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

摘要 寨卡病毒（ZIKV）大流行在不到一年的时间里席卷了拉丁美洲和非洲。 加勒比海过去一年，尼加拉瓜记录了1，000多起病例，活跃病例仍在继续 待鉴定预计该病毒将在未来2-4年内席卷该国。现在很清楚，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 严重。虽然在感染性病原体中，它并不是唯一能够穿过胎盘并引起病理的病原体 在发育中的胎儿中，由于其交叉反应性血清学，ZIKV确实存在独特的诊断挑战 与其他黄病毒。在本申请中，我们提出了一系列活动，将大大有助于 我们目前对母胎ZIKV感染的理解。在整个城市范围内，监视着 产前和分娩血液标本在莱昂，尼加拉瓜，我们将研究ZIKV流行病学在这主要是 ZIKV初治人群，调查人群中垂直传播的比率和风险因素 水平我们的方法利用分娩和妊娠期间收集的“残留”标本， 根据ZIKV暴露和感染状况对婴儿进行分类。我们还将测试新的诊断方法 正在开发中的协议在医学院，研究胎儿/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.