ctgtgaacga gctgccccac
     2821 ggctggaagg cttgggggaa atcgtacttc gtcagagcag caaagacaaa taacagcttt
     2881 gtcgtggatg gtgacacact gaaggaatgc ccactcaaac atagagcatg gaacagcttt
     2941 cttgtggagg atcatgggtt cggggtattt cacactagtg tctggctcaa ggttagagaa
     3001 gattattcat tagagtgtga tccagccgtt attggaacag ctgttaaggg aaaggaggct
     3061 gtacacagtg atctaggcta ctggattgag agtgagaaga atgacacatg gaggctgaag
     3121 agggcccatc tgatcgagat gaaaacatgt gaatggccac agtcccacac attgtggaca
     3181 gatggaatag aagagagtga tctgatcata cccaagtctt tagctgggcc actcagccat
     3241 cacaatacca gagagggcta caggacccaa atgaaagggc catggcacag tgaagagctt
     3301 gaaattcggt ttgaggaatg cccaggcact aaggtccacg tggaggaaac atgtggaaca
     3361 agaggaccat ctctgagatc aaccactgca agcggaaggg tgatcgagga atggtgctgc
     3421 agggagtgca caatgccccc actgtcgttc cgggctaaag atggctgttg gtatggaatg
     3481 gagataaggc ccaggaaaga accagaaagc aacttagtaa ggtcaatggt gactgcagga
     3541 tcaactgatc acatggatca cttctccctt ggagtgcttg tgattctgct catggtgcag
     3601 gaagggctaa agaagagaat gaccacaaag atcatcataa gcacatcaat ggcagtgctg
     3661 gtagctatga tcctgggagg attttcaatg agtgacctgg ctaagcttgc aattttgatg
     3721 ggtgccacct tcgcggaaat gaacactgga ggagatgtag ctcatctggc gctgatagcg
     3781 gcattcaaag tcagaccagc gttgctggta tctttcatct tcagagctaa ttggacaccc
     3841 cgtgaaagca tgctactggc cttggcctcg tgtcttttgc aaactgcgat ctccgccttg
     3901 gaaggcgacc tgatggttct catcaatggt tttgctttgg cctggttggc aatacgagcg
     3961 atggttgttc cacgcactga taacatcacc ttggcaatcc tggctgctct gacaccactg
     4021 gcccggggca cactgcttgt ggcgtggaga gcaggccttg ctacttgcgg ggggtttatg
     4081 ctcctctctc tgaagggaaa aggcagtgtg aagaagaact taccatttgt catggccctg
     4141 ggactaaccg ctgtgaggct ggtcgacccc atcaacgtgg tgggactgct gttgctcaca
     4201 aggagtggga agcggagctg gccccctagc gaagtactca cagctgttgg cctgatatgc
     4261 gcattggctg gagggttcgc caaggcagat atagagatgg ctgggcccgt ggccgcggtc
     4321 ggtctgctaa ttgtcagtta cgtggtctca ggaaagagtg tggacatgta cattgaaaga
     4381 gcaggtgaca tcacatggga aaaagatgcg gaagtcactg gaaacagtcc ccggctcgat
     4441 gtggcgctag atgagagtgg tgatttctcc ctggtggagg atgacggtcc ccccatgaga
     4501 gagatcatac tcaaggtggt cctgatgacc atctgtggca tgaacccaat agccataccc
     4561 tttgcagctg gagcgtggta cgtatacgtg aagactggaa aaaggagtgg tgctctatgg
     4621 gatgtgcctg ctcccaagga agtaaaaaag ggggagacca cagatggagt gtacagagta
     4681 atgactcgta gactgctagg ttcaacacaa gttggagtgg gagttatgca agagggggtc
     4741 tttcacacta tgtggcacgt cacaaaagga tccgcactga gaagcggtga agggagactt
     4801 gatccatact ggggagatgt caagcaggat ctggtgtcat actgtggtcc atggaagcta
     4861 gatgccgcct gggacgggca cagcgaggtg cagctcttgg ccgtgccccc cggagagaga
     4921 gcgaggaaca tccagactct gcccggaata tttaagacaa aggatgggga cattggagcg
     4981 gttgcgctgg attacccagc aggaacttca ggatctccaa tcctagacaa gtgtgggaga
     5041 gtgataggac tttatggcaa tggggtcgtg atcaaaaatg ggagttatgt tagtgccatc
     5101 acccaaggga ggagggagga agagactcct gttgagtgct tcgagccttc gatgctgaag
     5161 aagaagcagc taactgtctt agacttacat cctggagctg ggaaaaccag gagagttctt
     5221 cctgaaatag tccgtgaagc cataaaaaca agactccgta ctgtgatctt agctccaacc
     5281 agggttgtcg ctgctgaaat ggaggaggcc cttagagggc ttccagtgcg ttatatgaca
     5341 acagcagtca atgtcaccca ctctggaaca gaaatcgtcg acttaatgtg ccatgccacc
     5401 ttcacttcac gtctactaca gccaatcaga gtccccaact ataatctgta tattatggat
     5461 gaggcccact tcacagatcc ctcaagtata gcagcaagag gatacatttc aacaagggtt
