Understanding Maternal-Fetal Zika Virus Transmission and its Complications in Nicaragua

摘要 寨卡病毒(ZIKV)大流行只用了不到一年的时间就席卷了拉丁美洲和 加勒比海。在过去的一年里，尼加拉瓜记录了1000多例病例，目前仍在继续。 以确定身份。预计该病毒将在未来2-4年内席卷全国。现在很明显，ZIKV 可以在子宫内从母亲传染给胎儿，先天性感染的后果可能是 很严重。尽管在感染性病原体中并不是唯一能够穿过胎盘并引起病理的 在发育中的胎儿中，由于其交叉反应血清学，ZIKV确实存在独特的诊断挑战 与其他黄病毒一起传播。在本申请中，我们提出了一系列活动，这些活动将对以下方面做出重大贡献 我们目前对母婴间ZIKV感染的认识。在全市范围内，对残留物的监控 尼加拉瓜莱昂的产前和分娩血液标本，我们将主要在这里研究寨卡病毒流行病学 ZIKV幼稚人群，调查人群垂直传播率和危险因素 水平。我们的方法利用在分娩时和怀孕期间收集的“残留”样本来 根据婴儿接触寨卡病毒和感染情况对婴儿进行分类。我们还将测试新的诊断 北卡罗来纳大学医学院正在制定的方案，调查胎儿/新生儿的免疫反应 ZIKV暴露，并跟踪一组婴儿的神经发育结果。

ABSTRACT It has taken less than a year for the Zika virus (ZIKV) pandemic to sweep across Latin America and the Caribbean. Over 1,000 cases have been documented in Nicaragua in the past year and active cases continue to be identified. The virus is expected to blanket the country over the next 2-4 years. It is now clear that ZIKV can be transmitted in utero from mother to fetus and that the consequences of congenital infection can be severe. Although not alone among infectious pathogens in its ability to cross the placenta and cause pathology in the developing fetus, ZIKV does present unique diagnostic challenges owing to its cross reactive serology with other flaviviruses. In this application, we propose a series of activities that will contribute substantially to our current understanding of maternal-fetal ZIKV infection. Through a city wide, surveillance of remnant antenatal and delivery blood specimens in León, Nicaragua, we will study ZIKV epidemiology in this mostly ZIKV naïve population, investigating rates of – and risk factors for – vertical transmission at the population level. Our approach makes use of “remnant” specimens collected at delivery and during pregnancy to categorize infants according to their ZIKV exposure and infection status. We will also test new diagnostic protocols under development at the UNC School of Medicine, investigate the fetal/newborn immune response to ZIKV exposure, and follow a cohort of infants for neurodevelopmental outcomes.