There remain a few of voids around the ZIKV/microcephaly topic that I can and have listed below…
- How long has ZIKV been in Brazil and in what numbers?
- What are the real (not affected by extra attention/poor reporting) rates of microcephaly in Brazil?
- Do real rates of microcephaly diagnoses vary by region/state?
- What are the real rates of microcephaly in countries other than Brazil?
- How many microcephaly diagnoses have been infected with ZIKV?
- How many infections by other viruses including Dengue virus (DENV)?
- Is microcephaly a seasonal diagnosis?
- What other possible causes of microcephaly also occur with a seasonal pattern?
- Are DENV and Chikungunya virus (CHIKV) and other mosquito-borne virus infections seasonal?
- Is ZIKV seasonal?
- Is mosquito treatment and/or mosquito breeding in this region seasonal?
- Apart from Pyriproxyfen, what other pesticides are in use and are they all equally safe?
- What has been excluded from having a role in causing a GBS or microcephaly diagnosis so far?
- What are the data supporting this?
- What about other chemicals that have been associated with microcephaly, for example Isoretinoids in cosmetics [22]
- What is the tissue distribution of the ZIKV receptor(s) and are we happy we know what that receptor(s) is/are [23]?
- Does ZIKV cross the blood-brain and placental barriers in the absence of microcephaly?
- What does ZIKV do in foetal, or infant/child/adult, brain tissue?
- Is it destructive or inflammatory and does it constantly produce new virus or does it enter some type of latency?
- How long does ZIKV persist in foetal tissues?
- Are there long-term disease consequences from ZIKV infection of brain tissue that stretch into adulthood?
- Does ZIKV persist in the adult central nervous system or anywhere else apart from semen (and what is the upper limit of persistence in semen)? Do DENV, CHIKV, JEV etc persist?
- Are the mutations observed between ZIKV lineages and within lineages important for viral virulence, transmissibility or for the clinical course of disease?
- Is ZIKV present in and/or able to persist in the eye (during or after conjunctivitis) or in other organs?
- Are there mums with evidence of past ZIKV infection who have delivered completely healthy babies?
- Do these babies have any other issues?
- How has the study of ZIKV infection in mums been done – by unbiased selection and testing or testing only those with symptoms?
- When would we expect to see signs of microcephaly among pregnant mothers in Colombia and other countries with large outbreaks of ZIKV?
Source: VDU’s blog: Zika virus: pathology, postulates and questions…
(it is not easy, is it?)









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