     5521 gagatgggcg aggcggctgc catcttcatg accgccacgc caccaggaac ccgtgacgca
     5581 tttccggact ccaactcacc aattatggac accgaagtgg aagtcccaga gagagcctgg
     5641 agctcaggct ttgattgggt gacggatcat tctggaaaaa cagtttggtt tgttccaagc
     5701 gtgaggaacg gcaatgagat cgcagcttgt ctgacaaagg ctggaaaacg ggtcatacag
     5761 ctcagcagaa agacttttga gacagagttc cagaaaacaa aacatcaaga gtgggacttt
     5821 gtcgtgacaa ctgacatttc agagatgggc gccaacttta aagctgaccg tgtcatagat
     5881 tccaggagat gcctaaagcc ggtcatactt gatggcgaga gagtcattct ggctggaccc
     5941 atgcctgtca cacatgccag cgctgctcag aggagggggc gcataggcag gaatcccaac
     6001 aaacctggag atgagtatct gtatggaggt gggtgcgcag agactgacga agaccatgca
     6061 cactggcttg aagcaagaat gctccttgac aatatttacc tccaagatgg cctcatagcc
     6121 tcgctctatc gacctgaggc cgacaaagta gcagccattg agggagagtt caagcttagg
     6181 acggagcaaa ggaagacctt tgtggaactc atgaaaagag gagatcttcc tgtttggctg
     6241 gcctatcagg ttgcatctgc cggaataacc tacacagata gaagatggtg ctttgatggc
     6301 gcgaccaaca acaccatact ggaagacagt gtgccggcag aggtgtggac cagacacgga
     6361 gagaaaagag tgctcaaacc gaggtggatg gacgccagag tttgttcaga tcatgcggcc
     6421 ctgaagtcat tcaaggagtt tgccgctggg aagagaggag cggcttttgg agtgatggaa
     6481 gccctgggaa cactgccagg acacatgaca gagagattcc aggaagccat tgacaacctc
     6541 gctgtgctca tgcgggcaga gactggaagc aggccttaca aagccgcggc ggcccaattg
     6601 ccggagaccc tagagaccat tatgcttttg gggttgctgg gaacagtctc gctgggaatc
     6661 tttttcgtct tgatgaggaa caagggcata gggaagatgg gctttggaat ggtgaccctt
     6721 ggggccagtg catggctcat gtggctctcg gaaattgagc cagccagaat tgcatgtgtc
     6781 ctcattgttg tgttcctatt gctggtggtg ctcatacctg agccagaaaa gcaaagatct
     6841 ccccaggaca accaaatggc aatcatcatc atggtagcag taggtcttct gggcttgatt
     6901 accgccaatg aactcggatg gttggagaga acaaagagtg acctaagcca tctaatggga
     6961 aggagagagg agggggcaac cataggattc tcaatggaca ttgacctgcg gccagcctca
     7021 gcttgggcca tctatgctgc cttgacaact ttcattaccc cagccgtcca acatgcagtg
     7081 accacttcat acaacaacta ctccttaatg gcgatggcca cgcaagctgg agtgttgttt
     7141 ggtatgggca aagggatgcc attctacgca tgggactttg gagtcccgct gctaatgata
     7201 ggttgctact cacaattaac acccctgacc ctaatagtgg ccatcatttt gctcgtggcg
     7261 cactacatgt acttgatccc agggctgcag gcagcagctg cgcgtgctgc ccagaagaga
     7321 acggcagctg gcatcatgaa gaaccctgtt gtggatggaa tagtggtgac tgacattgac
     7381 acaatgacaa ttgaccccca agtggagaaa aagatgggac aggtgctact catagcagta
     7441 gccgtctcca gcgccatact gtcgcggacc gcctgggggt ggggggaggc tggggccctg
     7501 atcacagccg caacttccac tttgtgggaa ggctctccga acaagtactg gaactcctct
     7561 acagccactt cactgtgtaa catttttagg ggaagttact tggctggagc ttctctaatc
     7621 tacacagtaa caagaaacgc tggcttggtc aagagacgtg ggggtggaac aggagagacc
     7681 ctgggagaga aatggaaggc ccgcttgaac cagatgtcgg ccctggagtt ctactcctac
     7741 aaaaagtcag gcatcaccga ggtgtgcaga gaagaggctc gccgcgccct caaggacggt
     7801 gtggcaacgg gaggccatgc tgtgtcccga ggaagtgcaa agctgagatg gttggtggag
     7861 cggggatacc tgcagcccta tggaaaggtc attgatcttg gatgtggcag agggggctgg
     7921 agttactacg ccgccaccat ccgcaaagtt caagaagtga aaggatacac aaaaggaggc
     7981 cctggtcatg aagaacccgt gttggtgcaa agctatgggt ggaacatagt ccgtcttaag
     8041 agtggggtgg acgtctttca tatggcggct gagccgtgtg acacgttgct gtgtgacata
     8101 ggtgagtcat catctagtcc tgaagtggaa gaaacacgga cgctcagagt cctctccatg
