Vertical Transmission of Dengue Virus in the Peripartum Period and Viral Kinetics in Newborns and Breast Milk: New Data

Abstract

The occurrence of vertical DENV transmission was high (90%) in viremic mothers at delivery, and these mothers and their infants were at major risk for obstetric and neonatal complications. The modes of viral transmission are difficult to clarify. The risk of DENV transmission through breast milk seems plausible. Close follow-up of mothers and prolonged surveillance of their newborns are required for minimizing complications. Complementary studies are needed to elaborate preventive recommendations.

Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review

“…DENV RNA was detected in milk samples from 10 women in two studies (one case report and one case series), including culturable virus in a sample from one woman . In the case report, DENV RNA was detected by RT‐PCR in milk samples collected on days six and eight after the woman’s symptom onset, with infectious virus particles detected at both time points .…”

“…In the case report, DENV RNA was detected by RT‐PCR in milk samples collected on days six and eight after the woman’s symptom onset, with infectious virus particles detected at both time points . The case series (n = 12) described DENV RNA detection in nine (75%) cases, with the longest observed period of detection being 14 days after maternal illness onset . All DENV RNA positive samples were assessed for infectivity but were negative in cell culture …”

“…Two studies (one case report and one case series) reported possible DENV transmission through human milk in two cases . In the case report, DENV was detected in both mother and infant by RT‐PCR .…”

“…The case series (n = 12) described DENV RNA detection in nine (75%) cases, with the longest observed period of detection being 14 days after maternal illness onset . All DENV RNA positive samples were assessed for infectivity but were negative in cell culture …”

“…The reports included in this review provide limited evidence of the possible transmission of certain flaviviruses through human and animal milk. The presence of viral RNA in human milk was confirmed for DENV, WNV, and ZIKV, and was found to be potentially infectious in five of 20 cases (4 ZIKV, 1 DENV) . For ZIKV specifically, infectious virus was detected as late as 32 days post‐onset of maternal illness .…”