Other viruses

13

May, 2022

Case numbers of acute hepatitis of unknown aetiology among children in 24 countries up to 18 April 2022 compared to the previous 5 years

 

Authors: Beek JV, Fraaij PL, Giaquinto C, Shingadia D,  Horby P, Indolfi G, Koopmans M, Acute hepatitis study group

Published in: Eurosurveillance

8

Mar, 2022

ZIKAction paediatric registry: maternal characteristics and clinical, radiological, and follow-up features of children born with congenital zika infection in brazil

 

Authors: B.L de Almeida, I.C de Siqueira, M.L.C Lage, L.S Lopes, A.L de Carvalho, M.M de Lima, M.d.F.N Goes, M.N Crispim, B.G.G Costa, C Giaquinto, G Fernandes, E Ruiz-Burga, C Thorne on belhaf of Zikaction consortium

Presented at: WSPID 2022

Abstract

Background: In 2015, Brazil experienced an unexpected increase in newborns with microcephaly. Subsequently, the association between microcephaly and Congenital Zika Infection (CZI) was confirmed.

Aims: This study, part of the ZIKAction Paediatric Registry, intends to describe clinical, radiological, neurodevelopmental, and laboratory features and follow-up of children with CZI in Bahia, Brazil.

Methods: This observational study had following inclusion criteria: intrauterine exposure to ZIKV, laboratory-confirmed CZI, or meeting the definition of suspected CZI, based on clinical and radiological features. Results: Of 129 participants, 57% were female. Most mothers (75%) had symptoms suggestive of Zika infection during pregnancy. Median gestational age at delivery was 38 weeks, with 19% delivered preterm. Median birth length and weight were 46cm and 2690g, respectively. Most infants (118, 91.5%) had microcephaly (median head circumference Zscore -3.51, IQR -4.69,-2.73), and 17 (13.2%) have arthrogryposis. During follow-up, 96% and 92% of children had hearing and ophthalmological assessments, with 21% and 57% having abnormalities respectively. Brain image was abnormal in all cases, with ventriculomegaly (70.1%), cerebral parenchyma calcifications (62.1%), and cortical atrophy (48.6%) were main findings. Median age at last follow-up was 5 years; to date, 54 (42%) participants needed hospitalization, 44 (35%) needed care in the emergency department, and two (1.5%) died.

Conclusion: CZI is an emerging disease shown to have a varied spectrum. Registry children were biased towards those with more severe disease, with several abnormalities and complications observed. Continued long-term follow-up is essential to understand the prognosis and clinical spectrum as these children reach school-age.

View presentation

21

Feb, 2022

Antenatal Seroprevalence of Zika and Chikungunya Viruses, Kingston Metropolitan Area, Jamaica, 2017–2019

 

Authors: J.J. Anzinger, C.D. Mears, A.E. Ades, K Francis, Y Phillips, Y.E. Leys, M.J. Spyer, D Brown, A.M.B.d Filippis, E Nastouli, T Byrne, H Bailey, P Palmer, L Bryan, K Webster-Kerr, C Giaquinto, C Thorne, C.D.C. Christie, and on behalf of the ZIKAction Consortium

Published in: Emerging Infectious Diseases Journal

 

24

Aug, 2021

Causes of Microcephaly in the Zika Era in Argentina: A Retrospective Study

Tags:

Authors: G Berberian, R Bologna, MG Pérez, A Mangano, PhD, M Costa, MSc, S Calligaris, MA Morales, C Rugilo, E Ruiz-Burga, C Thorne

Published in: Sage Journals

 

Abstract

There are gaps in understanding the causes and consequences of microcephaly. This paper describes the epidemiological characteristics, clinical presentations, and etiologies of children presenting microcephaly during the Zika outbreak in Argentina. This observational retrospective study conducted in the pediatric hospital of Juan P. Garrahan reviewed the medical records of 40 children presenting microcephaly between March 2017 and November 2019. The majority (60%) were males and born full-term. At first evaluation, microcephaly was defined as congenital (31/40, 77%) and associated with other features (68%) such as seizures, developmental delay, non-progressive chronic encephalopathy, and West Syndrome. It was found manifestations restricted to central nervous system (55%), ocular (8/40, 20%), and acoustic (9/40, 23%) defects, and abnormal neuroimaging findings (31/39, 79%). Non-infectious diseases were the primary cause of isolated microcephaly (21/37, 57%), largely related to genetic diseases (13/21, 62%). Only 3 were children were diagnosed with Congenital Zika infection (3/16, 7.5%).