     8161 gtgggggatt ggcttgaaaa aagaccagga gccttttgta taaaagtgtt gtgcccatac
     8221 accagcacta tgatggaaac cctggagcga ctgcagcgta ggtatggggg aggactggtc
     8281 agagtgccac tctcccgcaa ctctacacat gagatgtact gggtctctgg agcgaaaagc
     8341 aacaccataa aaagtgtgtc caccacgagc cagctcctct tggggcgcat ggacgggcct
     8401 aggaggccag tgaaatatga ggaggatgtg aatctcggct ctggcacgcg ggctgtggta
     8461 agctgcgctg aagctcccaa catgaagatc attggtaacc gcattgaaag gatccgcagt
     8521 gagcacgcgg aaacgtggtt ctttgacgag aaccacccat ataggacatg ggcttaccat
     8581 ggaagctatg aggcccccac acaagggtca gcgtcctctc taataaacgg ggttgtcagg
     8641 ctcctgtcaa aaccctggga tgtggtgact ggagtcacag gaatagctat gaccgacacc
     8701 acaccgtatg gtcagcaaag agttttcaag gaaaaagtgg acactagggt gccagacccc
     8761 caagaaggca ctcgtcaggt tatgagcatg gtctcttcct ggttgtggaa agagctaggc
     8821 aaacacaaac ggccacgagt ctgtaccaaa gaagagttca tcaacaaggt tcgtagcaat
     8881 gcagcattag gggcaatatt tgaagaggaa aaagagtgga agactgcagt ggaagctgtg
     8941 aacgatccaa ggttctgggc tctagtggac aaggaaagag agcaccacct gagaggagag
     9001 tgccagagtt gtgtgtacaa catgatggga aaaagagaaa agaaacaagg ggaatttgga
     9061 aaggccaagg gcagccgcgc catctggtat atgtggctag gggctagatt tctagagttc
     9121 gaagcccttg gattcttgaa cgaggatcac tggatgggga gagagaactc aggaggtggt
     9181 gttgaagggc tgggattaca aagactcgga tatgtcctag aagagatgag ttgcatacca
     9241 ggaggaagga tgtatgcaga tgacactgct ggctgggaca cccgcatcag caggtttgat
     9301 ctggagaatg aagctctaat caccaaccaa atggagaaag ggcacagggc cttggcattg
     9361 gccataatca agtacacata ccaaaacaaa gtggtaaagg tccttagacc agctgaaaaa
     9421 gggaaaacag ttatggacat tatttcgaga caagaccaaa gggggagcgg acaagttgtc
     9481 acttacgctc ttaacacatt taccaaccta gtggtgcaac tcattcggaa tatggaggct
     9541 gaggaagttc tagagatgca agacttgtgg ctgctgcgga ggtcagagaa agtgaccaac
     9601 tggttgcaga gcaacggatg ggataggctc aaacgaatgg cagtcagtgg agatgattgc
     9661 gttgtgaagc caattgatga taggtttgca catgccctca ggttcttgaa tgatatggga
     9721 aaagttagga aggacacaca agagtggaaa ccctcaactg gatgggacaa ctgggaagaa
     9781 gttccgtttt gctcccacca cttcaacaag ctccatctca aggacgggag gtccattgtg
     9841 gttccctgcc gccaccaaga tgaactgatt ggccgggccc gcgtctctcc aggggcggga
     9901 tggagcatcc gggagactgc ttgcctagca aaatcatatg cgcaaatgtg gcagctcctt
     9961 tatttccaca gaagggacct ccgactgatg gccaatgcca tttgttcatc tgtgccagtt
    10021 gactgggttc caactgggag aactacctgg tcaatccatg gaaagggaga atggatgacc
    10081 actgaagaca tgcttgtggt gtggaacaga gtgtggattg aggagaacga ccacatggaa
    10141 gacaagaccc cagttacgaa atggacagac attccctatt tgggaaaaag ggaagacttg
    10201 tggtgtggat ctctcatagg gcacagaccg cgcaccacct gggctgagaa cattaaaaac
    10261 acagtcaaca tggtgcgcag gatcataggt gatgaagaaa agtacatgga ctacctatcc
    10321 acccaagttc gctacttggg tgaagaaggg tctacacctg gagtgctgta agcaccaatc
    10381 ttaatgttgt caggcctgct agtcagccac agcttgggga aagctgtgca gcctgtgacc
    10441 cccccaggag aagctgggaa accaagccta tagtcaggcc gagaacgcca tggcacggaa
    10501 gaagccatgc tgcctgtgag cccctcagag gacactgagt caaaaaaccc cacgcgcttg
    10561 gaggcgcagg atgggaaaag aaggtggcga ccttccccac ccttcaatct ggggcctgaa
    10621 ctggagatca gctgtggatc tccagaagag ggactagtgg ttagaggaga ccccccggaa
    10681 aacgcaaaac agcatattga cgctgggaaa gaccagagac tccatgagtt tccaccacgc
    10741 tggccgccag gcacagatcg ccgaatagcg gcggccggtg tggggaaatc catgcagc
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Sequences producing significant alignments:

