High Zika Virus Seroprevalence in Salvador, Northeastern Brazil Limits the Potential for Further Outbreaks.

Autor: Netto EM; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil.; Instituto Brasileiro para a Investigação da Tuberculose/Fundação José Silveira (IBIT/FJS), Salvador, Brazil., Moreira-Soto A; Institute of Virology, University of Bonn Medical Centre, Bonn, Germany., Pedroso C; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil., Höser C; Institute for Hygiene and Public Health, GeoHealth Centre, WHO Collaborating Centre for Health Promoting Water Management & Risk Communication, University of Bonn, Bonn, Germany., Funk S; Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom., Kucharski AJ; Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom., Rockstroh A; Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany., Kümmerer BM; Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.; German Centre for Infection Research (DZIF), Germany., Sampaio GS; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil., Luz E; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil., Vaz SN; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil., Dias JP; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil., Bastos FA; Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, Brazil., Cabral R; Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, Brazil., Kistemann T; Institute for Hygiene and Public Health, GeoHealth Centre, WHO Collaborating Centre for Health Promoting Water Management & Risk Communication, University of Bonn, Bonn, Germany., Ulbert S; Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany., de Lamballerie X; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French 19 School of Public Health, EPV UMR_D 190 'Emergence des Pathologies Virales,' Marseille, France.; IHU Institute hospitalo-universitaire Méditerranée Infection, APHM Public Hospitals of Marseille 21, Marseille, France., Jaenisch T; German Centre for Infection Research (DZIF), Germany.; Section Clinical Tropical Medicine, Department for Infectious Diseases, INF 324, Heidelberg University Hospital, Heidelberg, Germany., Brady OJ; Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom., Drosten C; German Centre for Infection Research (DZIF), Germany.; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany., Sarno M; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil.; Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, Brazil., Brites C; Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil crbrites@ufba.br felix.drexler@charite.de., Drexler JF; Institute of Virology, University of Bonn Medical Centre, Bonn, Germany crbrites@ufba.br felix.drexler@charite.de.; German Centre for Infection Research (DZIF), Germany.; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.
Jazyk: angličtina
Zdroj: MBio [mBio] 2017 Nov 14; Vol. 8 (6). Date of Electronic Publication: 2017 Nov 14.
DOI: 10.1128/mBio.01390-17
Abstrakt: During 2015 to 2016, Brazil reported more Zika virus (ZIKV) cases than any other country, yet population exposure remains unknown. Serological studies of ZIKV are hampered by cross-reactive immune responses against heterologous viruses. We conducted serosurveys for ZIKV, dengue virus (DENV), and Chikungunya virus (CHIKV) in 633 individuals prospectively sampled during 2015 to 2016, including microcephaly and non-microcephaly pregnancies, HIV-infected patients, tuberculosis patients, and university staff in Salvador in northeastern Brazil using enzyme-linked immunosorbent assays (ELISAs) and plaque reduction neutralization tests. Sera sampled retrospectively during 2013 to 2015 from 277 HIV-infected patients were used to assess the spread of ZIKV over time. Individuals were georeferenced, and sociodemographic indicators were compared between ZIKV-positive and -negative areas and areas with and without microcephaly cases. Epidemiological key parameters were modeled in a Bayesian framework. ZIKV seroprevalence increased rapidly during 2015 to 2016, reaching 63.3% by 2016 (95% confidence interval [CI], 59.4 to 66.8%), comparable to the seroprevalence of DENV (75.7%; CI, 69.4 to 81.1%) and higher than that of CHIKV (7.4%; CI, 5.6 to 9.8%). Of 19 microcephaly pregnancies, 94.7% showed ZIKV IgG antibodies, compared to 69.3% of 257 non-microcephaly pregnancies ( P = 0.017). Analyses of sociodemographic data revealed a higher ZIKV burden in low socioeconomic status (SES) areas. High seroprevalence, combined with case data dynamics allowed estimates of the basic reproduction number R 0 of 2.1 (CI, 1.8 to 2.5) at the onset of the outbreak and an effective reproductive number R eff of <1 in subsequent years. Our data corroborate ZIKV-associated congenital disease and an association of low SES and ZIKV infection and suggest that population immunity caused cessation of the outbreak. Similar studies from other areas will be required to determine the fate of the American ZIKV outbreak. IMPORTANCE The ongoing American Zika virus (ZIKV) outbreak involves millions of cases and has a major impact on maternal and child health. Knowledge of infection rates is crucial to project future epidemic patterns and determine the absolute risk of microcephaly upon maternal ZIKV infection during pregnancy. For unknown reasons, the vast majority of ZIKV-associated microcephaly cases are concentrated in northeastern Brazil. We analyzed different subpopulations from Salvador, a Brazilian metropolis representing one of the most affected areas during the American ZIKV outbreak. We demonstrate rapid spread of ZIKV in Salvador, Brazil, and infection rates exceeding 60%. We provide evidence for the link between ZIKV and microcephaly, report that ZIKV predominantly affects geographic areas with low socioeconomic status, and show that population immunity likely caused cessation of the outbreak. Our results enable stakeholders to identify target populations for vaccination and for trials on vaccine efficacy and allow refocusing of research efforts and intervention strategies.
(Copyright © 2017 Netto et al.)
Databáze: MEDLINE
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