Acute Paralysis and Neuro-inflammation in Jamaican Children during ZIKV and Dengue Epidemics of 2016

Melbourne-Chambers, R; Christie, Celia D. C.; Greenaway, E; Bullock, R

doi:10.7727/wimj.2016.526

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…Phylogenetic studies confirmed the arrival of the zika virus (ZIKV) in Jamaica, the Dominican Republic and Haiti, over 9 months before the formal identification of the first clinical case [39,40 ▪▪ ]. Zika has penetrated the Caribbean region (Table 1) [25,39,40 ▪▪ ,41–50,51 ▪▪ ,52–54,55 ▪▪ ,56–65]. The link of zika to congenital zika syndrome (CZS) and Guillain–Barre syndrome (GBS) has been established in the Caribbean, along with other intrauterine pregnancy complications, febrile illnesses, and unusual neurological complications in children (Figs.…”

Section: Zikamentioning

confidence: 89%

Dengue, chikungunya and zika arbovirus infections in Caribbean children

Christie

Lue²,

Melbourne-Chambers

2023

Current Opinion in Pediatrics

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Purpose of reviewDengue, chikungunya and zika have caused significant epidemics in the Caribbean in recent years. This review highlights their impact in Caribbean children.Recent findingsDengue has been increasingly intense and severe, seroprevalence is 80–100% in the Caribbean, children have increased attributable morbidity and mortality. Severe dengue, especially dengue with haemorrhage was significantly associated with haemoglobin SC disease and multiple organ-systems involved. These included the gastrointestinal and haematologic systems with extremely high lactate dehydrogenases and creatinine phosphokinases and severely abnormal bleeding indices. Despite appropriate interventions, mortality was highest within the first 48 h of admission. Chikungunya, a togavirus, affected 80% of some Caribbean populations. Paediatric presentations included high fever, skin, joint and neurological manifestations. Children less than 5 years of age had the highest morbidity and mortality. This maiden chikungunya epidemic was explosive and overwhelmed public health systems. Zika, another flavivirus, has a seroprevalence of 15% in pregnancy, so the Caribbean remains susceptible. Paediatric complications include pregnancy losses, stillbirths, Congenital Zika syndrome, Guillain–Barre syndrome, acute disseminated encephalomyelitis and transverse myelitis. Neurodevelopment stimulation programs for zika-exposed infants have been effective in improving language and positive behaviour scores.SummaryCaribbean children remain at risk for dengue, chikungunya and zika, with high attributable morbidity and mortality.

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Section: Zikamentioning

confidence: 89%

Dengue, chikungunya and zika arbovirus infections in Caribbean children

Christie

Lue²,

Melbourne-Chambers

2023

Current Opinion in Pediatrics

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“…In 2014, an epidemic with several thousands of suspected cases of chikungunya virus (CHIKV) infections were reported with an 83.6% seropositivity (9)(10)(11)(12). In 2016, Jamaica experienced its maiden Zika virus (ZIKV) epidemic, when all three arboviruses co-circulated endemically (13)(14)(15)(16). In Cuba, two Ae aegypti mosquito populations became infected with and transmitted DENV-1, ZIKV and CHIKV together, albeit at low rates (17).…”

Section: Introductionmentioning

confidence: 99%

Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

et al. 2022

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ObjectiveIn 2019, dengue was among the “top-ten threats to global health,” with 3.1 million cases reported from the Americas, the highest ever. Simultaneously, Jamaica reported its largest dengue outbreak in 40 years, following Chikungunya and Zika virus epidemics, in 2014 and 2016–2017, respectively. We describe dengue in children admitted to five hospitals in Jamaica during August 2018 through September 2019.MethodsHospitalized children and adolescents aged 0 to 15 years with dengue were managed using PAHO/WHO criteria. Data were extracted from questionnaires, entered into a dataset on Microsoft Excel version 2016, exported to SPSS version 20 and analyzed. Groups were compared using Student's t-test for normally distributed parametric data. Chi-square analysis, or Fisher's exact test was used for categorical variables. A p-value < 0.05 was considered statistically significant.ResultsThere were 339 children, 245 (72.3%) aged 1–10 years, males:females 1:1. Classification was “dengue without warning signs” 53 (15.3%), “dengue with warning signs” 218 (64.3%) and “severe dengue” 68 (20%). Co-morbidities were reported in 88 (26%). Hemoglobin SC disease was associated with severe dengue with hemorrhage (p = 0.005). Organ-system involvement occurred in 334 (98.5%) including gastrointestinal 317 (93.5%), hematologic 311 (91.7%) and musculoskeletal 180 (53.1%). Thirty-nine (11.5%) had 5–7 organ-systems involved. Metabolomics emphasized increased hepatic transaminases 245 (72.3%), lactate dehydrogenase 164 (48.4%) and creatine phosphokinase 84 (24.8%) approaching the high thousands (121,560 u/L), both were markers for severe disease (p < 0.002). Thirteen (3.8%) received intensive care. Dengue was laboratory-confirmed in 220 (78.9%): NS1 antigen-positive (218); RT-PCR-positive (23), with an overlap of NS1 antigen and RT-PCR positive (21); DENV-3 serotype (20). Seventeen (5%) died, 16 (94.1%) had severe dengue and 11 (64.7%) succumbed within 24 to 48 h of admission despite resuscitation and transfusion of blood products.ConclusionSevere dengue with increased attributable mortality occurred in hospitalized children after Jamaica's maiden Zika epidemic.