Select:AllNone Selected:0

Sequences producing significant alignments:
Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccession
1842018420100%0.099%KU501217.1
1841718417100%0.099%KU501216.1
1837518375100%0.099%KU509998.1
1837218372100%0.099%KJ776791.1
1836318363100%0.099%KU707826.1
1836318363100%0.099%KU365779.1
1836318363100%0.099%KU321639.1
1835718357100%0.099%KU926309.1
1835418354100%0.099%KU729218.1
1834818348100%0.099%KU365780.1
1834518345100%0.099%KU365777.1
1833618336100%0.099%KU647676.1
1833018330100%0.099%KU365778.1
1833018330100%0.099%KU312312.1
1832718327100%0.099%KU729217.2
183271832799%0.099%KU497555.1
1832718327100%0.099%KU527068.1
1832118321100%0.099%KU820897.1
1832118321100%0.099%KU501215.1
1831818318100%0.099%KU922960.1
1831218312100%0.099%KU926310.1
1831218312100%0.099%KU922923.1
1830318303100%0.099%KU820898.1
1830318303100%0.099%KU853013.1
1830318303100%0.099%KU853012.1
1829418294100%0.099%KU740184.2
1829418294100%0.099%KU761564.1
1826718267100%0.099%KU820899.2
1815918159100%0.099%KU866423.1
1813718137100%0.099%KU744693.1
1802918029100%0.099%KU681081.3
177301773099%0.098%JN860885.1
176761767698%0.099%KF993678.1
1756717567100%0.098%EU545988.1
1742917429100%0.098%KU681082.3
163971639799%0.095%HQ234499.1
1328613286100%0.089%KU720415.1
132811328199%0.089%HQ234498.1
1327513275100%0.089%KF383115.1
1327013270100%0.089%KF268949.1
1327013270100%0.089%KF268948.1
1326313263100%0.089%LC002520.1
1326313263100%0.089%KF268950.1
1325913259100%0.089%KF383119.1
1324313243100%0.089%DQ859059.1
1323013230100%0.089%KF383116.1
132141321499%0.089%HQ234501.1
1320513205100%0.089%AY632535.2
1316013160100%0.088%KF383117.1
131441314499%0.088%HQ234500.1
1294513013100%0.088%KF383118.1
128551285597%0.089%KF383121.1
108771087797%0.084%KF383120.1
4967496727%0.099%KU312314.1
4940494027%0.099%KU312313.1
4655465525%0.099%KU646828.1
4646464625%0.099%KU646827.1
3440344018%0.099%KU312315.1
3214321417%0.099%KU740199.1
2879420695%0.071%DQ859064.1
2695269514%0.099%KJ634273.1
2042204211%0.099%KU686218.1
2021202111%0.099%KU179098.1
175217529%0.099%KM078936.1
174817489%0.099%KM078961.1
174617469%0.099%KM078930.1
174517459%0.099%KM078971.1
174517459%0.099%KM078970.1
174517459%0.099%KM078933.1
174317439%0.099%KM078929.1
160216028%0.099%KJ873160.1
142014207%0.099%KJ873161.1
138813887%0.099%KM851039.1
135213527%0.098%KM851038.1
134613467%0.099%KU556802.1
1306130610%0.088%AF013415.1
124012406%0.099%KU232300.1
124012406%0.099%KT200609.1
123112316%0.099%KU232290.1
122912296%0.099%KU232297.1
122012206%0.099%KU232294.1
121812186%0.099%KU232292.1
121412146%0.099%KU232298.1
121112116%0.099%KU232296.1
121112116%0.099%KU232293.1
120512056%0.099%KU232295.1
119511956%0.099%KU232288.1
119111916%0.099%KU232289.1
118711876%0.099%KU232299.1
118611866%0.099%KU232291.1
113011306%0.098%KU758878.1
106810688%0.088%KF270886.1
101810185%0.0100%KU867812.1
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Sequences producing significant alignments:

