RESUMO
The possibility of a Zika virus epidemic resurgence requires studies to understand its mechanisms of pathogenicity. Here, we describe the isolation of the Zika virus from breast milk (Rio-BM1) and compare its genetic and virological properties with two other isolates (Rio-U1 and Rio-S1) obtained during the same epidemic period. Complete genomic analysis of these three viral isolates showed that they carry characteristics of the American isolates and belong to the Asian genotype. Furthermore, we detected eight non-synonymous single nucleotide variants and multiple nucleotide polymorphisms that reflect phenotypic changes. The new isolate, Rio-BM1, showed the lowest replication rates in mammalian cells, induced lower cell death rates, was more susceptible to treatment with type I IFN, and was less pathogenic than Rio-U1 in a murine model. In conclusion, the present study shows evidence that the isolate Rio-BM1 is more attenuated than Rio-U1, probably due to the impact of genetic alterations in the modulation of virulence. The results obtained in our in vitro model were consistent with the pathogenicity observed in the animal model, indicating that this method can be used to assess the virulence level of other isolates or to predict the pathogenicity of reverse genetic constructs containing other polymorphisms.
RESUMO
BACKGROUND: The Zika virus outbreak has triggered a set of local and global actions for a rapid, effective, and timely public health response. A World Health Organization (WHO) initiative, supported by the Department of Chronic Condition Diseases and Sexually Transmitted Infections (DCCI) of the Health Surveillance Secretariat (SVS), Brazil Ministry of Health (MoH) and other public health funders, resulted in the start of the "Study on the persistence of Zika virus in body fluids of patients with ZIKV infection in Brazil - ZIKABRA study". The ZIKABRA study was designed to increase understanding of how long ZIKV persists in bodily fluids and informing best measures to prevent its transmission. Data collection began in July 2017 and the last follow up visit occurred in 06/26/2020. METHODS: A framework for the ZIKABRA Cooperation initiative is provided through a description and analysis of the mechanisms, strategies and the ethos that have guided the models of international governance and technical cooperation in health for scientific exchange in the context of a public health emergency. Among the methodological strategies, we included a review of the legal documents that supported the ZIKABRA Cooperation; weekly documents produced in the meetings and working sessions; technical reports; memorandum of understanding and the research protocol. CONCLUSION: We highlight the importance of working in cooperation between different institutional actors to achieve more significant results than that obtained by each group working in isolation. In addition, we point out the advantages of training activities, ongoing supervision, the construction of local installed research capacity, training academic and non-academic human resources, improvement of laboratory equipment, knowledge transfer and the availability of the ZIKABRA study protocol for development of similar studies, favoring the collective construction of knowledge to provide public health emergency responses. Strategy harmonization; human resources and health services; timing and recruiting particularities and processing institutional clearance in the different sites can be mentioned as challenges in this type of initiative.
Assuntos
Infecção por Zika virus , Zika virus , Brasil/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Saúde Pública , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controleRESUMO
We evaluated sweat, blood and urine specimens obtained from an ongoing cohort study in Brazil. Samples were collected at pre-established intervals after the initial rash presentation and tested for Zika virus (ZIKV) RNA presence by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). From 254 participants with confirmed infection, ZIKV RNA was detected in the sweat of 46 individuals (18.1%). Sweat presented a median cycle threshold (Ct) of 34.74 [interquartile range (IQR) 33.44-36.04], comparable to plasma (Ct 35.96 - IQR 33.29-36.69) and higher than urine (Ct 30.78 - IQR 28.72-33.22). Concomitant detection with other specimens was observed in 33 (72%) of 46 participants who had a positive result in sweat. These findings represent an unusual and not yet investigated virus shedding through eccrine glands.
