Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Visit old site
Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 624


 
 Table of Contents  
REVIEW ARTICLE
Year : 2016  |  Volume : 8  |  Issue : 3  |  Page : 123-128

Zika virus: A global threat to humanity: A comprehensive review and current developments


1 Department of Internal Medicine, Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
2 Department of Accident and Emergency, Lady Hardinge Medical College, New Delhi, India
3 Consultant Physician, NMB Diagnostics, Serampore, Hooghly, West Bengal, India

Date of Web Publication21-Mar-2016

Correspondence Address:
Adrija Hajra
Department of Internal Medicine, IPGMER, Kolkata, West Bengal
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-2714.179112

Rights and Permissions
  Abstract 

At present, one of greatest concerns of medical personnel is Zika virus (ZIKV). Though it has been reported for quite a long time, its rapid emergence, new modes of transmission, and more importantly, the congenital anomalies associated with it have made the situation worse. It was first detected in 1947. After that, this infection was found in the countries of Africa as well as Asia. At present, interestingly it has been reported from Brazil. Microcephaly and intracranial calcification have been postulated to be related to maternal infection with this virus. Though it is asymptomatic in maximum number of cases, the serious complications of the infection should be prevented at the earliest. No specific treatment and vaccine are available till now. But research continues and hopefully, success is not far off. The right information about this infection should reach patients as well as physicians. It will prevent unnecessary panic. In August, Brazil is going to organize the Olympic and Paralympic Games and all eyes are now focused on this. In this review article, the authors have tried to focus on the important points about this infection. The data were gathered after searching for relevant articles published in PubMed, the World Health Organization's (WHO) website, Centers for Disease Control and Prevention's (CDC) website, and some other related websites on the Internet.

Keywords: Aedes mosquitoes, microcephaly, pregnancy, Zika virus (ZIKV)


How to cite this article:
Hajra A, Bandyopadhyay D, Hajra SK. Zika virus: A global threat to humanity: A comprehensive review and current developments. North Am J Med Sci 2016;8:123-8

How to cite this URL:
Hajra A, Bandyopadhyay D, Hajra SK. Zika virus: A global threat to humanity: A comprehensive review and current developments. North Am J Med Sci [serial online] 2016 [cited 2020 Nov 29];8:123-8. Available from: https://www.najms.org/text.asp?2016/8/3/123/179112


  Introduction Top


The World Health Organization (WHO) declared a public health emergency of international concern (PHEIC) on February 1, 2016 as there were more than 4,000 microcephaly cases and neurological disorders in some areas affected by Zika virus (ZIKV). [1] Due to the rapid emergence of the ZIKV infection it is naturally becoming a concern all over the world. The single-stranded RNA arbovirus of Flavivirus genus was first identified in the Zika forest of Uganda and named accordingly. [2] In May 2015, it was first reported from Brazil. [3] Since then, it has rapidly become a significant problem in the medical field. In 1968, it was reported from Nigeria. From 1951 to 1981, infection due to this virus was documented from various African countries. At that time, such cases were also found in different countries of Asia. [4] In April 2007, there was an outbreak of ZIKV on Yap Island in the Federated States of Micronesia. [5] In 2013, another outbreak was reported in French Polynesia. From 2012 to 2014 in Thailand, some cases were identified to be affected by ZIKV. [6] Introduction of ZIKV in Easter Island in 2014 has been suggested to originate from French Polynesia in the literature. [7]

Similarities were found between the strains isolated from Thailand and the Pacific regions. It was postulated that might be a similar type of ZIKV prevalent among a large portion of the globe. [6] In the USA, most cases are related to travel and the first case of microcephaly was reported from Hawaii in January 2016. [8] In the past 6 weeks from 11 Feb, 2016, four cases have been documented in the UK. [9]


  Transmission Top


ZIKV has been transmitted mainly by the bite of female Aedes mosquitoes. [10] Favorable environmental factors for these vectors may play a role in the rapid emergence of the infection in countries in the Americas. [2] Some reports blame El Niño and global warming that cause hot winters and summers, which help in spreading this virus. At the time of drought local people usually store water in the container, which is the ideal environment to help in the breeding of Aedes mosquitoes. [11] But the infection can be spread through sexual intercourse, [12] blood transfusion, [13] and perinatal transmission. [2] Regarding blood transfusion during an outbreak in French Polynesia, a significant number of asymptomatic donors' blood was positive for ZIKV. So it may be a potential way of transmitting the disease. [13] In February 2016, a case of sexually transmitted ZIKV infection was reported from Texas, USA. [14]


