Zika Virus part 2

The danger of an epidemic from the Zika virus is widespread in the news so here let’s focus on virology rather than epidemiology. 

So far the means of combating the spread of Zika Virus has been limited to vector control.  Aedes mosquitos (africanus, aegypti, albopictus, etc.) Women of childbearing age are advised to wear mosquito repellant and to avoid getting pregnant. 

What studies have been made that may provide information leading to the development of vaccines and/or antivirals effective against Zika virus?

A paper, Genetic and Serologic Properties of Zika Virus Associated with an Epidemic, Yap State, Micronesia, 2007 can be found here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600394/

From the Lancet comes a paper with some genbank accession numbers for the genome sequences:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2900003-9/fulltext

These may provide useful information for those starting their Zika Virus research projects.

seeing a virus through 3D modelling

Zika

Updated: 6 January 2016

In some Brazilian states where Zika virus has been circulating in recent months, there has been a marked increase in cases of newborns with microcephaly. According to a preliminary analysis of research carried out by Brazilian authorities, the greatest risk of microcephaly and malformations is associated with infection during the first trimester of pregnancy. Health authorities, with support from PAHO and other agencies, are conducting research to clarify the cause, risk factors, and consequences of microcephaly.
PAHO/WHO recommends that countries continue to provide access to prenatal care for pregnant women. Women who are pregnant or of childbearing age should avoid exposure to mosquito bites.

What is Zika virus infection?

Zika virus infection is caused by the bite of an infected Aedes mosquito, usually causing mild fever, rash, conjunctivitis, and muscle pain.
The virus was isolated for the first time in 1947 in the Zika forest in Uganda. Since then, it has remained mainly in Africa, with small and sporadic outbreaks in Asia. In 2007, a major epidemic was reported on the island of Yap (Micronesia), where nearly 75% of the population was infected.
On 3 March 2014, Chile notified PAHO/WHO that it had confirmed a case of indigenous transmission of Zika virus on Easter Island, where the virus continued to be detected until June 2014.
In May 2015, the public health authorities of Brazil confirmed the transmission of Zika virus in the northeast of the country. Since October 2015, other countries and territories of the Americas have reported the presence of the virus. See updated list at: www.paho.org/zikavirus.

What are the symptoms?

The most common symptoms of Zika virus infection are mild fever and exanthema (skin rash), usually accompanied by conjunctivitis, muscle or joint pain, and general malaise that begins 2-7 days after the bite of an infected mosquito.
One out of four infected people develops symptoms of the disease. Among those who do, the disease is usually mild and can last 2-7 days. Symptoms are similar to those of dengue or chikungunya, which are transmitted by the same type of mosquito. Neurological and autoimmune complications are infrequent, but have been described in the outbreaks in Polynesia and, more recently, in Brazil. As the virus spreads in the Americas, giving us more experience with its symptoms and complications, it will be possible to characterize the disease better.

How is Zika virus transmitted? 

Zika virus is transmitted to people through the bite of an infected Aedes mosquito. This is the same mosquito that transmits dengue and chikungunya.

Can it be transmitted through blood or sexual contact? 

In general, the Zika virus needs a vector (a means of transportation) to infect people. That vector is the mosquito. The virus has also been isolated in semen, and one case of possible person-to-person sexual transmission has been described, but not confirmed.
Zika can be transmitted through blood, but this is an infrequent mechanism. The usual recommendations for safe transfusions should be followed (e.g., healthy volunteer donors).

Can it be transmitted from mother to child?

There is little information on transmission from mother to baby during pregnancy or childbirth. Perinatal transmission has been reported with other vector-borne viruses, such as dengue and chikungunya. Studies are now being conducted on possible mother-to-child transmission of the virus and its possible effects on the baby. More information.

What treatment is there?

Treatment consists of relieving pain, fever, and any other symptom that inconveniences the patient. To prevent dehydration, it is recommended to control the fever, rest, and drink plenty of water. There is no vaccine or specific drug for this virus.

Can it cause death?

In this Region, it is a new virus that up until now has had a very limited geographical and demographic distribution, and there is no evidence that it can cause death. However, sporadic cases have been reported of more serious manifestations and complications in patients with preexisting diseases or conditions, causing death.

Who is at risk of Zika infection? 

Anyone not previously exposed to the virus and who lives in an area where the mosquito is present, and where imported or local cases have been reported, may be infected. Since the Aedes mosquito is found throughout the Region (except in continental Chile and Canada), it is likely that outbreaks will occur in other countries that have not yet reported any cases.

How is Zika diagnosed?