Assuntos
RNA Viral/genética , Suor/virologia , Infecção por Zika virus/diagnóstico , Zika virus/isolamento & purificação , Adulto , Sangue/virologia , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , RNA Viral/classificação , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Urina/virologia , Zika virus/genética , Infecção por Zika virus/epidemiologiaRESUMO
Zika virus (ZIKV) has been detected in blood, urine, semen, cerebral spinal fluid, saliva, amniotic fluid, and breast milk. In most ZIKV infected individuals, the virus is detected in the blood to one week after the onset of symptoms and has been found to persist longer in urine and semen. To better understand virus dynamics, a prospective cohort study was conducted in Brazil to assess the presence and duration of ZIKV and related markers (viral RNA, antibodies, T cell response, and innate immunity) in blood, semen, saliva, urine, vaginal secretions/menstrual blood, rectal swab and sweat. The objective of the current manuscript is to describe the cohort, including an overview of the collected data and a description of the baseline characteristics of the participants. Men and women ≥ 18 years with acute illness and their symptomatic and asymptomatic household contacts with positive reverse transcriptase-polymerase chain reaction test for ZIKV in blood and/or urine were included. All participants were followed up for 12 months. From July 2017 to June 2019, a total of 786 participants (284 men, 502 women) were screened. Of these, 260 (33.1%) were enrolled in the study; index cases: 64 men (24.6%), 162 (62.3%) women; household contacts: 12 men (4.6%), 22 (8.5%) women. There was a statistically significant difference in age and sex between enrolled and not enrolled participants (p<0.005). Baseline sociodemographic and medical data were collected at enrollment from all participants. The median and interquartile range (IQR) age was 35 (IQR; 25.3, 43) for men and 36.5 years (IQR; 28, 47) for women. Following rash, which was one of the inclusion criteria for index cases, the most reported symptoms in the enrollment visit since the onset of the disease were fever, itching, arthralgia with or without edema, non-purulent conjunctivitis, headache, and myalgia. Ten hospitalizations were reported by eight patients (two patients were hospitalized twice) during follow up, after a median of 108 days following symptom onset (range 7 to 266 days) and with a median of 1.5 days (range 1 to 20 days) of hospital stay. A total of 4,137 visits were performed, 223 (85.8%) participants have attended all visits and 37 (14.2%) patients were discontinued.
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Leite Humano/virologia , RNA Viral/sangue , Saliva/virologia , Infecção por Zika virus/virologia , Zika virus/isolamento & purificação , Adulto , Brasil , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Carga Viral , Eliminação de Partículas Virais , Adulto JovemRESUMO
We evaluated sweat, blood and urine specimens obtained from an ongoing cohort study in Brazil. Samples were collected at pre-established intervals after the initial rash presentation and tested for Zika virus (ZIKV) RNA presence by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). From 254 participants with confirmed infection, ZIKV RNA was detected in the sweat of 46 individuals (18.1%). Sweat presented a median cycle threshold (Ct) of 34.74 [interquartile range (IQR) 33.44-36.04], comparable to plasma (Ct 35.96 - IQR 33.29-36.69) and higher than urine (Ct 30.78 - IQR 28.72-33.22). Concomitant detection with other specimens was observed in 33 (72%) of 46 participants who had a positive result in sweat. These findings represent an unusual and not yet investigated virus shedding through eccrine glands.
