Editorial
ZIKA VIRUS – A NEWLY EMERGING ARBOVIRUS OR GLOBAL PUBLIC HEALTH THREAT
TATJANA VILIBIĆ-ČAVLEK
orcid.org/0000-0002-1877-5547
; Croatian National Institute of Public Health, University of Zagreb, School of Medicine, Zagreb, Croatia
IRENA TABAIN
; Croatian National Institute of Public Health, Zagreb, Croatia
GORANKA PETROVIĆ
; Croatian National Institute of Public Health, Zagreb, Croatia
VLADIMIR STEVANOVIĆ
; University of Zagreb, Veterinary Faculty, Zagreb, Croatia
VLADIMIR SAVIĆ
; Croatian Veterinary Institute, Zagreb, Croatia
PAVLE JELIČIĆ
; Croatian National Institute of Public Health, Zagreb, Croatia
ANDREA BABIĆ-ERCEG
; Croatian National Institute of Public Health, Zagreb, Croatia
NENAD PANDAK
; Dr Josip Benčević General Hospital, Slavonski Brod, Croatia
LJUBO BARBIĆ
; University of Zagreb, Veterinary Faculty, Zagreb, Croatia
Abstract
Zika virus (ZIKV) was isolated in 1947 from a febrile rhesus monkey in the Zika forest, Uganda, and subsequently (1948) from Aedes africanus mosquitoes in the same region. First human cases were reported in 1952 in Uganda and Tanzania.until 2007, ZIKV was maintained in enzootic cycle within Africa with only sporadic human cases reported. After the outbreak on the Yap Island (Federated States of Micronesia) in 2007, several outbreaks were reported on the Pacifi c Islands (French Polynesia, New Caledonia, Cook Islands, Easter Island). In 2015, ZIKV was introduced in Brazil with further spreading across Central and South America. Comparing the pre-epidemic Asian and African lineage strains with the epidemic ZIKV strains, several amino acid substitutions were only present in the epidemic strains which could be associated with changes in virulence and the rapid spread of the virus. In a sylvatic cycle, ZIKV is transmitted between monkeys and different mosquito species of the genus Aedes. In an urban cycle, the virus is transmitted between humans through the bite of infected Aedes aegypti and less effi cient, Aedes albopictus mosquitoes. Some other modes of inter-human transmission have been demonstrated, including sexual transmission, blood transfusion/organ transplantation, transplacental and perinatal transmission. Although ZIKV RNA has been detected in breastmilk, transmission through breastfeeding has not been reported. The majority of infections (~80%) are asymptomatic. The main symptoms associated with ZIKV infection include fever, rash, myalgia, arthralgia and conjunctivitis. However, meningitis, encephalitis and myelitis have also been reported. Guillain-Barre syndrome is the most commonly reported neurological complication. ZIKV infection during pregnancy can result in spontaneous abortion or congenital ZIKV syndrome. The congenital abnormalities associated with maternal ZIKV
infection include microcephaly, intracerebral calcifi cations, ventriculomegaly and chorioretinal atrophy. Diagnosis of ZIKV includes direct (viral isolation, RT-PCR) and indirect (serology) methods. ZIKV RNA can be detected in blood, urine, saliva, semen and amniotic fl uid. Since cross-reactive antibodies with other fl aviviruses are commonly observed, especially with dengue virus, initially reactive results should be confirmed using neutralization tests. Due to similar clinical symptoms and geographical distribution, dengue and chikungunya should be included in the differential diagnosis of ZIKV infection. Many
importations of ZIKV infections have been reported in European countries since 2013. In Croatia, 106 travelers returning from endemic areas were tested so far. Clinically manifest ZIKV infection was serologically confi rmed in three patients.
Keywords
Zika virus; epidemiology; clinical picture; diagnosis; prevention
Hrčak ID:
193698
URI
Publication date:
15.2.2018.
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