Zika Virus Infection in Tourists Travelling to Thailand: Case Series Report (original) (raw)
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Detection of Zika Virus Infection in Thailand, 2012-2014
American Journal of Tropical Medicine and Hygiene, 2015
Zika virus (ZIKV) is an emerging mosquito-borne pathogen with reported cases in Africa, Asia, and large outbreaks in the Pacific. No autochthonous ZIKV infections have been confirmed in Thailand. However, there have been several cases reported in travelers returning from Thailand. Here we report seven cases of acute ZIKV infection in Thai residents across the country confirmed by molecular or serological testing including sequence data. These endemic cases, combined with previous reports in travelers, provide evidence that ZIKV is widespread throughout Thailand.
PLoS neglected tropical diseases, 2024
Background In response to the 2015-2016 Zika virus (ZIKV) outbreak and the causal relationship established between maternal ZIKV infection and adverse infant outcomes, we conducted a cohort study to estimate the incidence of ZIKV infection in pregnancy and assess its impacts in women and infants. Methodology/Principal findings From May 2018-January 2020, we prospectively followed pregnant women recruited from 134 participating hospitals in two non-adjacent provinces in northeastern Thailand. We collected demographic, clinical, and epidemiologic data and blood and urine at routine antenatal care visits until delivery. ZIKV infections were confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens with confirmed ZIKV underwent whole genome sequencing. Among 3,312 women enrolled, 12 (0.36%) had ZIKV infections, of which two (17%) were detected at enrollment. Ten (83%, 3 in 2 nd and 7 in 3 rd trimester) ZIKV infections were detected during study follow-up, resulting in an infection rate of 0.15 per 1,000 person-PLOS NEGLECTED TROPICAL DISEASES
Zika virus infection in a traveller returning from the Maldives, June 2015
Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin, 2016
We report a Zika virus (ZIKV) infection in a patient with fever and rash after returning to Finland from Maldives, June 2015. The patient had dengue virus (DENV) IgG and IgM antibodies but pan-flavivirus RT-PCR and subsequent sequencing showed presence of ZIKV RNA in urine. Recent association of ZIKV with microcephaly highlights the need for laboratory differentiation of ZIKV from DENV infection and the circulation of ZIKV in areas outside its currently known distribution range.
Viruses
Zika virus (ZIKV) is the mosquito-transmitted virus that the WHO declared a Public Health Emergency of International Concern in 2016 due to the consequence of microcephaly from infected pregnancies. The incidence of Zika infection has been unclear in many countries because most infected people have nonspecific febrile illnesses. This study’s aim is to investigate the incidence of symptomatic Zika virus infections from the archived samples of a dengue cohort study of children in central Thailand from 2006 to 2009. We performed Zika NS1 immunoglobulin (Ig)G enzyme-linked immunosorbent assay (ELISA) screening to identify symptomatic Zika infections in paired acute/convalescent serum samples. Symptomatic Zika infections were confirmed by reverse transcription polymerase chain reactions (RT-PCR) of acute serum samples. The comparison of the Zika NS1 IgG ELISA results between acute and convalescent samples showed 290/955 (30.4%) seropositive cases. Zika RT-PCR results were positive in 28 ...
Zika virus infection and its emerging trends in Southeast Asia
Asian Pacific Journal of Tropical Medicine, 2017
Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. Previously, this rare virus was limited to sporadic cases in Africa and Asia until its emergence in Brazil, South America in 2015, where it rapidly spread throughout the world. Recently, a high number of cases were reported in Singapore and other Southeast Asia countries. A combination of factors explains the current Zika virus outbreak although it is highly likely that the changes in the climate and high frequency of travelling contribute to the spread of Aedes vector carrying the Zika virus mainly to the tropical climate countries such as the Southeast Asia. The Zika virus is known to cause mild clinical symptoms similar to those of dengue and chikungunya and transmitted by different species of Aedes mosquitoes. However, neurological complications such as Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a serious concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Therefore, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.
Viruses, 2021
Data about Zika virus infection and adverse pregnancy outcomes in Southeast Asia are scarce. We conducted an unmatched case-control study of Zika virus (ZIKV) serology in pregnant women enrolled in human immunodeficiency virus (HIV) or hepatitis B virus (HBV) perinatal prevention trials between 1997 and 2015 in Thailand. Case and control groups included women with and without adverse pregnancy outcomes. Plasma samples collected during the last trimester of pregnancy were tested for ZIKV IgG/IgM and Dengue IgG/IgM (Euroimmun, AG, Germany). Case newborn plasma samples were tested for ZIKV IgM and ZIKV RNA (Viasure, Spain). The case group included women with stillbirth (n = 22) or whose infants had microcephaly (n = 4), a head circumference below the first percentile (n = 14), neurological disorders (n = 36), or had died within 10 days after birth (n = 11). No women in the case group were positive for ZIKV IgM, and none of their live-born neonates were positive for ZIKV IgM or ZIKV RNA...