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“…The congenital syndrome was also being recognized simultaneously in 0.8% to 2.2% of the newborns in 3 urban public maternity hospitals [ 23 ], with a 15.6% ZIKV immunoglobulin G antibody seroprevalence in pregnancy reported [ 19 ]. Other complications included Guillain-Barré syndrome and varied neurological presentations in children and adults [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…The ZIKV epidemic in Jamaica occurred in 2016-2017 [20][21][22][23]. National hospital-based surveillance revealed increased annual rates of severe microcephaly from 23.6 per 100,000 live births in 2010 (during the period of DENV outbreaks) to 41.7 per 100,000 live births in 2017 in association with the ZIKV epidemic [14], alongside surveillance reports of the congenital syndrome associated with ZIKV and related fetal brain disruption sequences temporally and spatially related to reported ZIKV cases [14].…”

Section: Introductionmentioning

confidence: 99%

Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study

Ruiz-Burga¹,

Bruijning-Verhagen²,

Palmer³

et al. 2022

JMIR Form Res

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Background There is growing evidence of the benefits of mobile health technology, which include symptom tracking apps for research, surveillance, and prevention. No study has yet addressed arbovirus symptom tracking in pregnancy. Objective This study aimed to evaluate the use of a smartphone app (ZIKApp) to self-report arbovirus symptoms and pregnancy complications and to assess compliance with daily symptom diaries during pregnancy in a cohort of women in an arbovirus-endemic, subtropical, middle-income country (Jamaica). Methods Pregnant women aged ≥16 years, having a smartphone, and planning on giving birth at the recruiting center were enrolled between February 2020 and July 2020. ZIKApp comprised a daily symptom diary based on algorithms to identify potential episodes of arbovirus infection and pregnancy complications. Sociodemographic, epidemiological, and obstetric information was collected at enrollment, with additional review of medical records, and users’ perception was collected through an exit survey. Descriptive analyses and logistic regression analysis of possible factors associated with diary adherence were performed. Results Of the 173 women enrolled, 157 (90.8%) used ZIKApp for a median duration of 155 (IQR 127-173) days until pregnancy end, 6 (3.5%) used the app for <7 days, and 10 (5.8%) exited the study early. For each successive 30-day period from enrollment up to 150 days after enrollment, of these 157 women, 121 (77.1%) to 129 (82.2%) completed their daily symptom diary; 50 (31.8%) to 56 (35.7%) did so on the same day. Overall, 31.8% (50/157) of the women had good adherence to diary reporting (ie, they completed the task on the same day or 2 to 3 days later for ≥80% of the days enrolled). There were 3-fold higher odds of good adherence for participants aged >34 years versus those aged 25 to 29 years (adjusted odds ratio 3.14, 95% CI 1.10-8.98) and 2-fold higher odds for women with tertiary versus secondary education (adjusted odds ratio 2.26, 95% CI 1.06-4.83). Of the 161 women who ever made a diary entry, 5454 individual symptom reports were made (median 17 per woman; IQR 4-42; range 0-278); 9 (5.6%) women reported symptom combinations triggering a potential arbovirus episode (none had an adverse pregnancy outcome) and 55 (34.2%) reported painful uterine contractions or vaginal bleeding, mainly in the month before delivery. Overall, 51.8% (71/137) of the women rated the app as an excellent experience and were less likely to be poor diary adherers (P=.04) and 99.3% (138/139) reported that the app was easy to understand and use. Conclusions This pilot found a high adherence to ZIKApp. It demonstrated the feasibility and usability of the app in an arbovirus-endemic region, supporting its future development to contribute to surveillance and diagnosis of arbovirus infections in pregnancy and to optimize maternal care.

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Acute Paralysis and Neuro-inflammation in Jamaican Children during ZIKV and Dengue Epidemics of 2016

Cited by 5 publications

References 15 publications

Dengue, chikungunya and zika arbovirus infections in Caribbean children

Dengue, chikungunya and zika arbovirus infections in Caribbean children

Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study

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