  Pathogenesis Top


The detailed pathogenesis is still unknown. Emerging evidence suggests that ZIKV after being injected through the skin, gains access initially to immature dendritic cells, dermal fibroblast, and epidermal keratinocytes. Adhesion factors such as DC-SIGN, AXL, Tyro3, and TIM-1 help entry in these cells. [15] With the help of envelope protein (E-protein), the virion attaches to the targeted cells. Then by the process of endocytosis with assistance from clathrin-coated pits, the virion enters the cytoplasm of the cells. [16] Replication occurs primarily in the cellular cytoplasm though ZIKV RNA has been isolated from the nucleus. [17] Then the cells undergo apoptosis and autophagy causing the release of virus particles, which ultimately spread to the lymphatics and blood stream leading to the florid manifestation of the disease. The host innate immune system produces type 1 and type 2 interferons to which ZIKV is susceptible. [15]


  Clinical Feature Top


The incubation period of ZIKV infection is not known precisely. Most of the cases occur 3-12 days after mosquito bites. [18] A majority of ZIKV infections are asymptomatic. Mild fever, skin rashes, conjunctivitis (nonpurulent), muscle pain and joint pain (small joints of hands and feet), back pain, malaise, or a headache lasting for 2-7 days are seen only in 20% of infected individuals. Other possible manifestations include anorexia, retro-orbital pain, edema, diarrhea, constipation, abdominal pain, dizziness, and pruritus. It is indistinguishable from the symptoms of other arboviral diseases such as dengue and chikungunya. [16],[19] Patients rarely become sick enough to get hospitalized, and mortality is rare. [20]


  Diagnosis Top


At present, there is no commercial test to diagnose ZIKV. Viral RNA can be detected by reverse transcription-polymerase chain reaction (RT-PCR), and the antiviral antibodies can be detected by either immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) or plaque reduction neutralization test (PRNT). IgM antibody appears in the blood toward the end of the first week of illness. Cross reaction with another Flavivirus is common. This cross-reaction effect can be attenuated by using PRNT. [21] Till date, there is no consensus about the superiority of one test over the other; so the Centers for Disease Control and Prevention (CDC) recommends performing both RT-PCR and serological test to diagnose congenital ZIKV infection. Serum from the umbilical cord or the infant within 2 days of birth is used for RT-PCR testing. Cerebrospinal fluid (CSF), placental tissue, and amniotic fluid can also be used for RT-PCR. The period of viremia is just about 3-5 days after onset of illness. ZIKV has been isolated from the saliva but did not help to extend the period of detection of the virus. [12] On the other hand, RNA can be isolated from urine even up to 3 weeks after the onset of symptoms, which is extremely advantageous in a practical scenario. [2] RT-PCR is positive only for 3-7 days. A negative result does not exclude the disease. Neutralizing antibody titers that are more than or equal to fourfold higher than dengue neutralizing antibody in the serum may be used in pregnant women (with or without symptoms). Other infections causing arthritis should be kept in mind. They are dengue, chikungunya, parvovirus, Rubella, measles, Leptospira, malaria, rickettsial infection, and Group A Streptococcus. [22]

ZIKV diagnosis can be performed by isolating it from mosquitoes and animals. [23]

Travelers returning from ZIKV-affected areas who are positive for dengue IgM antibody but negative dengue for IgG antibody on convalescent sera should be tested for ZIKV infection. [24] Recently, an individual with ZIKV infection was found to have false positive NS 1 dengue antigen. [25] So clinicians must be suspicious of the correct diagnosis of ZIKV infection.


  Potential Complications Top


Recently, ZIKV infection has become a well-discussed topic for not only its rapidity of spread but also its effect on the neurological system that has been documented. Guillain-Barré syndrome has been found to be associated with ZIKV infection. [26]

Around 10,000 ZIKV cases were registered in October 2013. Among them, there were cases of meningoencephalitis and autoimmune thrombocytopenia-like complications. [27]

Recently, ZIKV infection in pregnant mothers was identified to be associated with microcephaly of newborn children. [28] This finding has no doubt stolen the focus to a significant extent. In Brazil, a cohort of 35 infants with microcephaly was investigated. They were born during from August 2015 to October 2015. In all cases, the mothers had lived in or had paid a visit to ZIKV-affected areas during pregnancy. A task force has already been developed in Brazil to study antenatal cases thoroughly. Data from one study in Brazil suggested that first-trimester ZIKV infection in pregnant women carries more risk of microcephaly. [28]

