Urine and saliva as transmission threat?The Fiocruz Institute scientists initially announced their findings in Brazil in early February and published the full results on Jun 24 in Public Library of Science (PLoS) Neglected Tropical Diseases.Of nine patients sampled, 6 were from a group of pregnant women with rash, and 3—2 men and 1 woman—had sought care for their Zika symptoms at a Fiocruz acute care clinic. Nine urine samples and five saliva samples were collected from the patients. Tests on the samples included reverse-transcriptase polymerase chain reaction (RT-PCR), quantitative RT-PCR, nucleic acid testing (NAT), and Vero cell inoculation.Live virus was found in two samples from different patients, one from urine and one from saliva. For patients who submitted both types of sample, urine viral loads were higher than in saliva.The authors said their finding in saliva seems to confirm a case report of live virus isolated from the saliva of a patient who got sick in January after returning from the Dominican Republic to Italy, reported in March in Eurosurveillance.In April, French researchers in an early-online letter to the New England Journal of Medicine reported a sexual Zika transmission case in which they couldn’t rule out the possible of saliva as one of the ways the infected man passed the virus to his female partner.The importance of both body fluids as transmission routes isn’t clear and needs more study, the authors wrote. They noted that the acidic pH of urine might restrict viral spread.For saliva, the isolation of viable virus doesn’t always prove that the virus can transmit orally, because saliva typically contains antiviral molecules and is relatively hypotonic, meaning it can lyse enveloped viruses. They said the possibility of person-to-person spread through disruptions in oral mucosa or periodontal pockets, however, should be investigated.
A pair of studies today probing the complex antibody reactions between Zika and dengue infection have both bad news and good news: that earlier dengue infection can worsen Zika infections, but a certain antibody against dengue can also neutralize Zika virus, raising the possibility of a vaccine target.
In what may be the most accurate real-time picture of Zika activity in Puerto Rico, a sensitive test for screening blood donations shows rapidly rising levels that could result in thousands of infections in pregnant women, the US Centers for Disease Control and Prevention (CDC) warned today. At a media briefing, CDC Director Tom Frieden, MD, MPH, said high levels of Zika activity in the US territory could result in dozens to hundreds of babies born with microcephaly. Puerto Rico has been using a highly sensitive investigational test since Apr 3 to screen local blood collections. Frieden said that though it’s not a stand-in for a serologic survey and doesn’t reflect a random sample, “it gives us a window to see what’s happening with infection rates.” Illnesses probably haven’t peaked yet, and disease activity—in view of dengue and chikungunya patterns—may last through summer and into the fall.
In an update today. the CDC reported more local Zika infections in US territories and more travel-related cases in US states. Affected territories reported 135 more illnesses last week, raising the total number of local cases to 1,436. One fewer related Guillain-Barre syndrome (GBS) was reported in the territories, dropping that number to 6. In US states, 64 more travel-related Zika cases were reported, along with the recent lab-acquired case in Pennsylvania, putting the overall total at 756. The number of sexually transmitted Zika cases remained the same, at 11, and 1 more GBS cases was reported in US states, lifting that total to 3.
Meanwhile, it would be great if Brazil published its national numbers in a weekly report – along with confirmed numbers. The promise of the “Boletins Epidemiológicos de Dengue, Chikungunya e Zika” has not been realised with only two reports over the past 10 epidemiological weeks and no specific listing of laboratory confirmed numbers.
WHO: Cast surveillance net beyond microcephaly Current evidence and unpublished data coming into the WHO are showing a wider range of birth defects besides microcephaly, including craniofacial disproportion, spasticity, seizures, irritability, eye problems, and brainstem dysfunction, leading to, for example, feeding difficulties. The WHO said clinicians are seeing a range of severity, including neurologic problems in babies born with normal head circumference, similar to those associated with other maternal infections. Unpublished data from Colombia and Panama, however, hint that Zika virus might be linked to other problems in babies, affecting the genitourinary, cardiac, and digestive systems, according to the report. The WHO said it has established a process to define the new congenital syndrome, which will focus on mapping and analyzing the clinical manifestations. Experts will need good antenatal and postnatal histories and follow-up data, lab findings, and neuroimaging results to flesh out the syndrome, the agency added.
