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      A multi-faceted pandemic: a review of the state of knowledge on the Zika virus

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          Abstract

          While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands had been overlooked, the large-scale outbreak that started in Brazil in 2015 and the increase of microcephaly cases in the same place and time made media headlines. Considered as harmless until recently, Zika has given rise to an important global crisis that poses not only health challenges but also environmental, economical, social, and ethical challenges for states and people around the world. The main objective of this paper is to review the recent Zika outbreak by covering a broad range of disciplines and their interactions. This paper synthetises experts’ interviews and reactions conducted during a Massive Open Online Course (MOOC) entitled “In the footsteps of Zika…approaching the unknown.” It reviews knowledge and uncertainties around epidemiology, geographical dispersion of the virus and its vectors through globalization and climate change, and also its modes of transmission, diagnosis, symptoms, and treatment of the disease. The resulting societal and ethical issues in pregnancy and women of reproductive age were also addressed as well as the global outbreak alert and response network in international organizations and social media. This paper attempted to combine each piece of the jigsaw puzzle of the Zika phenomenon to complete the best realistic picture, while keeping in mind the balance between the interdisciplinary nature and international context of Zika and its unique characteristics.

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          First report of autochthonous transmission of Zika virus in Brazil

          In the early 2015, several cases of patients presenting symptoms of mild fever, rash, conjunctivitis and arthralgia were reported in the northeastern Brazil. Although all patients lived in a dengue endemic area, molecular and serological diagnosis for dengue resulted negative. Chikungunya virus infection was also discarded. Subsequently, Zika virus (ZIKV) was detected by reverse transcription-polymerase chain reaction from the sera of eight patients and the result was confirmed by DNA sequencing. Phylogenetic analysis suggests that the ZIKV identified belongs to the Asian clade. This is the first report of ZIKV infection in Brazil.
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            Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria.

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              Protective efficacy of multiple vaccine platforms against Zika virus challenge in rhesus monkeys.

              Zika virus (ZIKV) is responsible for a major ongoing epidemic in the Americas and has been causally associated with fetal microcephaly. The development of a safe and effective ZIKV vaccine is therefore an urgent global health priority. Here we demonstrate that three different vaccine platforms protect against ZIKV challenge in rhesus monkeys. A purified inactivated virus vaccine induced ZIKV-specific neutralizing antibodies and completely protected monkeys against ZIKV strains from both Brazil and Puerto Rico. Purified immunoglobulin from vaccinated monkeys also conferred passive protection in adoptive transfer studies. A plasmid DNA vaccine and a single-shot recombinant rhesus adenovirus serotype 52 vector vaccine, both expressing ZIKV premembrane and envelope, also elicited neutralizing antibodies and completely protected monkeys against ZIKV challenge. These data support the rapid clinical development of ZIKV vaccines for humans.
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                Author and article information

                Contributors
                anneliese.depoux@uspc.fr
                philibert.aline@gmail.com
                rabiers87@gmail.com
                henri-jean.philippe@aphp.fr
                arnaud.fontanet@pasteur.fr
                Antoine.Flahault@unige.ch
                Journal
                Public Health Rev
                Public Health Rev
                Public Health Reviews
                BioMed Central (London )
                0301-0422
                2107-6952
                15 May 2018
                15 May 2018
                2018
                : 39
                : 10
                Affiliations
                [1 ]ISNI 0000 0004 1788 6194, GRID grid.469994.f, Centre Virchow-Villermé, , Université Sorbonne Paris Cité, ; Paris, France
                [2 ]ISNI 0000 0001 2165 487X, GRID grid.46900.3b, GRIPIC, EA 1498, Université Paris Sorbonne – CELSA, ; Paris, France
                [3 ]ISNI 0000 0001 2181 0211, GRID grid.38678.32, Interdisciplinary Research Centre on Well-being, Health, Society and Environment (Cinbiose), , Université du Québec à Montréal, ; Montreal, Québec Canada
                [4 ]ISNI 0000 0001 2188 0914, GRID grid.10992.33, Faculté de Médecine, , Université Paris Descartes, ; Paris, France
                [5 ]ISNI 0000 0001 0274 3893, GRID grid.411784.f, Service de Chirurgie Générale, Plastique et Ambulatoire, AP-HP, HUPC, Hôpital Cochin, ; Paris, France
                [6 ]ISNI 0000 0001 2185 090X, GRID grid.36823.3c, Unité PACRI, Conservatoire National des Arts et Métiers, ; Paris, France
                [7 ]ISNI 0000 0001 2353 6535, GRID grid.428999.7, Institut Pasteur, Emerging Diseases Epidemiology Unit, ; Paris, France
                [8 ]ISNI 0000 0001 2322 4988, GRID grid.8591.5, Institute of Global Health, Faculty of Medicine, , University of Geneva, ; Geneva, Switzerland
                Article
                87
                10.1186/s40985-018-0087-6
                5952415
                bd0a7933-148b-497a-997b-df73bdc5b597
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 31 May 2017
                : 13 February 2018
                Categories
                Review
                Custom metadata
                © The Author(s) 2018

                zikv,neurologic disorders,vector control,microcephaly,aedes aegypti,mooc,health promotion,health policies,health management,who

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