There are several causes of microcephaly. More data are required to provide any conclusive data. [29]

Apart from these, ophthalmological involvement is a less discussed topic regarding ZIKV. Infants from Brazil were found to have macular pigment mottling and loss of foveal reflex. One of them manifested well-defined macular atrophy as well. [30] Chorioretinal scarring and other ocular abnormalities in infants have been reported recently. [31] Also, recently ZIKV has been detected by the RT-PCR method by performing autopsy in the fetal brain with microcephaly. The mother had a history of living in the state of Reo Grande do Norte, and she left the place at 28 weeks of gestation. The neurotropic character of the virus was suggested as the virus was not found in other organs of the fetus. [32]


  Treatment Top


There is no particular treatment for ZIKV infection. Supportive management is the only way. Taking rest, maintaining adequate hydration, and appropriate nutrition may help patients in early recovery. But patients must be kept under observation, and any signs of multiorgan involvement should be monitored. Acetaminophen may be used for relieving fever. Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin should be used cautiously and after dengue infection (to avoid hemorrhagic complications) and pregnancy are ruled out. Till date, no vaccine is available. [19],[20]


  Prevention Top


The Pan American Health Organization (PAHO) has pointed out reasons for rapid spread of the virus:

  1. The population of the Americas had no previous exposure to ZIKV and they have lack immunity, and
  2. Aedes mosquitoes - The principle vector for ZIKV transmission - Are present in all of the region's countries except Canada and continental Chile. [33]


Its recommendations are as follows: [33]

  1. Necessary reduction of the mosquito population.
  2. Removal of potential breeding sites of mosquitoes.
  3. Use of necessary personal protection.


People who live in or are going to visit susceptible areas have to use insect repellents and wear clothes covering the maximum body surface area.

Till date, there is no restriction in breastfeeding for the prevention of ZIKV transmission even though ZIKV RNA has been isolated from breast milk. [22]

The CDC has laid down guidelines for pregnant ladies [Figure 1]. [34]
Figure 1: CDC recommendation for pregnant lady for ZIKV infection

Click here to view


All pregnant women who visit the ZIKV-affected regions should consult their doctors for further suggestions. All symptomatic women including those who develop symptoms within 2 weeks of their travel in a ZIKV-endemic zone should positively consult the health care provider. ZIKV remains in the blood of an infected person for 1 week and in the semen for 2 weeks. There is currently no evidence of birth defects in babies conceived after the clearance of the virus from the blood or semen. [35]

The CDC has also provided detailed guidelines for infants with and without microcephaly or other clinical features whose mothers have lived in or paid a visit to ZIKV-infected areas. Infants with congenital anomaly should be tested for ZIKV and reported accordingly. If no congenital anomaly is present, mothers should be evaluated. It is to be found out whether she has been screened during the antenatal period. If the mother is tested to be positive, then the infant is also tested for the virus. [21]

To reduce sexual transmission, the following have been recommended: [36]

Men who live in or have to visit a ZIKV-infected area should use condoms during sex with their pregnant partners.

They should also use condoms during sex with nonpregnant partners.

Both the partners should discuss the possibility of transmission of the infection, and they should consult experts when needed.

ZIKV can be detected in the semen when viremia is not present in blood even after 2 weeks. [12] So it is important to make more conclusive guidelines and provide sexual safety to people at risk.

Travelers returning from an area with ZIKV infection should be kept under surveillance for ZIKV infection. [37]

The CDC has also developed travel notifications so that more stringent follow-ups can be done. [38]

The Assistant Director General, World Health Organization (WHO) has recently (28 January, 2016) stated that countries in the dengue belt with Aedes aegypti should look for ZIKV and take measures to detect neurological conditions. [26]