In most people, diagnosis is based on clinical symptoms and epidemiological circumstances (such as Zika outbreak in the patient’s area or trips to areas where the virus is circulating).
Blood tests can help to confirm the diagnosis. Some (virological PCR tests) are useful in the first 3-5 days after the onset of symptoms, while others (serological tests) detect the presence of antibodies but are useful only after five days.
Once it has been demonstrated that the virus is present in a given area or territory, confirmation of all cases is not necessary, and laboratory testing will be adjusted to routine virological surveillance of the disease.

Which is the difference between Zika, dengue, and chikungunya?

All these diseases present similar symptoms, but certain symptoms suggest one disease or another:
Dengue usually presents with higher fever and more severe muscle pain. There can be complications when the fever breaks: attention should be paid to warning signs such as bleeding.
Chikungunya presents with higher fever and more intense joint pain, affecting the hands, feet, knees, and back. It can disable people, bending them over so that they cannot walk or perform simple actions such as opening a water bottle.
Zika does not have clearly characteristic features, but most patients have skin rashes and some have conjunctivitis.

Is there a relationship between Guillain-Barré syndrome and Zika virus? 

An increase in Guillain-Barré syndrome (GBS) has been observed in areas where a Zika virus epidemic has been documented (e.g., in French Polynesia and Brazil).
However, a direct causal relationship has not been established between Zika virus infection and GBS. Prior infection with dengue or genetic factors could contribute to or increase cases of GBS. Several studies are underway to better establish the relationship between Zika and GBS.
GBS occurs when a person’s immune system attacks itself, in particular affecting the cells of the nervous system. This process can be initiated by infection with various viruses or bacteria. The main symptoms include muscular weakness and tingling (paresthesia) in the arms and legs, and severe complications can occur if the respiratory muscles are affected. The most seriously ill patients need attention in intensive care units.

CIRCULATION OF ZIKA VIRUS

Which countries have reported cases of Zika in the Americas? 

On 3 March 2014, Chile notified PAHO/WHO that it had confirmed a case of indigenous transmission of Zika virus on Easter Island, where the virus continued to be detected until June 2014.
In May 2015, the public health authorities of Brazil confirmed the transmission of Zika virus in the northeast of the country. Since October 2015, other countries and territories of the Americas have reported the presence of the virus. (See updated list at: www.paho.org/zikavirus.

What causes rapid transmission in an area?

There are two factors for rapid transmission (documented in other countries): (1) Since this is a new virus to the Americas, the entire population is susceptible, lacking defenses to Zika virus; and (2) The Aedes mosquito is widespread in the Region, given the climatic conditions, temperature, and humidity in tropical countries.

Is it advisable to travel to countries where Zika virus is circulating? 

PAHO/WHO does not recommend any travel or international trade restrictions related to Zika virus outbreaks. Travelers are advised to take the suggested precautions to prevent mosquito bites.

How many Zika cases have been reported in the Region of the Americas? 

Countries begin reporting when they detect the circulation of the virus in their territories. However, maintaining a case count is difficult because symptoms of the disease tend to be mild and not everyone affected is seen by health services. What is most important is to detect the circulation of the virus, strengthen the response of health services, and step up surveillance of serious cases and complications.

PREVENTION

What measures should be taken to prevent Zika virus infection? 

Prevention involves reducing mosquito populations and avoiding bites, which occur mainly during the day. Eliminating and controlling Aedes aegypti mosquito breeding sites reduces the chances that Zika, chikungunya, and dengue will be transmitted. An integrated response is required, involving action in several areas, including health, education, and the environment.
To eliminate and control the mosquito, it is recommended to:

• Avoid allowing standing water in outdoor containers (flower pots, bottles, and containers that collect water) so that they do not become mosquito breeding sites. 
• Cover domestic water tanks so that mosquitoes cannot get in. 
• Avoid accumulating garbage: Put it in closed plastic bags and keep it in closed containers. 
• Unblock drains that could accumulate standing water. 
• Use screens and mosquito nets in windows and doors to reduce contact between mosquitoes and people. 

To prevent mosquito bites, it is recommended that people who live in areas where there are cases of the disease, as well as travelers and, especially, pregnant women should:

• Cover exposed skin with long-sleeved shirts, trousers, and hats
• Use repellents recommended by the health authorities (and apply them as indicated on the label)
• Sleep under mosquito nets. 

People with symptoms of Zika, dengue, or chikungunya should visit a health center.

What is PAHO/WHO’s response in the Americas? 

PAHO/WHO is working actively with the countries of the Americas to develop or maintain their ability to detect and confirm cases of Zika virus infection, treat people affected by the disease, and implement effective strategies to reduce the presence of the mosquito and minimize the likelihood of an outbreak. PAHO/WHO’s support involves:

• Building the capacity of laboratories to detect the virus in a timely fashion (together with other collaborating centers and strategic partners). 
• Advising on risk communication to respond to the introduction of the virus in the country. 
• Controlling the vector by working actively with the populace to eliminate mosquito populations.
• Preparing recommendations for the clinical care and monitoring of persons with Zika virus infection, in collaboration with professional associations and experts from the countries. 
• Monitoring the geographic expansion of the virus and the emergence of complications and serious cases through surveillance of events and country reporting through the International Health Regulations channel.
• Supporting health ministry initiatives aimed at learning more about the characteristics of the virus, its impact on health, and the possible consequences of infection.