Assuntos
Humanos , Masculino , Feminino , Adulto , Suor/virologia , RNA Viral/genética , Zika virus/isolamento & purificação , Infecção por Zika virus/diagnóstico , Urina/virologia , Sangue/virologia , Brasil/epidemiologia , RNA Viral/isolamento & purificação , RNA Viral/classificação , Estudos de Coortes , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Reação em Cadeia da Polimerase em Tempo Real , Zika virus/genética , Infecção por Zika virus/epidemiologiaRESUMO
BACKGROUND: Zika virus (ZIKV) is an emergent threat provoking a worldwide explosive outbreak. Since January 2015, 41 countries reported autochthonous cases. In Brazil, an increase in Guillain-Barré syndrome and microcephaly cases was linked to ZIKV infections. A recent report describing low experimental transmission efficiency of its main putative vector, Ae. aegypti, in conjunction with apparent sexual transmission notifications, prompted the investigation of other potential sources of viral dissemination. Urine and saliva have been previously established as useful tools in ZIKV diagnosis. Here, we described the presence and isolation of infectious ZIKV particles from saliva and urine of acute phase patients in the Rio de Janeiro state, Brazil. METHODOLOGY/PRINCIPAL FINDINGS: Nine urine and five saliva samples from nine patients from Rio de Janeiro presenting rash and other typical Zika acute phase symptoms were inoculated in Vero cell culture and submitted to specific ZIKV RNA detection and quantification through, respectively, NAT-Zika, RT-PCR and RT-qPCR. Two ZIKV isolates were achieved, one from urine and one from saliva specimens. ZIKV nucleic acid was identified by all methods in four patients. Whenever both urine and saliva samples were available from the same patient, urine viral loads were higher, corroborating the general sense that it is a better source for ZIKV molecular diagnostic. In spite of this, from the two isolated strains, each from one patient, only one derived from urine, suggesting that other factors, like the acidic nature of this fluid, might interfere with virion infectivity. The complete genome of both ZIKV isolates was obtained. Phylogenetic analysis revealed similarity with strains previously isolated during the South America outbreak. CONCLUSIONS/SIGNIFICANCE: The detection of infectious ZIKV particles in urine and saliva of patients during the acute phase may represent a critical factor in the spread of virus. The epidemiological relevance of this finding, regarding the contribution of alternative non-vectorial ZIKV transmission routes, needs further investigation.
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Saliva/virologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/urina , Zika virus/isolamento & purificação , Adulto , Idoso , Brasil/epidemiologia , Feminino , Genoma Viral , Humanos , Pessoa de Meia-Idade , Filogenia , Gravidez , RNA Viral/classificação , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto Jovem , Infecção por Zika virus/epidemiologiaRESUMO
A Febre Amarela, uma doença causada por um representante do gênero Flavivírus, é caracterizada principalmente por grave injúria hepática que pode levar ao óbito. Há 70 anos, esta doença tem sido controlada por uma vacina constituída do vírus atenuado cepa 17D, que apresenta raríssimos casos de efeitos adversos. O vírus vacinal exibe replicação limitada no hospedeiro, porém com significativa disseminação da massa viral, levando a uma resposta imune forte e de longa duração. Devido a estas qualidades, o uso do vírus FA 17D como um vetor expressão mostra-se atraente para desenvolvimento de novas vacinas humanas. Apenas recentemente a vacina contra a febre amarela vem sendo estudada para esclarecimento dos mecanismos da imunidade gerada pelo vírus 17D e pouco é sabido sobre o tropismo e sítios de proliferação viral. Este trabalho investigou o potencial proliferativo do vírus FA 17D como modelo para o estudo de outros vírus recombinantes produzidos no laboratório, com o objetivo de caracterizar o grau de dispersão viral em diferentes órgãos. Para tanto, camundongos isogênicos (BALB/c) foram inoculados por via subcutânea na região dorsal com 105 ou 2 x 106 PFU do vírus 17DD, após 1, 2, 4, 7 e 11 dias foram colhidos o soro, a pele do sítio de inoculação, os linfonodos drenantes, o fígado e o baço para detecção do RNA viral por RT-PCR semi-nested e quantificação da carga viral por qRT-PCR. Verificou-se que com a dose maior mais camundongos apresentaram RNA viral nos órgãos e o vírus atingiu o fígado e o baço mais precocemente, sendo detectado também no soro a partir do primeiro dia pós-inoculação. Pele e linfonodo drenante do local da inoculação parecem ser sítios de replicação primária, onde o RNA viral foi detectado nos primeiros dias de infecção, com queda da carga viral após o sétimo dia. Foram dosados alguns marcadores de função hepática (AST, ALT e bilirrubina) para verificar se a imunização com o vírus 17DD poderia induzir disfunções ou lesões hepáticas, porém os resultados não mostraram diferença significativa entre o grupo vacinado e o grupo controle, mostrando que a vacina não afeta o funcionamento do fígado. Tentamos ainda avaliar alterações no perfil de citocinas séricas após imunização com o vírus 17DD através do ensaio de detecção múltipla, porém a técnica não foi sensível o suficiente para detectar qualquer alteração. O modelo estabelecido neste trabalho poderá servir como base de comparação para avaliação de novos candidatos vacinais constituídos de vírus FA recombinantes.