  Ongoing Researches on Zika Top


The National Institute of Allergy and Infectious Diseases is trying to find out antiviral drugs with actions against ZIKV. It is also working on Zika vaccine. A DNA-based vaccine with the same principle used for West Nile virus, a live attenuated ZIKV vaccine, and a genetically engineered vesicular stomatitis virus vaccine is being researched on. Hopefully, in 2016 we will be informed about the success in this field. [39] Animal models may be helpful for more information about the disease's course as well as treatment of ZIKV infection. [40] As the preventive methods such as removing the breeding areas and insecticide use are now proving insufficient, new approaches of genetically engineered mosquitoes are gaining importance. [41] A US scientist has predicted that it may take 2 years to develop a vaccine to be ready for testing and will take a decade to be available commercially. [42] One of the Indian biotechnology companies, Bharat Biotech, has reportedly claimed to develop two possible vaccines (recombinant and inactivated), which will be tested further in animal trials within a few weeks, (The article was accessed last on Feb 8, 2016). [43]

There are still some unknown facts about this virus. It is present in several body fluids such as the saliva and urine. But whether it can be transmitted by these is not known precisely. For this reason, countries have a ban on blood donations for 1 month after a visit to the affected countries. The ban may be longer if the individual develops symptoms. [44] Other unknown factors about pregnancy and Zika are whether there is any safe period during pregnancy when the infection will not affect the fetus. Another point is the clear-cut chance of transmission of the disease after the mosquito bite in pregnant lady, and the chance of occurrence of congenital anomaly is also not known precisely. We are waiting for the answers. [45]


  2016 Olympic Top


Brazil is going to organize the Olympic and Paralympic Games in 2016 in Rio de Janeiro. The organizing committee has confirmed that it is following the guidelines of WHO for prevention of Zika infection. The International Olympic Committee (IOC) has provided athletes and national olympic committees with guidance about the prevention and symptoms of ZIKV. [46] But as the events are in August (cooler and drier weather), there are less chance of transmission through mosquitoes. [44] We are hopeful that the great event will be a huge success without any medical problem.

Current scenario regarding Zika in the USA (as of February 10, 2016): [45]

In the US states: Travel-related ZIKV disease cases-52, locally acquired mosquito-borne cases-0.

In US territories: Travel-related cases-1, locally acquired cases-9. [45]


  Conclusion Top


Though there are several unknown facts about the pathogenesis, transmission, complications, and treatment of ZIKV, physicians should guide patients regarding prevention of the disease as much as possible. Particular care should be taken of pregnant women. The disease is asymptomatic in a majority of the cases. Affected patients should be kept under close observation. They should be counseled about the use of condoms and the risk of blood donations. Mosquito control measures should also be implemented stringently. Proper preventive methods will break the chain of transmission. Countries where other Aedes mosquito-borne diseases are endemic should be extremely cautious and have a thorough surveillance. In 2016, the vaccine of Zika is expected to arrive. If the current guidelines are followed properly, this infection can be combated successfully.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Public Health Emergency of International Concern (PHEIC) declared for Zika and clusters of microcephaly and neurological disorders. (Accessed February 11, 2016, at: http://ecdc.europa.eu/en/activities/sciadvice/_layouts/forms/Review_DispForm.aspx?List=a3216f4c-f040-4f51-9f77-a96046dbfd72&ID=790#sthash.qs56bU0i.WCbWDCmx.dpuf).  Back to cited text no. 1
    
2.
Petersen E, Wilson ME, Touch S, McCloskey B, Mwaba P, Bates M, et al. Rapid spread of zika virus in the Americas-implications for public health preparedness for mass gatherings at the 2016 Brazil olympic games. Int J Infect Dis 2016;44:11-5.  Back to cited text no. 2
    
3.
Zanluca C, de Melo VC, Mosimann AL, Dos Santos GI, Dos Santos CN, Luz K. First report of autochthonous transmission of Zika virus in Brazil. Mem Inst Oswaldo Cruz 2015;110:569-72.  Back to cited text no. 3
    
4.
Hayes EB. Zika virus outside Africa. Emerg Infect Dis 2009;15:1347-50.  Back to cited text no. 4
    
5.
Ioos S, Mallet HP, Leparc Goffart I, Gauthier V, Cardoso T, Herida M. Current Zika virus epidemiology and recent epidemics. Med Mal Infect 2014;44:302-7.  Back to cited text no. 5
    
6.
Buathong R, Hermann L, Thaisomboonsuk B, Rutvisuttinunt W, Klungthong C, Chinnawirotpisan P, et al. Detection of Zika virus infection in Thailand, 2012-2014. Am J Trop Med Hyg 2015;93:380-3.  Back to cited text no. 6
    