More info from PAHO:

http://www.paho.org/hq/index.php?option=com_topics&view=article&id=427&Itemid=41484&lang=en

Virology - 2 part online course - available until 6/30/16

Important update:
Effective June 30, 2016, courses on the old platform will no longer be available. You should use this opportunity to save any relevant course materials or assignments.

That includes these courses.  



So virology is a part of what we do at Nenufar, studying viruses to find out their habits and lifestyles and how to keep them from ruining our day.  If that seems even a little bit interesting, why not take a course, at no charge - thank you Vincent Racaniello, Ph.D and Columbia University

https://www.coursera.org/course/virology

Part 2 of the course: https://class.coursera.org/virology2-001

Hepatitis C, SARS

Hepatitis C

The World Health Organization estimates that about 3% of the world’s population has been infected with HCV and that there are more than 170 million chronic carriers who are at risk of developing liver cirrhosis and/or liver cancer with a mortality rate of about 6%. In 1998, the estimated annual costs of acute and chronic hepatitis C (medical and work loss) was above US$ 1 billion in the USA

SARS

On 12 March 2003, the World Health Organization issued a global alert of an emerging infectious disease characterized by fever and atypical pneumonia. The rapid spread of severe acute respiratory syndrome – or SARS – worldwide resulted in 8439 cases and 809 deaths in 25 countries.  Although SARS is currently not a big problem, there is concern about MERS (Middle East Respiratory Syndrome), a virus which though it is less contagious than SARS, is thought to be more deadly. 

Ebola Virus

In 1976 the first Ebola outbreak was reported in Zaire, Africa (now the DRC) with the virus infecting 318 people out of which there were only 38 survivors.  In March 2014 there was an outbreak of Ebola in Sub Saharan West Africa that has claimed 11,173 lives as of June 2015.  In 2014 there also occurred a much smaller unrelated outbreak in the DRC.   The West African epidemic is under control at this time, but announcements that Ebola was no longer present in Liberia and Sierra Leone have proven to be premature.  The latest such announcement by the WHO was last Thursday that West Africa was Ebola-Free

 (http://www.who.int/mediacentre/news/releases/2016/ebola-zero-liberia/en/) 

and was followed in just a few hours by the sad news of a new fatality, as a 22 year old woman had fallen victim to the virus in Sierra Leone.  Viruses such as Ebola can persist even after a patient is apparently cured.  They find hiding places in the body and can still be transmitted through bodily fluids.  In laboratories around the world, research is making progress, there are vaccines currently available.  A 2014 document on potential therapies and vaccines may be viewed here  It is interesting to note that Marburg virus is similar enough to Ebola that any outbreak of Marburg could likely be controlled with the same or like therapies and vaccines used against Ebola.

NML is also conducting research that may eventually add a useful medicine to combat the future spread of Ebola.  We'll keep you updated here.  For more information about other research and development please visit: 

http://www.niaid.nih.gov/topics/ebolamarburg/research/pages/default.aspx

http://www.eurekalert.org/pub_releases/2016-01/aeco-eiz010716.php

http://news.xinhuanet.com/english/video/2016-01/16/c_135015519.htm

http://www.sciencedaily.com/releases/2016/01/160111152819.htm

http://www.niaid.nih.gov/topics/ebolamarburg/pages/maskingtechnique.aspx

http://www.niaid.nih.gov/topics/ebolamarburg/pages/rabiesvaccebola.aspx

https://idsa.confex.com/idsa/2015/webprogram/Paper54208.html

https://en.wikipedia.org/wiki/Brincidofovir

http://investor.arbutusbio.com/releasedetail.cfm?ReleaseID=918694

HIV general statistical overview

Imagine for a moment the city the size of Philadelphia or Phoenix.  You visit the thriving city and then return the following year to find it a complete ghost town. 

 Everyone in the city is dead.

The Global Health Observatory estimates that 1.5 million people died from HIV/Aids in 2013 which is roughly the population of one of the above mentioned cities.

Up until now at least 39 million people have died from HIV/Aids worldwide.

About 1 in 20 adults living in Sub Saharan Africa are infected with HIV

In 2010 the Centers for Disease Control estimated that HIV infection was the ninth leading cause of death for Native American people ages 25 to 34

Every year, with increased prevention education and availability of antiretroviral therapy, the death toll is going down.

Though progress is being in the fight against HIV, the devastating effects of the retrovirus are still a major health problem and cause of human suffering.

About 35 million people were living with HIV in 2013