View article 

12

Jan, 2021

Zika virus infection in pregnancy: a protocol for the join analysis of the prospective cohort studies of the ZIKAlliance, ZikaPLAN and ZIKAction consortia

Tags: ,

Authors: A E Ades, Elizabeth B Brickley, Neal Alexander, David Brown, Thomas Jaenisch, Demócrito de Barros Miranda-Filho, Moritz Pohl, Kerstin D Rosenberger, Antoni Soriano-Arandes , Claire Thorne et al.

Published in: BMJ Journals

 

Abstract: 

Introduction    Zika virus (ZIKV) infection in pregnancy has been associated with microcephaly and severe neurological damage to the fetus. Our aim is to document the risks of adverse pregnancy and birth outcomes and the prevalence of laboratory markers of congenital infection in deliveries to women experiencing ZIKV infection during pregnancy, using data from European Commission-funded prospective cohort studies in 20 centres in 11 countries across Latin America and the Caribbean.

Methods and analysis    We will carry out a centre-by- centre analysis of the risks of adverse pregnancy and birth outcomes, comparing women with confirmed and suspected ZIKV infection in pregnancy to those with no evidence of infection in pregnancy. We will document the proportion of deliveries in which laboratory markers of congenital infection were present. Finally, we will investigate the associations of trimester of maternal infection in pregnancy, presence or absence of maternal symptoms of acute ZIKV infection and previous flavivirus infections with adverse outcomes and with markers of congenital infection. Centre-specific estimates will be pooled using a two-stage approach.

Ethics and dissemination   Ethical approval was obtained at each centre. Findings will be presented at international conferences and published in peer-reviewed open access journals and discussed with local public health officials and representatives of the national Ministries of Health, Pan American Health Organization and WHO involved with ZIKV prevention and control activities.

Read full article

Read

22

Dec, 2020

Clinical Charateristrics of 58 Children with a Pediatric Inflmmatory Multisystem Syndrome Temporally Associated with SARS-CoV-2

Tags: ,

Authors: Elizabeth Whittaker, Alasdair Bamford, Julia Kenny, Myrsini Kaforou, Christine E Jones, Priyen Shah, Padmanabhan Ramnarayan, Alain Fraisse, Owen Miller, Patrick Davies, Filip Kucera, Joe Brierley, Marilyn McDougall, Michael Carter, Adriana Tremoulet, Chisato Shimizu, Jethro Herberg, Jane C Burns, Hermione Lyall, Michael Levin, PIMS-TS Study Group and EUCLIDS and PERFORM Consortia

Published in: JAMA Network

 

Abstract: Importance: In communities with high rates of coronavirus disease 2019, reports have emerged of children with an unusual syndrome of fever and inflammation.

Objectives:To describe the clinical and laboratory characteristics of hospitalized children who met criteria for the pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS) and compare these characteristics with other pediatric inflammatory disorders.

Design, setting, and participants:Case series of 58 children from 8 hospitals in England admitted between March 23 and May 16, 2020, with persistent fever and laboratory evidence of inflammation meeting published definitions for PIMS-TS. The final date of follow-up was May 22, 2020. Clinical and laboratory characteristics were abstracted by medical record review, and were compared with clinical characteristics of patients with Kawasaki disease (KD) (n = 1132), KD shock syndrome (n = 45), and toxic shock syndrome (n = 37) who had been admitted to hospitals in Europe and the US from 2002 to 2019.