7.
Tognarelli J, Ulloa S, Villagra E, Lagos J, Aguayo C, Fasce R, et al. A report on the outbreak of Zika virus on easter island, South Pacific, 2014. Arch Virol 2015. [Epub ahead of print].  Back to cited text no. 7
    
8.
State of Hawaii. DOH News Release: Hawaii Department of Health Receives Confirmation of Zika Infection in Baby Born with Microcephaly. (Accessed January 27, 2016, at: http://governor.hawaii.gov/newsroom/doh-news-release-hawaii-department-of-health-receives-confirmation-of-zika-infection-in-baby-born-with-microcephaly/).   Back to cited text no. 8
    
9.
O′Dowd A.UK records four cases of Zika virus in past six weeks. BMJ 2016;352:i875.  Back to cited text no. 9
    
10.
Zika virus transmission, Centers for disease control and prevention. (Accessed February 13, 2016, at: http://www.cdc.gov/zika/transmission/index.html).  Back to cited text no. 10
    
11.
Parry L. ′El Niño is to blame for the Zika outbreak′: Exceptionally hot and dry winter in Brazil triggered the crisis, say experts. (Accessed February 5, 2016, at: http://www.dailymail.co.uk/health/article-3433996/El-Ni-o-blame-Zika-outbreak-Exceptionally).  Back to cited text no. 11
    
12.
Musso D, Roche C, Nhan TX, Robin E, Teissier A, Cao-Lormeau VM. Detection of Zika virus in saliva. J Clin Virol 2015;68:53-5.  Back to cited text no. 12
    
13.
Marano G, Pupella S, Vaglio S, Liumbruno GM, Grazzini G. Zika virus and the never-ending story of emerging pathogens and transfusion medicine. Blood Transfus 2015;1-6. [Epub ahead of print].  Back to cited text no. 13
    
14.
Dallas County Health and Human Services. DCHHS Reports First Zika Virus Case in Dallas County Acquired Through Sexual Transmission. (Accessed February 3, 2016, at: http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdf).  Back to cited text no. 14
    
15.
Hamel R, Dejarnac O, Wichit S, Ekchariyawat P, Neyret A, Luplertlop N, et al. Biology of Zika virus infection in human skin cells. J Virol 2015;89:8880-96.  Back to cited text no. 15
    
16.
Sikka V, Chattu VK, Popli RK, Galwankar SC, Kelkar D, Sawicki SG, et al. The emergence of zika virus as a global health security threat: A review and a consensus statement of the INDUSEM Joint working Group (JWG). J Global Infect Dis 2016;8:3-15.  Back to cited text no. 16
  Medknow Journal  
17.
Buckley A, Gould EA. Detection of virus-specific antigen in the nuclei or nucleoli of cells infected with Zika or Langat virus. J Gen Virol 1988;69:1913-20.  Back to cited text no. 17
    
18.
Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009;360:2536-43.  Back to cited text no. 18
    
19.
Zika virus, World health organization. (Accessed February 13, 2016, at: http://www.who.int/mediacentre/factsheets/zika/en).   Back to cited text no. 19
    
20.
Zika virus: Symptoms, Diagnosis, and Treatment, Centers for disease control and prevention. (Accessed February 3, 2016, at: http://www.cdc.symptoms/index.gov/zika/html ).   Back to cited text no. 20
    
21.
Staples JE, Dziuban EJ, Fischer M, Cragan JD, Rasmussen SA, Cannon MJ, et al. Interim guidelines for the evaluation and testing of infants with possible congenital Zika virus infection-United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:63-7.  Back to cited text no. 21
[PUBMED]    
22.
Sexton DJ. Zika virus infection. In: Hirsch MS, Lockwood CJ, Edwards MS. editors. UpToDate; 2016. (Accessed February 13, 2016, at: http://www.uptodate.com/contents/zika-virus-infection).   Back to cited text no. 22
    
23.
Faye O, Faye O, Diallo D, Diallo M, Weidmann M, Sall AA. Quantitative real-time PCR detection of Zika virus and evaluation with field-caught mosquitoes. Virol J 2013;10:311.  Back to cited text no. 23
    
24.
European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus infection outbreak, Brazil and the Pacific region - 25 May 2015. Stockholm: ECDC; 2015. Doi:10.1001/jamaophthalmol.2016.0284.  Back to cited text no. 24
    
