What you should know about the Zika virus and its effects.

CORAL GABLES, Fla.– With Zika spreading rapidly across the Americas for over a year, there is still much to be learned about this insect-borne disease and its effects on humans. But scientists and researchers do have some knowledge about the virus and its public health implications.

Zika symptoms include fever, rash, joint pain, conjunctivitis (red eyes) and can include muscle pain and headaches. The symptoms usually last for several days and typically are not enough to prompt an emergency room visit. People very rarely die of Zika. Most people (4 out of 5) who have been infected with Zika will show mild to no symptoms of the virus. There is currently no medicine or vaccine for Zika but you can take steps to alleviate the symptoms, such as getting plenty of rest, staying hydrated, and taking medicine such as acetaminophen or paracetamol to reduce fever and pain. If you think you have been infected with Zika, talk to your doctor or healthcare provider.

Though spread mostly by the bite of Aedes aegypti and Aedes albopictus mosquitoes, which are aggressive daytime biters but can bite around the clock, Zika can also be transmitted from a pregnant woman to her fetus, through sex, or, very rarely but still likely, through blood transfusions.

The Aedes aegypti and Aedes albopictus mosquitoes are the same mosquitoes that spread dengue and chikungunya. They typically lay eggs in and near standing water, such as in buckets, bowls, flower pots and vases. These mosquitoes prefer to bite people and they become infected when they feed on the blood of a person already infected with the virus. Infected mosquitoes then go on to spread the virus by biting other people.

A pregnant woman infected with Zika can pass the virus to her fetus during the pregnancy or at the time of birth. To date, there are no reports of infants getting Zika through breastfeeding. Zika is a cause of microcephaly—babies born with smaller heads and incomplete brain development—and can cause other severe fetal brain defects.

Zika can also be transmitted via sex, even if the infected person does not have any symptoms at the time. Studies are currently underway to find out how long Zika stays in semen and vaginal fluids of people with the virus.

To date there have been no confirmed cases of transmission of Zika through blood transfusions in the United States, but there have been several reports of such cases in Brazil.

Though no vaccine for Zika currently exists, the virus can be prevented by avoiding mosquito bites and using protection while having sex.

Key points:

1. Zika primarily spreads through infected mosquitoes. You can also get Zika through sex.
2. The best way to prevent Zika is to prevent mosquito bites, by using insect repellent, wearing long-sleeved shirts and long pants, and removing standing water around your home.
3. Zika is linked to birth defects.
4. Pregnant women should not travel to areas with Zika.
5. Travelers that become infected with Zika overseas or domestically can spread the virus at home through mosquito bites. During the first week of infection, Zika virus can be found in a person’s blood and can pass from an infected person to a mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.

For more information, visit http://www.cdc.gov/zika/index.html.

Photo credit: Felipe Dana/Associated Press

The post About Zika first appeared on Zika Global Network.

Overview of where the Zika virus started and where it’s moved across the globe.

CORAL GABLES, Fla.—Zika often goes undiagnosed because its symptoms are so similar to many other diseases, including dengue and chikungunya. Zika was first discovered in 1947 in a rhesus monkey in the Zika forest of Uganda, which gave the virus its name. The virus was recovered from the Aedes africanus mosquito in the Zika forest in 1948. In 1952, the first human cases of Zika were detected in Uganda and Tanzania. From the 1960s through the 1980s, the disease was mapped as it moved from Uganda to western Africa and Asia. Between 1969 and 1983, Zika was detected in mosquitoes found in equatorial Asia, including India, Indonesia, Malaysia, and Pakistan.

Before 2007, only 14 cases of the virus had been documented, though it is likely that other cases had occurred but were just not reported. In 2007, the first large Zika virus epidemic took place in Micronesia on the Island of Yap. The following year, an American scientist working in Senegal was infected with Zika while abroad and, upon his return to Colorado, infected his wife in what is believed to be the first case of sexual transmission of an insect-borne disease.

Five years later, Zika outbreaks occurred in four other Pacific Island groups—French Polynesia, Easter Island, the Cook Islands, and New Caledonia.