Exposures:Signs and symptoms and laboratory and imaging findings of children who met definitional criteria for PIMS-TS from the UK, the US, and World Health Organization.

Main outcomes and measures:Clinical, laboratory, and imaging characteristics of children meeting definitional criteria for PIMS-TS, and comparison with the characteristics of other pediatric inflammatory disorders.

Results:Fifty-eight children (median age, 9 years [interquartile range {IQR}, 5.7-14]; 20 girls [34%]) were identified who met the criteria for PIMS-TS. Results from SARS-CoV-2 polymerase chain reaction tests were positive in 15 of 58 patients (26%) and SARS-CoV-2 IgG test results were positive in 40 of 46 (87%). In total, 45 of 58 patients (78%) had evidence of current or prior SARS-CoV-2 infection. All children presented with fever and nonspecific symptoms, including vomiting (26/58 [45%]), abdominal pain (31/58 [53%]), and diarrhea (30/58 [52%]). Rash was present in 30 of 58 (52%), and conjunctival injection in 26 of 58 (45%) cases. Laboratory evaluation was consistent with marked inflammation, for example, C-reactive protein (229 mg/L [IQR, 156-338], assessed in 58 of 58) and ferritin (610 μg/L [IQR, 359-1280], assessed in 53 of 58). Of the 58 children, 29 developed shock (with biochemical evidence of myocardial dysfunction) and required inotropic support and fluid resuscitation (including 23/29 [79%] who received mechanical ventilation); 13 met the American Heart Association definition of KD, and 23 had fever and inflammation without features of shock or KD. Eight patients (14%) developed coronary artery dilatation or aneurysm. Comparison of PIMS-TS with KD and with KD shock syndrome showed differences in clinical and laboratory features, including older age (median age, 9 years [IQR, 5.7-14] vs 2.7 years [IQR, 1.4-4.7] and 3.8 years [IQR, 0.2-18], respectively), and greater elevation of inflammatory markers such as C-reactive protein (median, 229 mg/L [IQR 156-338] vs 67 mg/L [IQR, 40-150 mg/L] and 193 mg/L [IQR, 83-237], respectively).

Conclusions and relevance:In this case series of hospitalized children who met criteria for PIMS-TS, there was a wide spectrum of presenting signs and symptoms and disease severity, ranging from fever and inflammation to myocardial injury, shock, and development of coronary artery aneurysms. The comparison with patients with KD and KD shock syndrome provides insights into this syndrome, and suggests this disorder differs from other pediatric inflammatory entities.

Read full article

Read

2

Nov, 2020

Vertical transmission of Zika virus and its outcomes: a Bayesian synthesis of prospective studies

Tags: ,

Authors: A E Ades, Antoni Soriano-Arandes, Ana Alarcon, Francesco Bonfante, Claire Thorne, Catherine S Peckham, Carlo Giaquinto

Published in: The Lancet

Abstract
Background:  Prospective studies of Zika virus in pregnancy have reported rates of congenital Zika syndrome and other adverse outcomes by trimester. However, Zika virus can infect and damage the fetus early in utero, but clear before delivery. The true vertical transmission rate is therefore unknown. We aimed to provide the first estimates of underlying vertical transmission rates and adverse outcomes due to congenital infection with Zika virus by trimester of exposure.

Methods: This was a Bayesian latent class analysis of data from seven prospective studies of Zika virus in pregnancy. We estimated vertical transmission rates, rates of Zika-virus-related and non-Zika-virus-related adverse outcomes, and the diagnostic sensitivity of markers of congenital infection. We allowed for variation between studies in these parameters and used information from women in comparison groups with no PCR-confirmed infection, where available.

Funding: European Union Horizon 2020 programme.