25.
Gyurech D, Schilling J, Schmidt-Chanasit J, Cassinotti P, Kaeppeli F, Dobec M. False positive dengue NS1 antigen test in a traveller with an acute Zika virus infection imported into Switzerland. Swiss Med Wkly 2016;146:w14296.   Back to cited text no. 25
    
26.
Gatherer D, Kohl A. Zika virus: A previously slow pandemic spreads rapidly through the Americas. J Gen Virol 2015. [Epub ahead of print].  Back to cited text no. 26
    
27.
Samarasekera U, Triunfol M. Concern over Zika virus grips the world. Lancet 2016;387:521-4.  Back to cited text no. 27
[PUBMED]    
28.
Schuler-Faccini L, Ribeiro EM, Feitosa IM, Horovitz DD, Cavalcanti DP, Pessoa A, et al.; Brazilian Medical Genetics Society-Zika Embryopathy Task Force. Possible association between Zika virus infection and microcephaly-Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016;65:59-62.  Back to cited text no. 28
[PUBMED]    
29.
Jampol LM, Goldstein DA. Zika virus infection and the Eye. JAMA Ophthalmol 2016;1-8.   Back to cited text no. 29
    
30.
Ventura CV, Maia M, Bravo-Filho V, Góis AL, Belfort R Jr. Zika virus in Brazil and macular atrophy in a child with microcephaly. Lancet 2016;387:228.   Back to cited text no. 30
    
31.
de Paula Freitas B, de Oliveira Dias JR, Prazeres J, Sacramento GA, Ko AI, Maia M. Ocular findings in infants with microcephaly associated with presumed Zika virus congenital infection in Salvador, Brazil. JAMA Ophthalmol 2016. [Epub ahead of print].  Back to cited text no. 31
    
32.
Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, et al. Zika virus associated with microcephaly. N Engl J Med 2016. [Epub ahead of print].  Back to cited text no. 32
    
33.
Pan American Health Organization (PAHO), World Health Organization (WHO). PAHO Statement on Zika virus transmission and prevention. (Accessed February 13, 2016, at: http://www.paho.org/hq/index.php?option=com_content&view=article&id=11605&Itemid=0&lang=en).   Back to cited text no. 33
    
34.
Petersen EE, Staples JE, Meaney-Delman D, Fischer M, Ellington SR, Callaghan WM, et al. Interim guidelines for pregnant women during a Zika virus outbreak-United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:30-3.  Back to cited text no. 34
[PUBMED]    
35.
Question and Answers: Zika virus infection (Zika) and pregnancy. (Accessed February 13, 2016, at: http://www.cdc.gov/zika/pregnancy/question-answers.html).   Back to cited text no. 35
    
36.
Oster AM, Brooks JT, Stryker JE, Kachur RE, Mead P, Pesik NT, et al. Interim guidelines for prevention of sexual transmission of Zika virus-United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120-1.  Back to cited text no. 36
[PUBMED]    
37.
Recognizing, Managing, and Reporting Zika Virus Infections in Travelers Returning from Central America, South America, the Caribbean, and Mexico. (Accessed February 13, 2016, at: http://emergency.cdc.gov/han/han00385.asp ).   Back to cited text no. 37
    
38.
Travel Health Notices. (Accessed February 13, 2016, at: http://wwwnc.cdc.gov/travel/notices).   Back to cited text no. 38
    
39.
Zika virus. National Institute of Allergy and Infectious Disease. (Accessed February 13, 2016, at: http://www.niaid.nih.gov/topics/zika/Pages/default.aspx).   Back to cited text no. 39
    
40.
Animal Models Helping to Combat Zika Virus by NABR (national association for biomedical research). (Accessed February 13, 2016, at: http://www.nabr.org/animal-models-helping-to-combat-zika-virus/).   Back to cited text no. 40
    
41.
Pollackjan A. Jan 30, 2016. New Weapon to Fight Zika: The Mosquitohttp. (Accessed February 10, 2016, at: http://www.nytimes.com/2016/01/31/business/new-weapon-to-fight-zika-the-mosquito.html?_r=0).   Back to cited text no. 41
    
42.
Cook J (27 January 2016). "Zika virus: US scientists say vaccine ′10 years away′-BBC News". BBC News. (Accessed January 28, 2016, at: http://www.bbc.com/news/world-us-canada-35423288).  Back to cited text no. 42
    
43.
Siddiqi Z (3 February 2016). "Bharat Biotech says working on two possible Zika vaccines". Reuters. (Accessed February 8, 2016, at: http://in.reuters.com/article/health-zika-vaccine-idINKCN0VC12U).   Back to cited text no. 43
    
