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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060
EISSN: 1678-8060
Vol. 112, No. 5, 2017, pp. 319-327
Bioline Code: oc17041
Full paper language: English
Document type: Review Article
Document available free of charge

Memórias do Instituto Oswaldo Cruz, Vol. 112, No. 5, 2017, pp. 319-327

 en Zika puzzle in Brazil: peculiar conditions of viral introduction and dissemination - A Review
Possas, Cristina; Brasil, Patricia; Marzochi, Mauro CA; Tanuri, Amilcar; Martins, Reinaldo M; Marques, Ernesto TA; Bonaldo, Myrna C; Ferreira, Antonio GP; Lourenço-de-Oliveira, Ricardo; Nogueira, Rita Maria R; Sequeira, Patricia C; Marzochi, Keyla BF & Homma, Akira

Abstract

This article discusses the peculiar conditions that favoured the unexpected introduction of Zika virus into the poorest northeastern region of Brazil in 2015, its speed of transmission to other Brazilian states, other Latin American countries and other regions, and the severity of related neurological disorders in newborns and adults. Contrasting with evidence that Zika had so far caused only mild cases in humans in the last six decades, the epidemiological scenario of this outbreak in Brazil indicates dramatic health effects: in 2015, an increase of 20-fold in notified cases of microcephaly and/or central nervous system (CNS) alterations suggestive of Zika congenital infection, followed by an exponential increase in 2016, with 2366 cumulative cases confirmed in the country by the end of December 2016. A significant increase in Guillain-Barré syndrome in adults has also been reported. Factors involved in viral dissemination, neural pathogenesis and routes of transmission in Brazil are examined, such as the role of social and environmental factors and the controversies involved in the hypothesis of antibody-dependent enhancement, to explain the incidence of congenital Zika syndrome in Brazil. Responses to the Zika outbreak and the development of new products are also discussed.

Keywords
Zika; microcephaly; congenital Zika syndrome; neurological disorders; pathogenesis; epidemiology

 
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