 

Read

14

Oct, 2020

SARS-CoV-2 testing and infection control strategies in European paediatric emergency departments during the first wave of the pandemic

Tags: , ,

 

Published in: European Journal of Pediatrics

 

Authors: Malte Kohns Vasconcelos & Hanna Renk & Jolanta Popielska & Maggie Nyirenda Nyang’wa & Sigita Burokiene & Despoina Gkentzi & Ewelina Gowin & Daniele Donà & Sara Villanueva-Medina & Andrew Riordan & Markus Hufnagel & Sarah Eisen & Liviana Da Dalt & Carlo Giaquinto & Julia A. Bielicki1

 

Abstract: Between February and May 2020, during the first wave of the COVID-19 pandemic, paediatric emergency departments in 12 European countries were prospectively surveyed on their implementation of SARS-CoV-2 disease (COVID-19) testing and infection control strategies. All participating departments (23) implemented standardised case definitions, testing guidelines, early triage and infection control strategies early in the outbreak. Patient testing criteria initially focused on suspect cases and later began to include screening, mainly for hospital admissions. Long turnaround times for test results likely put additional strain on healthcare resources.

Conclusion: Shortening turnaround times for SARS-CoV-2 tests should be a priority. Specific paediatric testing criteria are needed.

 

Download the full article here.KohnsVasconcelos2020_Article_SARS-CoV-2TestingAndInfectionC

26

May, 2020

Clinical outcomes of a Zika virus mother–child pair cohort in Spain

 

Authors: Soriano-Arandes A, Frick MA, García López-Hortelano M, et al.

Published in: Pathogens 2020;9(5):E352

Background: Zika virus (ZIKV) infection has been associated with congenital microcephaly and other neurodevelopmental abnormalities. There is little published research on the effect of maternal ZIKV infection in a non-endemic European region. We aimed to describe the outcomes of pregnant travelers diagnosed as ZIKV-infected in Spain, and their exposed children.

Methods: This prospective observational cohort study of nine referral hospitals enrolled pregnant women (PW) who travelled to endemic areas during their pregnancy or the two previous months, or those whose sexual partners visited endemic areas in the previous 6 months. Infants of ZIKV-infected mothers were followed for about two years.

Results: ZIKV infection was diagnosed in 163 PW; 112 (70%) were asymptomatic and 24 (14.7%) were confirmed cases. Among 143 infants, 14 (9.8%) had adverse outcomes during follow-up; three had a congenital Zika syndrome (CZS), and 11 other potential Zika-related outcomes. The overall incidence of CZS was 2.1% (95%CI: 0.4–6.0%), but among infants born to ZIKV-confirmed mothers, this increased to 15.8% (95%CI: 3.4–39.6%).

Conclusions: A nearly 10% overall risk of neurologic and hearing adverse outcomes was found in ZIKV-exposed children born to a ZIKV-infected traveler PW. Longer-term follow-up of these children is needed to assess whether there are any later-onset manifestations.

Read

17

Apr, 2020

Genomic and epidemiological surveillance of Zika virus in the Amazon region

Tags: ,

Authors: Giovanetti M, Faria NR, Lourenco J, et al.

Published in:  Cell Rep. 2020;30(7):2275-2283

Abstract Zika virus (ZIKV) has caused an explosive epidemic linked to severe clinical outcomes in the Americas. As of June 2018, 4,929 ZIKV suspected infections and 46 congenital syndrome cases had been reported in Manaus, Amazonas, Brazil. Although Manaus is a key demographic hub in the Amazon region, little is known about the ZIKV epidemic there, in terms of both transmission and viral genetic diversity. Using portable virus genome sequencing, we generated 59 ZIKV genomes in Manaus. Phylogenetic analyses indi- cated multiple introductions of ZIKV from northeastern Brazil to Manaus. Spatial genomic analysis of virus movement among six areas in Manaus suggested that populous northern neighborhoods acted as sources of virus transmission to other neighborhoods. Our study revealed how the ZIKV epidemic was ignited and maintained within the largest urban metropolis in the Amazon. These results might contribute to improving the public health response to outbreaks in Brazil.

Read
NEWSLETTER

We would like to update you on our recent activities