Factors Related to Fetal Death in Pregnant Women with Cholera, Haiti, 2011–2014

Schillberg, Erin; Ariti, Cono; Bryson, Lindsay; Delva-Senat, Rodnie; Price, Debbie; Grandpierre, R; Lenglet, Annick

doi:10.3201/eid2201.151078

Cited by 9 publications

(15 citation statements)

References 9 publications

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“…42 The Haiti study, conducted with 263 women with cholera-like illness, also suggested that severe maternal dehydration (risk ratio = 9.4; 95% CI: 2.5-35.3) and severe vomiting (5.1; 95% CI: 1.1-23.8) were risk factors for fetal death. 43,44 These data imply that an OCV should not be counter-indicated during pregnancy, and studies conducted in Guinea, 45 Zanzibar, 46 Malawi, 47 and Bangladesh 48 have not observed statistically significant adverse outcomes to fetus, newborn, or mother from OCV exposure. Given the risk to the fetus from maternal cholera and the excellent vaccine safety record, there is no scientific basis to withhold OCVs from pregnant women.…”

Section: Operational Enhancements To Ocv Usementioning

confidence: 96%

Oral cholera vaccines and their impact on the global burden of disease

Wierzba

2018

Human Vaccines & Immunotherapeutics

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With one-third of nations at risk of cholera, we can expect to experience massive, rapidly disseminated, and prolonged cholera outbreaks such as those recently experienced in Yemen and Haiti. The prevention of cholera outbreaks like these includes the provision of potable water, sanitation, and hygiene (WASH). This approach has been known for generations. However, it will be many years before universal global access to WASH is achieved. While working toward universal WASH, study data has shown that licensed and WHO prequalified cholera vaccines are important tools for cholera prevention. Oral inactivated whole-cell vaccines such as Shanchol and Euvichol-plus provide well-documented direct benefits to vaccine recipients and to the unimmunized through herd protection. Manufacturers have now increased the cholera vaccine supply, and since 2013 vaccine doses have been available for emergency and endemic control through a global stockpile. Advances in packaging and vaccine temperature control, reduced vaccine costs, the inclusion of pregnant women in vaccine campaigns, and a targeted approach to high incidence endemic areas are further increasing the usefulness of these vaccines for reducing the global cholera burden.

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Section: Operational Enhancements To Ocv Usementioning

confidence: 96%

Oral cholera vaccines and their impact on the global burden of disease

Wierzba

2018

Human Vaccines & Immunotherapeutics

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“…In early 2015, a serious ZIKV outbreak was recorded in Camaçari, Bahia, Brazil ( Plourde and Bloch, 2016 , Cerbino-Neto et al, 2016 ) and this was later followed by similar illnesses in five neighboring states leading the Ministry of Health to issue a ZIKV alert in April ( Rasmussen et al, 2016 , Chan et al, 2016 ). By the end of the year the virus had spread through 19 states, many in the northeastern part of the country.…”

Section: Introductionmentioning

confidence: 99%

Infectivity of Immature Neurons to Zika Virus: A Link to Congenital Zika Syndrome

et al. 2016

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BackgroundEpidemiological data strongly suggest that microcephaly cases in Brazil are associated with the ongoing epidemic of Zika virus (ZIKV). In order to further solidify the possible link, we investigated the infectivity of ZIKV using various neuroblastoma (NB) cell lines.MethodsSix undifferentiated, two terminally differentiated and two retinoic acid (RA) –induced, partially differentiated cell lines were exposed to ZIKV strain PRVABC59, which is genetically similar to the French Polynesia strain, with 97–100% genetic homology to the current ZIKV strain found in Brazil. All infections were confirmed by real-time PCR (RT-qPCR), immunofluorescence assay (IFA) probing with anti-flavivirus E antibody, and evaluation of cytopathic effects.FindingsZIKV infected all six undifferentiated NB cell lines. In five out of six NB cell lines, between 90 and 70% cells were positive by IFA whereas for one cell line, CCL-127, ~ 80% of cells were positive for ZIKV as determined by IFA but showed persistent infection. Two differentiated cell lines, JFEN and T-268, were highly resistant to ZIKV with < 1% of the cells being susceptible, as determined by IFA and confirmed by qRT-PCR. Two retinoic acid (RA)-induced NB partially differentiated cell lines showed no difference in permissiveness as compared to their undifferentiated mother cell lines.InterpretationThese findings strengthen the reported association between high incidences of microcephaly and ZIKV infection in newborns in Brazil. Our results suggest that the undifferentiated neurons are highly permissive to ZIKV infection, as one would expect during the early stages of neurogenesis in fetal brains; whereas differentiated neurons, representative of adult brain neurons, are relatively resistant to the virus, which explains the rare occurrence of neurological complications in adults infected with ZIKV. Our studies confirm the neurotropism of the ZIKV strain closely related to the current epidemic in Latin America.

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“…This outbreak was initially thought to be Dengue, but serological analyses identified RNA of ZIKV. Subsequently, ZIKV occurrences were reported for French Polynesia, Easter Island, the Cook Islands, and New Caledonia [ 14 , 15 , 17 ]; with the initiating strain most likely being derived from South-east Asia [ 7 ]. The French Polynesian outbreak of ZIKV was remarkable because 74 infected individuals presented with neurological symptoms, of which 47 were later diagnosed with Guillain-Barré Syndrome (GBS; [ 18 ]).…”

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confidence: 99%

“…In certain instances, impacted regions registered a more than tenfold increased occurrence; a magnitude surge that cannot be explained by random clustering. Because the microcephaly amplification was registered within nine months of the ZIKV outbreak, and since materno-fetal transmissions of other Flaviviruses are known to occur, it has been suggested that a link may exist for ZIKV and microcephaly [ 14 , 18 ]. There is mounting evidence that ZIKV is associated with a variety of neurological syndromes, including GBS, meningitis, myelitis, and meningocephalitis [ 15 ].…”

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confidence: 99%

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Computational identification of mutually homologous Zika virus miRNAs that target microcephaly genes

McLean

Bhattarai

Hughes

et al. 2017

Libyan Journal of Medicine

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Background Zika virus (ZIKV) has been associated with a variety of neuropathologies, including microcephaly. We hypothesize that ZIKV genes activate host microRNAs (miRNAs) causing dysfunctional development of human fetal brains. Objectives/methods A bioinformatics search for miRNA genome-wide binding sites in the prototypic ZIKV (strain MR766) was undertaken to hunt for miRNAs with significant similarities with MCPH genetic sequences responsible for inducing MCHP in human fetal brains. Results Six ZIKV miRNAs were found to share mutual homology with 12 MCPH genetic sequences responsible for inducing MCPH. Noteworthy was miR-1304, which expressed 100% identity to six different MCPH genes. Conclusions We suggest that following infection of fetal neurons ZIKV may modulate the action of various miRNAs, and miR-1304 in particular, resulting in microcephaly.

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Factors Related to Fetal Death in Pregnant Women with Cholera, Haiti, 2011–2014

Cited by 9 publications

References 9 publications

Oral cholera vaccines and their impact on the global burden of disease

Oral cholera vaccines and their impact on the global burden of disease

Infectivity of Immature Neurons to Zika Virus: A Link to Congenital Zika Syndrome

Computational identification of mutually homologous Zika virus miRNAs that target microcephaly genes

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