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Review
Zika: what we do and do not know based on the experiences of Brazil
Cristina Possas
Epidemiol Health. 2016;38:e2016023.   Published online May 31, 2016
DOI: https://doi.org/10.4178/epih.e2016023
  • 19,008 View
  • 381 Download
  • 18 Web of Science
  • 22 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Zika virus, which was first discovered in 1947, has become a global threat to human health as it is rapidly spreading through Latin America, the Caribbean, the US and Asia, after causing a large outbreak in the Northeast region of Brazil in 2015. There is ample evidence to support that Zika virus is associated with neurological complications such as microcephaly. The review aims to provide an overview on the complex issues involved in the emergence of Zika virus’s neurological disorders and to discuss possible explanations of Zika virus introduction and dissemination in Brazil. We also suggest national and global strategies to adequately respond to the Zika virus emergence.
METHODS
We provide an analytical evaluation of the main issues related to the Zika outbreak in Brazil, based on available scientific literature, including government documents, and on epidemiological information from national surveillance databases.
RESULTS
The studies on the clinical manifestations of the Zika virus infection coupled with the epidemiological surveillance information in Brazil have provided significant evidence that the Zika virus is associated with neurological disorders such as microcephaly and Guillain-Barré syndrome. Based on phylogenetic and molecular analysis, the hypothesis regarding the introduction of Zika virus in the country is that it took place following international events in 2013 and 2014, when many foreign visitors could have brought Zika virus into Brazil. The immunologically naïve status of populations in the Americas, previous infection with dengue virus, and the increased activity of Aedes aegypti might be the contributing factors for such an outbreak in Brazil. The Zika virus emergence emphasized the importance of cross-disciplinary perspective. Besides the scientific-based vector control strategies, it is important to understand the nature of the evolutionary processes involved in the viral evolution in complex ecosystems and to have social and anthropological knowledge on the conditions related to the spread of the disease in order to properly respond to the spread of the Zika virus.
CONCLUSIONS
The experiences of Brazil have demonstrated the significance of multi-disciplinary approach in response to new and resurgent arboviral diseases and provided important lessons that could be applied to other developing countries.
Summary

Citations

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  • Ações educativas de enfrentamento ao Aedes Aegypti: revisão integrativa
    Ítala Keane Rodrigues Dias, Rosa Maria Grangeiro Martins, Cicera Luciana da Silva Sobreira, Rhavena Maria Gomes Sousa Rocha, Maria do Socorro Vieira Lopes
    Ciência & Saúde Coletiva.2022; 27(1): 231.     CrossRef
  • Survival and Replication of Zika Virus in Diapause Eggs of Aedes Albopictus From Beijing, China
    Qianghui Zhang, Yuting Jiang, Chaojie Li, Jian Gao, Teng Zhao, Hengduan Zhang, Chunxiao Li, Dan Xing, Yande Dong, Tongyan Zhao, Xiaoxia Guo
    Frontiers in Microbiology.2022;[Epub]     CrossRef
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    Eliana Harumi Morioka Takahasi, Maria Teresa Seabra Soares de Britto e Alves, Marizélia Rodrigues Costa Ribeiro, Alcione Miranda dos Santos, Marcos Adriano Garcia Campos, Vanda Maria Ferreira Simões, Gláucio Andrade Amaral, Patrícia da Silva Sousa, Demócr
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    Jane Cox
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    Cristina Possas, Patricia Brasil, Mauro CA Marzochi, Amilcar Tanuri, Reinaldo M Martins, Ernesto TA Marques, Myrna C Bonaldo, Antonio GP Ferreira, Ricardo Lourenço-de-Oliveira, Rita Maria R Nogueira, Patricia C Sequeira, Keyla BF Marzochi, Akira Homma
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Original Article
Evaluation of Acute Flaccid Paralysis in Hamadan, Iran from 2002 to 2009
Jalal Poorolajal, Shadi Ghasemi, Leila Nezamabadi Farahani, Atefeh Sadat Hosseini, Seyyed Jalal Bathaei, Ali Zahiri
Epidemiol Health. 2011;33:e2011011.   Published online November 16, 2011
DOI: https://doi.org/10.4178/epih/e2011011
  • 16,077 View
  • 106 Download
  • 9 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran.</p></sec><sec><title>METHODS</title><p>A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged <15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis.</p></sec><sec><title>RESULTS</title><p>During the eight-year survey, 88 AFP cases aged <15 years old were reported. About 40% (35/88) of cases were aged ≤5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged <15 years old in all years. The risk of AFP in patients aged <5 years old was almost double that of older patients. Guillain-Barré Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected.</p></sec><sec><title>CONCLUSION</title><p>The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged <15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers' special attention, although AFP cases were still above the target level.</p></sec>
Summary

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