“The clearest consequence is that you increase the risk of spreading the virus and the disease. With half-a-million people going to Rio for the Games – not just the usual visitors but people coming from every corner of the world – you open up the possibility of someone from each one of those places getting infected. Once the individual returns to his country, the local mosquitoes may then transmit the disease,” says Amir Attaran, a professor of epidemiology and public health at the University of Ottawa. Attaran co-authored the letter that more than 170 scientists have signed and sent to the World Health Organization (WHO) and the International Olympic Committee, urging them to postpone the upcoming Games – scheduled for August 5 to August 21 – until the Zika virus is no longer a threat. The letter also asks the organizations to consider moving the Games to another host country.
WHO noted, however, that people continue to travel between countries with the virus. There are also those who do not travel, for a number of other reasons. WHO has already urged pregnant women not to attend the games and in February called the virus a global health concern. The health experts questioned a possible conflict of interest because of WHO’s relationship with the International Olympics Committee. They called for an unbiased, evidence-based assessment to guide the UN health body. Moving the Olympics in such a short time period is not practical and cancelling or postponing the games would entail massive economic losses.
The outbreak of seven autochthonous dengue cases reported by Succo et al. in this issue of Eurosurveillance  was triggered by one infected traveller returning from French Polynesia in the summer of 2015, and occurred in an area where another vector, Ae. albopictus, the Asian Tiger mosquito, was established in 2005. This is not the first event of local transmission of DENV reported in Europe in recent years. Since 2010, at least 23 dengue cases were detected. In September 2010, two autochthonous cases of dengue fever were identified in Nice, southern France. The index case had friends from the West French Indies staying with him, while the second case was an individual living nearby . In the summer of the same year, another transmission event occurred in Croatia [8,9]. The index case was a German man returning in mid-August from a two-week holiday spent at the Peljesac peninsula and the isle of Korĉula, ca 100 km north-west of Dubrovnik. A second autochthonous case, and other 15 individuals with serological evidence of recent infection, were identified in October 2010. How the virus was introduced in Croatia remains unclear. In 2013 and 2014, five autochthonous case of dengue were identified in southern France, one in Bouches-du-Rhône (2013) , and four in Aubage and Toulon-Hìres (2014) . Ae. albopictus was the vector in all the transmission events listed here. Dengue is not the only Aedes-borne viral disease threatening the health of European citizens. Nearly 10 years ago, in the summer of 2007, more than 250 cases of chikungunya occurred in the north-east of Italy . The primary case was a viraemic individual arriving from the Indian State of Kerala. The chikungunya virus (CHIKV) implicated in the sustained outbreak carried the A226V mutation, which increases virus fitness and is usually detected in areas where the Tiger mosquito is the predominant vector . In September 2010, autochthonous transmission of the CHIKV was also identified in south-east France, where chikungunya was diagnosed in two children living in the same area as another child who developed a febrile illness after returning from Rajasthan, India .
Source: Eurosurveillance – View Article
The new Brazilian president’s first pick for science minister was a creationist. He chose a soybean tycoon who has deforested large tracts of the Amazon rain forest to be his agriculture minister. And he is the first leader in decades to have no women in his cabinet at all. The new government of President Michel Temer — the 75-year-old lawyer who took the helm of Brazil on Thursday after his predecessor, Dilma Rousseff, was suspended by the Senate to face an impeachment trial — could cause a significant shift to the political right in Latin America’s largest country. “Temer’s government is starting out well,” Silas Malafaia, a television evangelist and author of best-selling books like “How to Defeat Satan’s Strategies,” wrote on Twitter. “He’ll be able to sweep away the ideology of pathological leftists,” Mr. Malafaia added of a conservative lawmaker whom Mr. Temer chose as education minister.