In May 2015, Brazil confirmed the Zika virus was circulating in the country and this was the first report about locally acquired Zika in the Americas. Two months later, Brazil reported neurological disorders associated with a history of infection, primarily from the northeastern state of Bahia. Among these reports, 49 cases were confirmed as Guillain-Barré syndrome, a rare condition in which a person’s immune system attacks their peripheral nerves, which can result in muscle weakness, loss of sensation in the limbs, or even paralysis.

In October 2015, Colombia confirmed over 150 cases of Zika. The same month, Brazil reported an unusual increase in the number of cases of microcephaly among newborns. In November, Brazil reported two adult deaths and one newborn death associated with Zika virus infection. Over the next two months, the virus continued to spread across Latin America and the Caribbean with reported cases in Suriname, El Salvador, Guatemala, Mexico, Paraguay, Venezuela, Panama, Honduras, French Guyana, and Puerto Rico.

In December 2015, the World Health Organization and the Pan-American Health Organization issued an epidemiological alert on the association of Zika with neurological syndromes and congenital malformations in the Americas. The cases of microcephaly, Guillain-Barré syndrome, and other neurological and development abnormalities associated with the Zika virus infection continued to rise in newborns in early 2016. At the same time, the list of countries with confirmed Zika cases in the Americas and the Caribbean continued to grow.

In February 2016, the United States reported three cases of sexual transmission of Zika. In July 2016, the first case of locally acquired Zika in the United States was confirmed in Miami.

Currently, cheaper and more accurate preventative, diagnostic, and therapeutic treatments for the Zika virus are being developed. Browse this site to learn more about what the University of Miami is doing to combat the Zika epidemic.

For more information, visit http://www.who.int/emergencies/zika-virus/history/en/ and http://www.cdc.gov/zika/about/overview.html.

Photo credits: Isaac Kasamani/AFP/Getty Images

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Researchers at the University of Miami Miller School of Medicine collaborate with other U.S. and Brazilian scientists to discover a monoclonal antibody “cocktail” that prevents Zika infection in primates.

A collaborative study led by a University of Miami Miller School of Medicine researcher has found that a “cocktail” of monoclonal antibodies prevented Zika virus (ZIKV) infection in primates. “This is a promising intervention to prevent and treat ZIKV infection during pregnancy,” said David Watkins, professor and vice chair for research, Department of Pathology. “We would like to develop this antibody combination and get it into clinical trials as soon as possible.”

Watkins and Dennis Burton, chairman and professor of the Department of Immunology & Microbiology at the Scripps Research Institute, led the collaborative international study, “Neutralizing Human Monoclonal Antibodies Prevents Zika Virus Infection in Macaques,” published recently in Science Translational Medicine. Miller School co-authors included Diogo M. Magnani, associate scientist and co-first author of the study; Ronald C. Desrosiers, professor of pathology and director of research faculty development; Michael J. Ricciardi, Varian K. Bailey, Lucas Gonzalez-Nieto, Martin J. Gutman, Núria Pedreño-Lopez, Helen S. Maxwell, Aline Domingues, and Mauricio A. Martins, all in the Department of Pathology.

“ZIKV infection is a serious, ongoing public health threat to South Florida, the Caribbean, Latin America and other regions around the world,” Watkins said. “If a Zika outbreak occurs in a metropolitan area like Miami, the only way to prevent infection is to avoid the Aedes aegypti mosquitoes that carry the virus. Therapies to prevent maternal Zika virus infection and its subsequent fetal developmental complications are urgently required.”

Working closely with Burton and Tom Rogers, from the Scripps Research Institute in La Jolla, California, Watkins’ laboratory team used a cocktail of three monoclonal antibodies to treat four monkeys. These three potent ZIKV-neutralizing monoclonal antibodies – called SMZAb1, SMZAb2, and SMZAb5 – were isolated by the Burton group from a South American patient.

“We administered a cocktail of these three antibodies to nonhuman primates one day before challenging them with Zika virus that had been isolated from a pregnant woman during the 2016 epidemic in Rio de Janeiro,” he said. “To our surprise, this prophylactic treatment completely prevented the virus from taking hold in the animals.”