The Lancet Regional Health - Western Pacific, 2021
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Early detection of Zika virus infection among travellers from areas of ongoing transmission in China
Journal of travel medicine, 2016
Nine imported Zika virus (ZIKV) infections (four through temperature monitoring and epidemiological investigation at entry and five by active surveillance tracking of index case contacts during follow-up; from Venezuela [n = 5], Samoa [n = 3] and both Samoa and Fiji [n = 1]) were detected in mainland China from February 1 to 29, 2016. The minimal incubation period lasted 5.2 days, with mean lag time to diagnosis of 2.6 days. Diagnosis relied on positive real-time reverse transcriptase polymerase chain reaction for ZIKV RNA in serum (n = 7), urine (n = 4) or saliva (n = 3), respectively. All cases recovered rapidly without serious complications.
Archives of Virology, 2020
In this study, we compared the characteristics of two strains of Zika virus (ZIKV) isolated in Thailand, one isolated from a febrile patient and one isolated from tissues of a fetus medically terminated due to congenital Zika syndrome (CZS). Replication profiles showed that the isolate from the fetal tissues replicated significantly more slowly than the fever-associated isolate in human lung A549 cells during the first 24 hours postinfection but showed a similar growth profile over longerterm infection. A much smaller difference was observed in Aedes albopictus C6/36 cells. In a quasispecies analysis, a high proportion (approximately 20%) of nonfunctional genomes was identified, caused by an adenine insertion in the prM gene. This insertion was found to be present in two Thai fever strains and as such may represent a common feature of Thai endemic ZIKV. Comparison between viral RNA copy number and viral titer showed that the isolate from fetal tissues was produced more efficiently than the fever-associated isolate. Together, these results suggest that different ZIKV isolates differ in their replication capacity, and this might contribute to the fetotropic potential of a particular strain.
Analysis of Zika virus neutralizing antibodies in normal healthy Thais
Scientific Reports
Zika virus (ZIKV) infections have been reported from all over Thailand, but the number of reported cases remains low, suggesting a degree of immune protection against ZIKV infection. To address this possibility, the presence of ZIKV neutralizing antibodies was determined in serum from 135 healthy Thai adults with a plaque reduction neutralization test (PRNT), and a number of samples were subsequently analyzed for the presence of neutralizing antibodies to dengue virus (DENV) and Japanese encephalitis virus (JEV). Results showed that 70.4% (PRNT 50 ≥ 10), 55.6 (PRNT 50 ≥ 20) or 22.2% (PRNT 90 ≥ 20) of the samples showed neutralizing antibodies to ZIKV. Detailed analysis showed no association between the presence of neutralizing antibodies to other flaviviruses (DENV, JEV) and the presence of ZIKV neutralizing antibodies. These results suggest that the level of ZIKV neutralizing antibodies in the Thai population is enough to dampen the transmission of the virus in Thailand. ZIKV was first isolated from a sentinel monkey in Zika forest Uganda in 1947 1 , and the virus was isolated from Aedes africanus mosquitoes in the same forest a year later 1. The first reported human case of ZIKV infection was reported nearly a decade later, with infection again occurring in Zika forest in Uganda 2,3. Between the initial identification of ZIKV and 2007 only a few sporadic cases of human ZIKV infection in Africa and Asia were reported (as reviewed elsewhere 4). In 2007 a small outbreak on the islands of Yap State in Micronesia represented the first time the virus was detected outside of Africa and Asia and analysis suggested this virus has originated in Southeast Asia 5. The virus again emerged from Southeast Asia in 2013 where it was detected as the causative agent in an outbreak of Zika fever in French Polynesia 6. The virus subsequently spread to many of the islands in the Pacific Ocean, and was detected in Brazil in March 2015 7,8 , and within one year more than a million cases of infection were reported. From Brazil the virus spread quickly to other countries in South, Central and North America (as reviewed elsewhere 4). While serological studies have suggested the presence of ZIKV in Southeast Asia for more than 60 years 9-11 , definitive evidence of the presence of the virus was first reported in 1966 12 , and the first virologically confirmed case of human infection was reported from Cambodia in 2010 13. In 2013 two tourists to Thailand were diagnosed on their return to their home countries with ZIKV infection 14,15 and a subsequent retrospective study by the Thai Ministry of Health confirmed that the virus was present in Thailand and causing disease in the local population 16 , with the earliest confirmed cases dating to infections occurring in 2012. Currently, some 1,600 cases of ZIKV infection are reported to have occurred in 2016 and 2017 by the Thai Ministry of Public Health 17. The basis of the markedly different population impact of ZIKV in the Americas and Southeast Asia remains unknown. At least three human pathogenic mosquito transmitted flavivirus circulate in Thailand, and in addition to ZIKV, both dengue virus (DENV) and Japanese encephalitis virus (JEV) circulate. DENV consists of four closely related, but antigenically distinct viruses 18 , termed DENV 1 to 4 all of which are endemic in Thailand 19. Currently the main public health problem caused by these viruses is infections with DENV, as there are an average of 50,000 cases per year in Thailand, and DENV infection is the leading cause of hospitalization amongst children in Southeast Asia 20. There is a national vaccination program to protect against JEV infections established in 1990 21 , however, JEV infection was the leading cause of hospitalizations for encephalitis in a study undertaken between 2003 and 2005 22. DENV infection induces protective immunity that lasts for many decades and possibly lifelong 23. However the immunity raised is against the homotypic virus only, and only limited or transient protection is generated against heterotypic DENV, and thus multiple infections with DENV are possible 24. Studies have shown that some 90% of Thai adults have antibodies against at least one DENV 25-27. Given the national JEV vaccination campaign, adults