Select:AllNone Selected:0

Sequences producing significant alignments:
Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccession
1852518525100%0.0100%KU870645.1
1842018420100%0.099%KU501217.1
1841718417100%0.099%KU501216.1
1837518375100%0.099%KU509998.1
1837218372100%0.099%KJ776791.1
1836318363100%0.099%KU707826.1
1836318363100%0.099%KU365779.1
1836318363100%0.099%KU321639.1
1835718357100%0.099%KU926309.1
1835418354100%0.099%KU729218.1
1834818348100%0.099%KU365780.1
1834518345100%0.099%KU365777.1
1833618336100%0.099%KU647676.1
1833018330100%0.099%KU365778.1
1833018330100%0.099%KU312312.1
1832718327100%0.099%KU729217.2
183271832799%0.099%KU497555.1
1832718327100%0.099%KU527068.1
1832118321100%0.099%KU820897.1
1832118321100%0.099%KU501215.1
1831818318100%0.099%KU922960.1
1831218312100%0.099%KU926310.1
1831218312100%0.099%KU922923.1
1830318303100%0.099%KU820898.1
1830318303100%0.099%KU853013.1
1830318303100%0.099%KU853012.1
1830018300100%0.099%KU955590.1
1829418294100%0.099%KU740184.2
1829418294100%0.099%KU761564.1
1826718267100%0.099%KU955589.1
1826718267100%0.099%KU820899.2
1815918159100%0.099%KU866423.1
1813718137100%0.099%KU744693.1
1802918029100%0.099%KU681081.3
1773217732100%0.098%KU955593.1
177301773099%0.098%JN860885.1
176761767698%0.099%KF993678.1
1756717567100%0.098%EU545988.1
1742917429100%0.098%KU681082.3
163971639799%0.095%HQ234499.1
1328613286100%0.089%KU720415.1
132811328199%0.089%HQ234498.1
1327513275100%0.089%KF383115.1
1327213272100%0.089%KU955595.1
1327013270100%0.089%KF268949.1
1327013270100%0.089%KF268948.1
1326313263100%0.089%KU955592.1
1326313263100%0.089%LC002520.1
1326313263100%0.089%KF268950.1
1325913259100%0.089%KF383119.1
1324713247100%0.089%KU955594.1
1324513245100%0.089%KU955591.1
1324313243100%0.089%DQ859059.1
1323013230100%0.089%KF383116.1
132141321499%0.089%HQ234501.1
1320513205100%0.089%AY632535.2
1316013160100%0.088%KF383117.1
131441314499%0.088%HQ234500.1
1294513013100%0.088%KF383118.1
128551285597%0.089%KF383121.1
108771087797%0.084%KF383120.1
4967496727%0.099%KU312314.1
4940494027%0.099%KU312313.1
4655465525%0.099%KU646828.1
4646464625%0.099%KU646827.1
3440344018%0.099%KU312315.1
3214321417%0.099%KU740199.1
2879420695%0.071%DQ859064.1
2695269514%0.099%KJ634273.1
2042204211%0.099%KU686218.1
2021202111%0.099%KU179098.1
175217529%0.099%KM078936.1
174817489%0.099%KM078961.1
174617469%0.099%KM078930.1
174517459%0.099%KM078971.1
174517459%0.099%KM078970.1
174517459%0.099%KM078933.1
174317439%0.099%KM078929.1
160216028%0.099%KJ873160.1
142014207%0.099%KJ873161.1
138813887%0.099%KM851039.1
135213527%0.098%KM851038.1
134613467%0.099%KU556802.1
1306130610%0.088%AF013415.1
124012406%0.099%KU232300.1
124012406%0.099%KT200609.1
123112316%0.099%KU232290.1
122912296%0.099%KU232297.1
122012206%0.099%KU232294.1
121812186%0.099%KU232292.1
121412146%0.099%KU232298.1
121112116%0.099%KU232296.1
121112116%0.099%KU232293.1
120512056%0.099%KU232295.1
119511956%0.099%KU232288.1
119111916%0.099%KU232289.1
118711876%0.099%KU232299.1
118611866%0.099%KU232291.1
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Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities

Rita W. Driggers, M.D., Cheng-Ying Ho, M.D., Ph.D., Essi M. Korhonen, M.Sc., Suvi Kuivanen, M.Sc., Anne J. Jääskeläinen, Ph.D., Teemu Smura, Ph.D., Avi Rosenberg, M.D., Ph.D., D. Ashley Hill, M.D., Roberta L. DeBiasi, M.D., Gilbert Vezina, M.D., Julia Timofeev, M.D., Fausto J. Rodriguez, M.D., Lev Levanov, Ph.D., Jennifer Razak, M.G.C., C.G.C, Preetha Iyengar, M.D., Andrew Hennenfent, D.V.M., M.P.H., Richard Kennedy, M.D., Robert Lanciotti, Ph.D., Adre du Plessis, M.B., Ch.B., M.P.H., and Olli Vapalahti, M.D., Ph.D.