In four control animals, the virus caused a fulminant infection that lasted for seven days, Watkins added. But there were no measurable virus levels in the blood of the four animals treated with the monoclonal combination, nor was there any immune system response, indicating the virus had been blocked completely.

“Since these antibodies have exceptional safety profiles in humans and cross the placenta, this combination could be rapidly developed to protect uninfected pregnant women and their fetuses,” he said.

The collaborative study involved research teams led by Burton; Esper G. Kallas, an infectious disease specialist at the University of São Paulo; Myrna C. Bonaldo, Laboratório de Biologia Molecular de Flavivírus, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; Guido Silvestri, professor of pathology, and Thomas Vanderford, Yerkes National Primate Research in Atlanta where the macaques used in this study were housed; and Stephen S. Whitehead, senior associate scientist, Laboratory of Infectious Diseases at the National Institutes of Health, Bethesda, Maryland.

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UM infectious disease specialist Mario Stevenson, Ph.D., discusses ways that UM Miller School of Medicine scientists are working to tackle the Zika virus.

Mario Stevenson, Ph.D., is chief of the division of infectious diseases and co-director of CFAR, and professor of medicine at the Miller School of Medicine. Stevenson’s research is aimed at uncovering the functions of viral accessory genes, mechanisms of viral persistence and immunopathogenicity as well as cellular factors influencing virus-host cell interplay. He worked with colleagues to develop a diagnostic blood test for Zika that costs a fraction of current tests, delivers results quickly, and can be performed on the spot in any hospital or outpatient clinic. Here, Stevenson describes the various Zika detection tests that UM scientists are developing, as well as the projects underway at the UM Miller School to understand the spread of the virus.

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UM obstetrician and gynecologist Christine L. Curry, M.D., Ph.D., helps women and mothers deal with uncertainties of the Zika virus.

Christine L. Curry, M.D., Ph.D. is co-director of the Zika Response Team, housed in the Department of Pediatrics, and assistant professor of obstetrics and gynecology. Curry’s research interests include global health, health disparities, comprehensive reproductive health and medical education. In this video, she looks back on the past year of helping to treat women and mothers with potential, active or previous infection of the Zika virus in South Florida.

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UM pediatric specialist Ivan A. Gonzalez, M.D. helps mothers and their young children deal with uncertainties of the Zika virus.

Ivan A. Gonzalez, M.D., co-director of the Zika Response Team, housed in the Department of Pediatrics, and assistant professor of clinical pediatrics, discusses the role and importance of caring for babies and their mothers through potential and active Zika infection. Gonzalez specializes in pediatrics and pediatric infectious diseases and his research interests include patients with recurrent soft tissue infection with MRSA, recurrent fevers, fevers of unknown origin, tropical infections as well as potential immunodeficiency patients. Since the outbreak and spread of the Zika virus in South Florida, Gonzalez has been pivotal in the realm of pediatric care for young children who have Zika, or who could have Zika through mother-to-child transmission.

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UM biochemist and molecular biologist Sylvia Daunert, Ph.D., describes promising research she is undertaking with her team to develop quick and accurate tests for Zika detection.

Sylvia Daunert, Ph.D., is an associate director of the Dr. John T. Macdonald Foundation Biomedical Nanotechnology Institute, director of research for the Center for Integrative and Complementary Medicine, the Lucille P. Markey chair of biochemistry and molecular biology, and professor of biochemistry and molecular biology. Daunert’s research interests include bionanotechnology, biosensing and molecular diagnostics. Here she discusses different projects she is working on with other UM Miller School of Medicine researchers on nuclear and molecular detection tests for past and present infection of the Zika virus.

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UM public health specialist John C. Beier, Sc.D. discusses ways that UM Miller School of Medicine scientists are working to control vectors of the Zika virus.