44.
Gallagher J. Zika outbreak: What you need to know. 4 February 2016. (Accessed February 10, 2016, at: http://www.bbc.com/news/health-35370848).   Back to cited text no. 44
    
45.
Zika virus, Centers for disease control and prevention. (Accessed February 13, 2016, at: http://www.cdc.gov/zika/index.html).   Back to cited text no. 45
    
46.
Rio 2016 following World Health Organisation advice on zica alert. (Accessed February 13, 2016, at: http://www.rio2016.com/en/news/rio-2016-following-world-health-organisation-advice-on-zica-alert).  Back to cited text no. 46
    


    Figures

  [Figure 1]


This article has been cited by
1 Practical management plan for invasive mosquito species in Europe: I. Asian tiger mosquito (Aedes albopictus)
Romeo Bellini,Antonios Michaelakis,Dušan Petric,Francis Schaffner,Bulent Alten,Paola Angelini,Carles Aranda,Norbert Becker,Marco Carrieri,Marco Di Luca,Elena Falcuta,Eleonora Flacio,Ana Klobucar,Christophe Lagneau,Enrih Merdic,Ognyan Mikov,Igor Pajovic,Dimitrios Papachristos,Carla A. Sousa,Arjan Stroo,Luciano Toma,Marlen I. Vasquez,Enkelejda Velo,Claudio Venturelli,Marija Zgomba
Travel Medicine and Infectious Disease. 2020; : 101691
[Pubmed] | [DOI]
2 Therapeutic Applications of Peptides against Zika Virus: A Review
Preeti Karwal,Ishwar Dutt Vats,Niharika Sinha,Anchal Singhal,Teena Sehgal,Pratibha Kumari
Current Medicinal Chemistry. 2020; 27(23): 3906
[Pubmed] | [DOI]
3 Orally Administrable Therapeutic Synthetic Nanoparticle for Zika Virus
Bapurao Surnar,Mohammad Z. Kamran,Anuj S. Shah,Uttara Basu,Nagesh Kolishetti,Sapna Deo,Dushyantha T. Jayaweera,Sylvia Daunert,Shanta Dhar
ACS Nano. 2019;
[Pubmed] | [DOI]
4 Zika Virus Potentiates the Development of Neurological Defects and Microcephaly: Challenges and Control Strategies
Rabeea Siddique,Yang Liu,Ghulam Nabi,Wasim Sajjad,Mengzhou Xue,Suliman Khan
Frontiers in Neurology. 2019; 10
[Pubmed] | [DOI]
5 Zika virus: - a review of the main aspects of this type of arbovirosis
Ítala Keane Rodrigues Dias,Cicera Luciana da Silva Sobreira,Rosa Maria Grangeiro Martins,Kelly Fernanda Silva Santana,Maria do Socorro Vieira Lopes,Emanuella Silva Joventino,Maria Corina Amaral Viana
Revista da Sociedade Brasileira de Medicina Tropical. 2018; 51(3): 261
[Pubmed] | [DOI]
6 Prevention and Control Strategies to Counter Zika Virus, a Special Focus on Intervention Approaches against Vector Mosquitoes—Current Updates
Raj K. Singh,Kuldeep Dhama,Rekha Khandia,Ashok Munjal,Kumaragurubaran Karthik,Ruchi Tiwari,Sandip Chakraborty,Yashpal S. Malik,Rubén Bueno-Marí
Frontiers in Microbiology. 2018; 9
[Pubmed] | [DOI]
7 Metal–Organic Frameworks for Cell and Virus Biology: A Perspective
Raffaele Riccò,Weibin Liang,Shaobo Li,Jeremiah J. Gassensmith,Frank Caruso,Christian Doonan,Paolo Falcaro
ACS Nano. 2018; 12(1): 13
[Pubmed] | [DOI]
8 ZIKA virus: A new threat to the eyes
Dhrubajyoti Bandyopadhyay,Adrija Hajra
European Journal of Internal Medicine. 2017;
[Pubmed] | [DOI]
9 Advances in Designing and Developing Vaccines Against Zika Virus
Ashok Munjal,Rekha Khandia,Ruchi Tiwari,Sandip Chakrabort,Kumaragurubaran Karthik,Kuldeep Dhama
International Journal of Pharmacology. 2017; 13(7): 667
[Pubmed] | [DOI]
10 Zika Virus Infection in Pregnancy, Microcephaly, and Maternal and Fetal Health: What We Think, What We Know, and What We Think We Know