March 30, 2016DOI: 10.1056/NEJMoa1601824

 

SOURCE INFORMATION

From the Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine (R.W.D., J.T.), and the Department of Pathology (F.J.R.), Johns Hopkins University School of Medicine, Baltimore; the Division of Maternal Fetal Medicine, Sibley Memorial Hospital (R.W.D., J.T., J.R.), the Division of Pathology and Center for Genetic Medicine Research (C.-Y.H., A.R., D.A.H.), Division of Pediatric Infectious Diseases (R.L.D.), Department of Diagnostic Radiology and Imaging (G.V.), and the Fetal Medicine Institute, Division of Fetal and Transitional Medicine (A.P.), Children’s National Health System, the Departments of Integrative Systems Biology (C.-Y.H., D.A.H.), Pediatrics and Microbiology, Immunology and Tropical Medicine (R.L.D.B.), and Radiology and Pediatrics (G.V.), George Washington University School of Medicine and Health Sciences, the Center for Policy, Planning and Evaluation (P.I.) and Centers for Disease Control and Prevention (CDC)–Council of State and Territorial Epidemiologists (CSTE) Applied Epidemiology Fellowship (A.H.), District of Columbia Department of Health, and One Medical Group (R.K.) — all in Washington, DC; the Departments of Virology (E.M.K., S.K., T.S., L.L., O.V.) and Veterinary Biosciences (E.M.K., O.V.), University of Helsinki, and the Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital (A.J.J., O.V.), Helsinki; and the Arboviral Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging Zoonotic Infectious Diseases, CDC, Atlanta (R.L.).

Address reprint requests to Dr. Driggers at , to Dr. du Plessis at , or to Dr. Vapalahti at .

http://www.nejm.org/doi/full/10.1056/NEJMoa1601824#t=article

Edited by niman
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CASE REPORT

A 33-year-old Finnish woman who was in the 11th week of gestation was on holiday in Mexico, Guatemala, and Belize with her husband in late November 2015. (Details are provided in Section 1.0 of the Supplementary Appendix, available with the full text of this article at NEJM.org.) During their travels, she and her husband recalled being bitten by mosquitoes, particularly in Guatemala. One day after her arrival at her current residence in Washington, D.C., she became ill with ocular pain, myalgia, and mild fever (maximum, 37.5°C), which lasted for 5 days. On the second day of fever, a rash developed (Figure 1FIGURE 1nejmoa1601824_f1.gifTimeline of Symptoms and Radiographic and Laboratory Studies., and Fig. S5 in the Supplementary Appendix). Her husband was concomitantly reporting similar symptoms. Serologic analysis that was performed 4 weeks after the onset of illness while she was on a trip to her native Finland was positive for IgG antibodies and negative for IgM antibodies against dengue virus. Subsequent serologic analysis was positive for both IgG and IgM antibodies against ZIKV, findings that were compatible with acute or recent ZIKV infection. Serologic analysis for the presence of chikungunya virus was negative. The patient had been vaccinated against tick-borne encephalitis and yellow fever more than 10 years earlier.

Fetal ultrasonography that was performed at 13, 16, and 17 weeks of gestation (1, 4, and 5 weeks after the resolution of symptoms) showed no evidence of microcephaly or intracranial calcifications. However, there was a decrease in the fetal head circumference from the 47th percentile at 16 weeks to the 24th percentile at 20 weeks.

At 16 weeks of gestation, the presence of flavivirus in serum was detected on nested reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay, and sequencing showed identity to Central American epidemic strains of ZIKV. The finding was confirmed with a specific ZIKV quantitative RT-PCR assay (Table S2 in the Supplementary Appendix). The Division of Vector-Borne Diseases Arbovirus Diagnostic Laboratory at the CDC reported serologic evidence of infection at 17 weeks of gestation, with serum positivity for ZIKV IgM and a titer of more than 1:2560 on a plaque-reduction neutralization test. On the basis of these results, the patient sought more thorough assessment of the fetus.

Fetal ultrasonography at 19 weeks of gestation showed abnormal intracranial anatomy (Figure 2FIGURE 2nejmoa1601824_f2.gifFetal Ultrasonography at 19 Weeks of Gestation., and Fig. S1 in the Supplementary Appendix). The cerebral mantle appeared to be thin with increased extra-axial spaces. Both frontal horns were enlarged with heterogeneous, predominantly echogenic material present in the frontal horn and body of the left lateral ventricle, a finding that raised concern about intraventricular hemorrhage. Dilation and upward displacement of the third ventricle, dilation of the frontal horns of the lateral ventricles, concave medial borders of the lateral ventricles, and the absence of the cavum septum pellucidum suggested agenesis of the corpus callosum. No parenchymal calcifications were seen. The head circumference measured in the 24th percentile for gestational age. The remainder of the fetal anatomy was normal.

