Transcript zika virus

ZIKA VIRUS
Maria Francesca Manca
Interne en médecine
SEHH
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Flaviviridae
Positive, singlestranded genomic
RNA encoding a
protein
Swiss Institute of Bioinformatics [Acceded Feb. 17, 2016]
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Zika
Ecker DJ, The Microbial Rosetta Stone Database: A compilation of global and emerging
infectious microorganisms and bioterrorist threat agents. BMC Microbiology 2005;5:19
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Famille
Flaviviridae
Genre
Flavivirus
Réservoir
Inconnu (primates?)
Transmission
Aedes, ++ Aedes aegypti [Arbovirus]
Transmission sexuelle? Sang?
R0
Inconnu (haut?)
Découverte
1947, Uganda, Zika Forest
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PRECEDENTES EPIDEMIES
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2007, Micronésie (Yap)
2013-2014: Polynésie française
Mai, 2015: Amérique
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28 pays et
territoires
CDC, Last update: February 5, 2016
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ZIKA VIRUS
Clinique
(1/5)
Prévention
Thérapie
≥ 2:
•Fièvre aigue
•Rash maculopapulaire
•Arthralgie
•Conjonctivite
•Prév. des piqûres de moustiques
•Abstinence/protection des rapports
sexuels
TTT de support (Ø aspirine et AINS)
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ZIKA & LE SYSTÈME NERVEUX
ZIKA VIRUS
MICROCEPHALIE
AUTRES DEFECTS
CONGENITAUX
GUILLAIN-BARRE
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CRITERES DE BRADFORD-HILL
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Association forte
Temporalité: La cause
précède l’effet
Spécificité de
l’association
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Reproductibilité des
résultats
Cohérence biologique
Plausibilité biologique
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MICROCEPHALIE
Microcephaly is a head size (measured as
the distance around the top of the head)
significantly below the mean for the
infant's age and sex : <3 SD or <42 cm in
circumference at full growth.
Edmunds S. Mind the Zika Data Gap.
http://blogs.biomedcentral.com
https://www.nlm.nih.gov
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MICROCEPHALIE
20x
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PEC femme enceinte
Voyage/Rapport sexuel
avec ps infectée
Test
Pos/
Non conclusif
Nég
PCR
IgM
Echo répétée ±
Amniocentèse
Echo: microcéphalie/
Calcifications (II-III)
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www.cdc.gov
CAT A L’HOPITAL
PC Contact?
Contact+Gouttelettes?
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PREVENTION
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www.cdc.gov [Accès 29/02/16]
PREVENTION
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Growing Support Among Experts for Zika Advice to
Delay Pregnancy, McNeil DG, New York Times (5 Fev 2016)
Avantages?
Inconvénients?
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DEBUNKING
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L’environnement et la pauvreté
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WHAT NEXT
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La recherche: Vaccin, Modèles animales
La prévention: la lutte au vecteur,
l’information, l’urbanisation
La thérapie: la nécessité des lits de thérapie
intensive etc.
Le problématiques sociales et éducatives
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REFERENCES
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Swiss Institute of Bioinformatics [Acceded Feb. 17, 2016]
Ecker DJ, The Microbial Rosetta Stone Database: A compilation of global and emerging infectious
microorganisms and bioterrorist threat agents. BMC Microbiology2005;5:19
Inserm: Dossier d’information Dengue
Fauci AS. Zika Virus in the Americas — Yet Another Arbovirus Threat. 18 Feb 2016. NEJM
www.cdc.gov
Christofferson R.C. Zika virus emergence and expansion: Lessons learned from Dengue and Chikungunya
may not provide all the answers. Am Soc of Trop Med and Hyg. 22 Feb 2016.
British medical journal: http://sandpit.bmj.com/graphics/2016/zika/index.html
Zika virus en tissues:
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Calvet G. Detection and sequencing of Zika virus from amniotic fl uidof fetuses with microcephaly in Brazil: a case
study. 17 Feb 2016. The Lancet Infectious diseases.
Sarno M; Zika virus infection and stillbirths: a case of hydrops fetalis, hydranencephaly and fetal demise. PLOS
Negl Trop Dis. 25 Feb 2016.
Martines R. Notes from the field: Evidence of ZV infection in brain and placental tissues from two congenitally
infected newborns and two fetal losses. MMWR. 2016.
Mlakar J. Zika virus associated with microcephaly. Brief report. NEJM. 10 Feb 2016.
Alpert SG. Intrauterine West Nile Virus: ocular and systemic findings. Am J Ophthalmol 2003;136:733-5.
Tsai TF. Congenital arboviral infections: something new, something old. Pediatrics. 2006;117:936-9.
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REFERENCES
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Growing Support Among Experts for Zika Advice to Delay Pregnancy, McNeil DG, New
York Times (5 Fev 2016)
Debunking Zika conspiracy theories, Hay M, www.good.is
https://zikainfection.tghn.org/
Venturi G. An autochthonous case of Zika due to possible sexual transmission, Florence,
Italy, 2014. Euro Surveill. 2016 Feb 25;21(8). doi: 10.2807/1560-7917.ES.2016.21.8.30148.
Gulland A. Zika virus may be linked to several birth defects, expert warns. BMJ
2016;352:i1322
Burd I. The chasm between public health and reproductive research: what history tells us
about Zika virus. J Assist Reprod Gene;Feb. 2016.
Cao-Lormeau VM. Guillain-Barré Syndrome outbreak associated with Zika virus infection
in French Polynesia: a case-control study. The Lancet (online 29 Feb.2016).
Hills SL. Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of
Ongoing Transmission — Continental United States, 2016. MMWR. Feb 26, 2016.
Becker R. Missing link: Animal models to study whether Zika causes birth defects. Nat
Med; 2016 Mar 3;22(3):225-7.
WHO Zika Situation Report. 12 Feb 2016.
Duffy MR. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J
Med. 2009 Jun 11;360(24):2536-43
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