Epidemiology and neurological complications of infection by the Zika virus: a new emerging neurotropic virus

Rev Neurol. 2016 Apr 1;62(7):317-28.
[Article in English, Spanish]

Abstract

Introduction: The current epidemic outbreak due to Zika virus began in 2015 and since then it has been reported in 31 countries and territories in America. The epidemiological and clinical aspects related to infection by Zika virus are reviewed.

Development: Since 2007, 55 countries in America, Asia, Africa and Oceania have detected local transmission of the virus. This epidemic has affected almost 1.5 million people in Brazil. 80% of the cases are asymptomatic. The symptoms of Zika virus disease include fever, maculopapular rash, arthralgia and non-purulent conjunctivitis. The symptoms are usually self-limiting and last one week. An increase in the incidence of cases of microcephaly, retinal lesions and Guillain-Barre syndrome associated with the Zika virus has been reported. Zika-associated Guillain-Barre syndrome in Polynesia is a pure motor axonal variant. The RNA of the Zika virus has been identified in samples of brain tissue, placenta and amniotic liquid of children with microcephaly and in the still-born infants of women infected by Zika during pregnancy. The reverse transcription polymerase chain reaction test is recommended to detect viral RNA, and serological tests (IgM ELISA and neutralising antibodies) should be conducted to confirm infection by Zika. The differential diagnosis includes infection by the dengue and chikungunya viruses.

Conclusions: Knowledge about the pathogenic mechanisms involved in infection due to Zika virus and its long-term consequences in adults and newborn infants is still limited.

Title: Epidemiologia y complicaciones neurologicas de la infeccion por el virus del Zika: un nuevo virus neurotropo emergente.

Introduccion. El actual brote epidemico por virus Zika se inicio en 2015 y en la actualidad afecta a 31 paises y territorios en America. Se revisan los aspectos epidemiologicos y clinicos asociados con la infeccion por virus Zika. Desarrollo. Desde 2007, 55 paises de America, Asia, Africa y Oceania han detectado transmision local del virus. La actual epidemia ha afectado a casi 1,5 millones de personas en Brasil. El 80% de los casos son asintomaticos. La enfermedad por virus Zika cursa con fiebre, exantema maculopapular, artralgias y conjuntivitis no purulenta. Los sintomas suelen ser autolimitados y duran una semana. Se ha descrito un aumento de la incidencia de los casos de microcefalia, lesiones retinianas y sindrome de Guillain-Barre asociados con el virus Zika. El sindrome de Guillain-Barre asociado al Zika en la Polinesia es una variante axonal motora pura. El ARN del virus Zika se ha identificado en muestras de tejido cerebral, placenta y liquido amniotico de niños con microcefalia y en perdidas fetales de mujeres infectadas por Zika durante el embarazo. Se recomienda realizar la prueba de reaccion en cadena de la polimerasa mediante transcriptasa inversa para detectar ARN virico y pruebas serologicas (IgM ELISA y anticuerpos neutralizantes) para confirmar una infeccion por Zika. El diagnostico diferencial incluye la infeccion por virus dengue y chikungunya. Conclusiones. Existe un conocimiento limitado sobre los mecanismos patogenicos implicados y las consecuencias a largo plazo de la infeccion por virus Zika en adultos y recien nacidos.

Publication types

  • Review

MeSH terms

  • Adult
  • Aedes / virology
  • Animals
  • Chikungunya Fever / diagnosis
  • Communicable Diseases, Emerging / epidemiology*
  • Dengue / diagnosis
  • Disease Outbreaks*
  • Female
  • Global Health
  • Guillain-Barre Syndrome / epidemiology
  • Guillain-Barre Syndrome / etiology
  • Humans
  • Incidence
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Insect Vectors / virology
  • Male
  • Microcephaly / epidemiology
  • Microcephaly / etiology
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / virology
  • Retinal Diseases / epidemiology
  • Retinal Diseases / etiology
  • Sexually Transmitted Diseases, Viral / epidemiology
  • Stillbirth
  • Transfusion Reaction
  • Zika Virus / genetics
  • Zika Virus / isolation & purification
  • Zika Virus Infection / complications
  • Zika Virus Infection / epidemiology*
  • Zika Virus Infection / transmission