Fetal MRI at 20 weeks of gestation showed diffuse atrophy of the cerebral mantle, which was most severe in the frontal and parietal lobes, with the anterior temporal lobes least affected (Figure 3FIGURE 3nejmoa1601824_f3.gifMagnetic Resonance Imaging of the Fetal Brain at 19 Weeks of Gestation.). The normal lamination pattern of the cerebral mantle was absent, and the subplate zone was largely undetectable. The corpus callosum was significantly shorter than expected for gestational age, with an anterior–posterior length of 14 mm (expected range, 18 to 22).18,19 The cavum septum pellucidum was very small. The lateral ventricles were mildly enlarged, as was the third ventricle, with a transverse diameter measuring 2.5 mm (average measurement at gestational age, 1.75 mm [range, 1.1 to 2.3]).18 The fourth ventricle was normal. The volume of the choroid plexus was unusually prominent, without evidence of hemorrhage. No focal destructive lesions were identified within the cerebral cortex or white matter. The cerebellum was normal in appearance and size. Given the grave prognosis, the patient elected to terminate the pregnancy at 21 weeks of gestation.

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Ultrasounds missed her Zika infection–until one showed serious harm to her fetus

 
   

What a new case reveals about pregnant women and the Zika virus

 
Play Video1:15
 
The case of a Washington, D.C., woman who terminated her pregnancy after contracting Zika provides new information on detecting fetal brain abnormalities. (Gillian Brockell,Claritza Jimenez/The Washington Post)

Zika successfully hid through nearly half of a District woman’s pregnancy, its damage to her fetus not showing despite a series of early ultrasounds. But suddenly at 19 weeks, another scan revealed significant abnormalities, and a more sophisticated test one week later identified even greater damage in her baby’s brain. In early February, the woman terminated the pregnancy.

The report, published Wednesday in the New England Journal of Medicine, provides troubling new information about the capacity of the virus to infect a fetus and cause serious harm. The case also indicates that Zika may remain in the blood for a long time: The 33-year-old woman still tested positive for Zika 10 weeks after she likely was infected during a trip to Guatemala – far beyond what scientists have thought is the case.

"This helps put more pieces together in the puzzle because we know so little about how this virus acts and when and how long it stays in your blood after you have symptoms," said Laura Riley, vice chair of obstetrics and gynecology at Massachusetts General Hospital in Boston, who was not part of the study. Even though the study only involves one patient, "it's very important because she was followed so closely and there is so much detailed information. "

 
 

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While the case offers important details to researchers and obstetricians-gynecologists counseling pregnant women who may have been exposed to the virus, "we're going to need to study this with a large number of patients to provide guidance for women," said Catherine Spong, acting director for the National Institute of Child Health and Human Development.

The woman and her husband traveled on vacation to Mexico, Guatemala and Belize in late November when she was 11 weeks pregnant. The couple told researchers they had been bitten by mosquitoes during their trip, particularly in Guatemala. After returning home, the woman developed eye and muscle pain, fever and a rash. A series of ultrasounds that began one week after her symptoms subsided -- at 13, 16 and 17 weeks of pregnancy -- showed none of the characteristic problems linked to Zika. The most prominent in utero are an abnormally small head and brain calcifications, bright, white spots that indicate something is amiss. Both are key to a diagnosis of a rare condition called microcephaly.

 

Yet on the ultrasound at 19 weeks, significant brain abnormalities appeared: The baby's brain was small and contained an unusual amount of fluid. The cerebral cortex, its outer layer, was very thin. By the 20th week, a fetal MRI showed severe atrophy, especially in the front and top brain areas that are involved in decision-making, learning, vision, hearing, touch and taste. The fetus did not meet the threshold to be diagnosed with microcephaly.

In the initial ultrasounds, "they only looked at the size of the head and looked for brain calcifications to make sure she didn't have microcephaly and reassured her that everything looks okay," said Rita Driggers, one of the study's lead authors and medical director of Sibley Memorial Hospital’s maternal-fetal medicine division. Driggers, an assistant professor of gynecology and obstetrics at Johns Hopkins University School of Medicine, was involved in the patient's care.

The takeaway for clinicians, she and others said, is to make sure during ultrasounds to look for other brain changes beyond microcephaly and intracranial calcifications.

Adre du Plessis, director of Children's National Health System's Fetal Medicine Institute and another study author, said Wednesday that the lack of those markers in the earlier ultrasounds may have led to "false reassurances" for the mother. What's more, he said, such delayed diagnosis of brain infection in the fetus may put women who'd opt to terminate a pregnancy "outside the legal limits" of an abortion.

 

Forty-three states prohibit abortions after a specified point in pregnancy -- most often the point of fetal viability -- except when necessary to protect the woman’s life or health.