John C. Beier, Sc.D., is director of the division of environment and public health and professor in the department of public health sciences at the University of Miami Miller School of Medicine, and professor in the Leonard and Jayne Abess Center for Ecosystem Science and Policy. Beier’s expertise and research interests lie in vector-borne diseases, vector biology and control, environmental management, insect ecology and behavior and transmission dynamics. Here, Beier discusses ways that he and other public health scientists from the UM Miller School of Medicine are working with local officials to control vectors that transmit the Zika virus in South Florida.

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UM tropical disease specialist Paola N. Lichtenberger, M.D., is hard at work understanding the spread of the Zika virus in South Florida and other tropical climates.

Paola N. Lichtenberger, M.D., is an assistant professor of clinical medicine and director of the tropical disease program. Lichtenberger’s research focuses on infectious and tropical diseases. She has been working with David Watkins, Ronald Desrosiers, and investigators at the University of São Paulo, Brazil, and the Scripps Research Institute in La Jolla, California, taking a preventative approach in studying the virus by using antibodies from Zika patients. Lichtenberger discusses here how South Florida’s tropical climate made it particularly vulnerable to the Zika outbreak in 2016, and steps that individuals can take to reduce the likelihood of being infected with the virus.

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While progress has been made in many areas, many unknowns remain when dealing with Zika.

Christine L. Curry, M.D., Ph.D., assistant professor of obstetrics and gynecology for the University of Miami Health System, was thrust into the national spotlight in 2016 for her leadership in caring for pregnant women infected with Zika.

Today, Curry is still on the frontlines of caring for newly infected pregnant women as co-director of UM’s Zika Response Team, while collaborating on important data-gathering and research studies to monitor the infants.

“From a clinical perspective, we have made significant progress,” said Curry, who has a background in virology. “Pregnant women now know that they have the right to free testing. Also test results are coming back much more quickly for patients seen at UHealth clinics and our affiliate Jackson Memorial Hospital. That’s important because it’s hard to counsel women when you don’t know if they were infected or not.”

Christine L. Curry, M.D., Ph.D., assistant professor of obstetrics and gynecology, is treating and counseling women infected with Zika.

The CDC now recommends pregnant women be screened for Zika at least once every trimester.

“Along with receiving prenatal care, it’s important for Zika-positive mothers to deliver at a location where their babies can receive comprehensive care in their first days of life,” Curry said. “We also stay in close touch with these new mothers, even if their babies do not have any evident problems.”

In 2016, UHealth and Jackson identified more than 50 babies born to mothers with confirmed Zika infections. The percentage of infections was highest in Haitian-Creole and Spanish-speaking mothers, pointing to health disparities in the South Florida community. Because so many Miami-Dade residents travel to and from the Caribbean and Latin America, clinicians no longer ask whether the mothers acquired the infection locally or during a visit to another country, Curry added.

Audina M. Berrocal, M.D., professor of clinical ophthalmology at UM’s Bascom Palmer Eye Institute

New information from the U.S. Centers for Disease Control and Prevention (CDC) Zika registry is providing a better idea of the risks. “It now appears that only about 10 percent to 20 percent of infected mothers pass the Zika virus to the fetus,” Curry said, adding that only 1 in 20 infected babies show immediate effects from Zika.

Claudia A. Martinez, M.D., associate professor of medicine at the University of Miami Miller School of Medicine

Vision problems are part of the damaging cluster of medical issues affecting these infants. Audina M. Berrocal, M.D., professor of clinical ophthalmology at UM’s Bascom Palmer Eye Institute, and Camila V. Ventura, M.D., a former pediatric retina research fellow at Bascom Palmer, collaborated on a study of 32 Brazilian infants who tested positive for Zika infection. Visual impairment was detected in all 32 babies, and retinal or optic nerve problems were observed in 14 patients.

Zika may also cause cardiac problems, and Claudia A. Martinez, M.D., associate professor of medicine, is leading a state-funded study of adult, non-pregnant Zika patients to determine if Zika increases the risk.

Other pediatric specialists with the Zika Response Team are studying Zika’s potential impact on hearing and are rigorously screening asymptomatic newborns to identify blood markers or other subtle indicators of Zika’s impact.

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