Emergence of the Asian lineage of Zika virus in Angola: an outbreak investigation
Emergence of the Asian lineage of Zika virus in Angola: an outbreak investigation
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DOI：
10.1016/s1473-3099(19)30293-2
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发表时间：
2019-10-01
影响因子：
56.3
通讯作者：
Faria, Nuno R.
中科院分区：
文献类型：
--
作者：
Hill, Sarah C.;Vasconcelos, Jocelyne;Faria, Nuno R.
背景 自 2016 年底以来，安哥拉已报告寨卡病毒感染和疑似小头畸形病例，但没有关于该病毒的起源、流行病学和多样性的数据。我们的目的是调查寨卡病毒在安哥拉的出现和传播。方法安哥拉卫生部收集的诊断样本作为常规虫媒病毒监测的一部分，由 Instituto Nacional de Investigacao em Saude（安哥拉罗安达卫生部）通过实时逆转录 PCR 进行检测。为了进一步确定寨卡病毒呈阳性且适合进行基因组测序的样本，我们还测试了 2017 年罗安达艾滋病毒感染者研究中的样本。通过实时逆转录PCR，使用便携式测序仪从三名寨卡病毒感染呈阳性的人中生成安哥拉寨卡病毒基因组序列，其中包括一名患有小头畸形的新生儿。对遗传和流动性数据进行分析，以调查寨卡病毒在安哥拉的传入日期和地理起源。对一名小头畸形儿童进行脑部 CT 和 MRI 以及血清学检测，以确认小头畸形并评估既往寨卡病毒感染情况。结果 通过实时反向检测对 54 名疑似急性寨卡病毒感染者、76 名疑似小头畸形婴儿、24 名疑似小头畸形婴儿的母亲、336 名疑似登革热病毒或基孔肯雅病毒感染患者以及来自 HIV 研究的 349 份样本的血清样本进行了检测转录PCR。 2016 年 12 月至 2017 年 6 月期间发现的四例寨卡病毒检测呈阳性。对病毒基因组和人类流动性数据的分析表明，寨卡病毒可能在 2015 年 7 月至 2016 年 6 月期间从巴西传入安哥拉。这种引入可能引发了寨卡病毒在安哥拉的局部传播，这种传播至少持续到 2017 年 6 月。接受 CT 和 MRI 检查的小头畸形婴儿的大脑异常与先天性寨卡综合征和寨卡病毒感染的血清学证据一致。寨卡病毒的亚洲谱系已发生在非洲。整个非洲大陆的寨卡病毒监测和小头畸形相关病例的监测至关重要。
Background Zika virus infections and suspected microcephaly cases have been reported in Angola since late 2016, but no data are available about the origins, epidemiology, and diversity of the virus. We aimed to investigate the emergence and circulation of Zika virus in Angola.Methods Diagnostic samples collected by the Angolan Ministry of Health as part of routine arboviral surveillance were tested by real-time reverse transcription PCR by the Instituto Nacional de Investigacao em Saude (Ministry of Health, Luanda, Angola). To identify further samples positive for Zika virus and appropriate for genomic sequencing, we also tested samples from a 2017 study of people with HIV in Luanda. Portable sequencing was used to generate Angolan Zika virus genome sequences from three people positive for Zika virus infection by real-time reverse transcription PCR, including one neonate with microcephaly. Genetic and mobility data were analysed to investigate the date of introduction and geographical origin of Zika virus in Angola. Brain CT and MRI, and serological assays were done on a child with microcephaly to confirm microcephaly and assess previous Zika virus infection.Findings Serum samples from 54 people with suspected acute Zika virus infection, 76 infants with suspected microcephaly, 24 mothers of infants with suspected microcephaly, 336 patients with suspected dengue virus or chikungunya virus infection, and 349 samples from the HIV study were tested by real-time reverse transcription PCR. Four cases identified between December, 2016, and June, 2017, tested positive for Zika virus. Analyses of viral genomic and human mobility data suggest that Zika virus was probably introduced to Angola from Brazil between July, 2015, and June, 2016. This introduction probably initiated local circulation of Zika virus in Angola that continued until at least June, 2017. The infant with microcephaly in whom CT and MRI were done had brain abnormalities consistent with congenital Zika syndrome and serological evidence for Zika virus infection.Interpretation Our analyses show that autochthonous transmission of the Asian lineage of Zika virus has taken place in Africa. Zika virus surveillance and surveillance of associated cases of microcephaly throughout the continent is crucial.