Researchers said they are not recommending that all pregnant women infected with Zika uniformly seek out fetal MRIs, which are expensive and not readily available in many of the countries in Central and South America that have been hardest hit by the Zika epidemic. In the United States, the technology is available at most major medical centers.

It's possible that researchers might be able to develop other markers to predict whether babies will become infected and develop abnormalities, du Plessis said.

The study also provides new information about how long the virus persists in the blood of an infected person. The common thinking has been that the virus is only present for seven days to about two weeks at the outer limits. But this patient had virus in her blood from the time she became infected, when she was about 11 weeks pregnant, up until the time of her abortion, at 21 weeks.

"That's a very novel finding and important for future study," said Roberta DeBiasi, Children's chief of infectious disease division and another study author.

Have you had an experience with Zika? We'd like to hear from you.

It's possible that the woman's persistent infection was the result of the virus replicating in the fetus or placenta, the researchers said.

Researchers also found "significant" cell death of neurons in the part of the brain that plays a role in sight, hearing and language, researchers said.

https://www.washingtonpost.com/news/to-your-health/wp/2016/03/30/why-ultrasounds-may-give-mothers-with-zika-a-false-sense-of-security/

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Zika: established the first association with microcephaly

 

The virus was isolated from the tissues of a fetus and identified in the mother's blood, weeks after the disappearance of symptoms

11557918553_242c2d054b_z

The infection of the Zika virus during pregnancy appears to be associated with a risk of microcephaly in the child. Image credits: tipstimes.com/pregnancy, Flickr

HEALTH - Researchers at the University of Helsinki have managed to isolate the Zika virusfrom the brain tissue of a fetus developing, after spotting it in the mother's blood samples. The study, conducted on a single pregnant woman, was recently published on The New England Journal of Medicine . Although this is for now only a single case, it would be the first to confirm the association between infection and Zika microcephaly , pathology that affects fetuses and causes significant reduction in brain volume and head circumference.

In one year the cases of microcephaly registered in Brazil were more than 4000, but during the health emergency in recent months scientists around the world have remained cautious in confirming an association with the virus, known for some time and suddenly jumped in the spotlight. Earlier this month, another research has clarified what are the outlets cells targetedby the infection, but the authors had reiterated that it was still early to speak of a causal effect. Brazil is not the only one to be hit hard: in 2013 in French Polynesia cases of Zika virus infection were 28 000, 11% of the population, and the virus has continued to maintain a presence in the following years. In the same period, health officials reported an increase in cases of brain malformations and polimalformative syndromes that could be associated just to Zika.

Now things could change: Olli Vapalahti and Finnish university colleagues have shown that small traces of genetic material Zika can be detected in the blood of a pregnant woman even weeks after the end of the symptoms (rashes, fever ...). In these early stages of fetal development, the techniques of neuroimaging have allowed us to observe the growth of the brain and identify abnormalities, already present.

The emergency surrounding Zika caught us unprepared in part, even if the virus is known from the forties of last century, when it was discovered in Uganda. Precisely why many laboratories around the world have immediately put to work to think of a vaccine and effective antiviral treatment. One of these, at Purdue University , was the first to determine the structure of the virus and identify the characteristics that could be targeted in fight infection. "The structure of the virus gives us a hypothetical map with the regions to be hit with a therapeutic treatment, to be used to develop a vaccine or to improve our ability to diagnose and distinguish infection Zika from that of other similar viruses," comments in a statement Richard Kuhn, the scientist who led the study just came out of Science .

In addition to describing structure, Kuhn and colleagues also identified the differences that distinguish it from other Zika Flavivirus (transmitted by the same host species mosquitoes,Aedes aegypti and Aedes albopictus ) as dengue, West Nile fever, yellow fever and Japanese encephalitis. All these features help us to know him better, both from the point of view of the transmission is the onset of symptoms. With regard to the diagnosis, the methods recommended by the experts are the detection of viral RNA and the presence of antibodies in the blood. Pregnant women are recommended to undergo ultrasound, as well as to examine the amniotic fluid to determine the possible presence of Zika.

To date, transmission of the virus has been confirmed in 33 countries, 12 of which have also reported an increased incidence of Guillain-Barre syndrome , a disease that affects the nervous system of adults and children, causing muscle weakness and progressive loss of sensitivity. Here, too, we will need new data to establish the causal link with scientific basis.

@Eleonoraseeing

http://oggiscienza.it/2016/04/04/zika-causa-microcefalia-vaccino-virus/

 

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Microcephaly and other fetal malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported in six countries (Brazil, Cabo Verde, Colombia, French Polynesia, Martinique and Panama). Two cases, each linked to a stay in Brazil, were detected in Slovenia and the United States of America. A further case, linked to a brief stay in Mexico, Guatemala and Belize, was detected in a pregnant woman in the United States of America.

http://www.who.int/emergencies/zika-virus/situation-report/21-april-2016/en/

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