Maria Gabriela Alvarado,David A. Schwartz
Archives of Pathology & Laboratory Medicine. 2017; 141(1): 26
[Pubmed] | [DOI]
11 Crystal structure of full-length Zika virus NS5 protein reveals a conformation similar to Japanese encephalitis virus NS5
Anup K. Upadhyay,Matthew Cyr,Kenton Longenecker,Rakesh Tripathi,Chaohong Sun,Dale J. Kempf
Acta Crystallographica Section F Structural Biology Communications. 2017; 73(3): 116
[Pubmed] | [DOI]
12 Zika virus infection reprograms global transcription of host cells to allow sustained infection
Shashi Kant Tiwari,Jason Dang,Yue Qin,Gianluigi Lichinchi,Vikas Bansal,Tariq M Rana
Emerging Microbes & Infections. 2017; 6(4): e24
[Pubmed] | [DOI]
13 Adenosine triphosphate analogs can efficiently inhibit the Zika virus RNA-dependent RNA polymerase
Kamil Hercík,Jaroslav Kozak,Michal Šála,Milan Dejmek,Hubert Hrebabecký,Eva Zborníková,Miroslav Smola,Daniel Ruzek,Radim Nencka,Evzen Boura
Antiviral Research. 2017; 137: 131
[Pubmed] | [DOI]
14 Knowledge and attitudes towards Zika virus among medical students in King Abdulaziz University, Jeddah, Saudi Arabia
Nahla K. Ibrahim,Rana H. Moshref,Leena H. Moshref,Jawaher B. Walid,Hadeel S. Alsati
Journal of Infection and Public Health. 2017;
[Pubmed] | [DOI]
15 Simultaneous detection of Dengue and Zika virus RNA sequences with a three-dimensional Cu-based zwitterionic metal–organic framework, comparison of single and synchronous fluorescence analysis
Bao-Ping Xie,Gui-Hua Qiu,Pei-Pei Hu,Zhen Liang,Ye-Mei Liang,Bin Sun,Li-Ping Bai,Zhi-Hong Jiang,Jin-Xiang Chen
Sensors and Actuators B: Chemical. 2017;
[Pubmed] | [DOI]
16 Neurological aspects of chemical and biological terrorism: guidelines for neurologists
Harald De Cauwer,Francis J. M. P. Somville,Marieke Joillet
Acta Neurologica Belgica. 2017;
[Pubmed] | [DOI]
17 An ultrasensitive electrogenerated chemiluminescence-based immunoassay for specific detection of Zika virus
Dhiraj Acharya,Pradip Bastola,Linda Le,Amber M. Paul,Estefania Fernandez,Michael S. Diamond,Wujian Miao,Fengwei Bai
Scientific Reports. 2016; 6: 32227
[Pubmed] | [DOI]
18 Structural Elucidation of the Cell-Penetrating Penetratin Peptide in Model Membranes at the Atomic Level: Probing Hydrophobic Interactions in the Blood–Brain Barrier
Swapna Bera,Rajiv K. Kar,Susanta Mondal,Kalipada Pahan,Anirban Bhunia
Biochemistry. 2016;
[Pubmed] | [DOI]
19 Zika Virus Disease
Richmond Darko,Jessica L. Mashburn
Pediatric Emergency Care. 2016; 32(10): 705
[Pubmed] | [DOI]
20 Zika and pregnancy: A comprehensive review
Adrija Hajra,Dhrubajyoti Bandyopadhyay,Lyndsey R. Heise,Rajarshi Bhadra,Somedeb Ball,Shyamal Kumar Hajra
American Journal of Reproductive Immunology. 2016;
[Pubmed] | [DOI]
21 Zika live Twitter chat
Beuy Joob,Viroj Wiwanitkit
American Journal of Infection Control. 2016; 44(12): 1756
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Transmission
Pathogenesis
Clinical Feature
Diagnosis
Potential Compli...
Treatment
Prevention
Ongoing Research...
2016 Olympic
Conclusion
References
Article Figures

 Article Access Statistics
    Viewed4535    
    Printed63    
    Emailed0    
    PDF Downloaded1120    
    Comments [Add]    
    Cited by others 21    

Recommend this journal