Vertically transmitted Chikunugunya, Zika and Dengue Virus infections. The pathogenesis from mother to fetus and the implications of co-infections and vaccine development

Publication date: Available online 29 May 2019Source: International Journal of Pediatrics and Adolescent MedicineAuthor(s): Tracy Evans-GilbertAbstractChikungunya (CHIKV), Zika (ZIKV), and Dengue viruses (DENV) exhibit similar ecological, evolutionary, and epidemiological patterns but have different pathophysiological mechanisms of disease manifestations. Clinical presentations overlap and can be asymptomatic. Differences occur in the severity of clinical presentations with the highest mortality in the general population attributed to DENV and neurological morbidity due to ZIKV. ZIKV and DENV infections can cause fetal loss with ZIKV exhibiting teratogenesis. CHIKV is associated with severe complications in the newborn. Co-circulation of the three viruses and the cross-reactive immune response between ZIKV and DENV viruses has implications for an attenuated clinical response and future vaccine development. Co-infections could increase due to the epidemiologic synergy and extensive global spread of these viruses, but there is limited evidence about the clinical effects, especially for the vulnerable newborn.The purpose of this paper is to review the pathophysiological basis for vertically transmission manifestations due to CHIKV, DENV, and ZIKV, to determine the potential effects of co-circulation on newborn outcomes and the potential for vaccine protection. Although the pregnant state and the placenta protect the fetus during pregnancy, the genomic evolution of the virus has ...
Source: International Journal of Pediatrics and Adolescent Medicine - Category: Pediatrics Source Type: research