PLoS ONE: Prevalence of Antibodies to Zika Virus in Mothers from Hawaii Who Delivered Babies with and without Microcephaly between 2009-2012

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Citation: Kumar M, Ching L, Astern J, Lim E, Stokes AJ, Melish M, et al. (2016) Prevalence of Antibodies to Zika Virus in Mothers from Hawaii Who Delivered Babies with and without Microcephaly between 2009-2012. PLoS Negl Trop Dis 10(12): e0005262. doi:10.1371/journal.pntd.0005262
[h=2]Abstract[/h] Zika virus (ZIKV) is an emerging mosquito-borne pathogen. ZIKV infection is linked to the development of severe fetal abnormalities that include spontaneous abortion, stillbirth, hydranencephaly, and microcephaly. ZIKV outbreaks have been recorded in the United States. We recently demonstrated the first congenital ZIKV infection in the United States. In this study, we investigated archived blood samples from six mothers who gave birth to babies with microcephaly and 12 mothers who gave birth to healthy babies in Hawaii between 2009 and 2012. We tested maternal blood for the presence of ZIKV IgM and IgG antibodies using commercially available human ZIKV IgM and IgG ELISA kits. Blood from one mother who delivered babies with microcephaly tested positive for ZIKV IgM antibody (16.6%) and blood from three mothers tested positive for ZIKV IgG antibody (50%). ZIKV showed a trend toward significance with microcephaly. ZIKV IgG antibody positive mothers were more likely to deliver babies with microcephaly than mothers who were negative for ZIKV IgG antibodies (Odds ratio [OR] = 11.0, 95% confidence interval [CI] = 0.8?147.9, p = 0.083). Similarly, ZIKV IgM antibody positive mothers were also more likely to deliver babies with microcephaly than mothers who were negative for ZIKV IgM antibody (OR = 6.8, 95% CI = 0.2?195.1). These data provide further evidence of a link between ZIKV infection and microcephaly and suggests presence of ZIKV positive cases and associated microcephaly in the United States as early as 2009.
[h=2]Author Summary[/h] Zika virus (ZIKV) infection is linked to the development of severe fetal abnormalities that include spontaneous abortion, stillbirth, hydranencephaly, and microcephaly. The WHO in early February 2016 declared global ZIKV outbreaks and its link to birth defects an international public health emergency. ZIKV outbreaks have been recorded in the United States. In a quest to find a link between ZIKV infection and babies born with microcephaly in Hawaii, we investigated archived blood samples from mothers who gave birth in Hawaii between 2009 and 2012 to babies with microcephaly. ZIKV antibodies were detected in three (50%) out of total six mothers who delivered babies with microcephaly. ZIKV showed a trend toward significance with microcephaly. This report adds to the potential evidence of a link between ZIKV infection and microcephaly and suggests presence of ZIKV positive cases and associated microcephaly in the United States as early as 2009.

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http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005262

 

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Zika virus-infected mothers delivered babies with microcephaly as early as 2009

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Dec 23 2016

University of Hawaiʻi scientists? finding adds to evidence linking the virus and severe fetal abnormalities

University of Hawaiʻi (UH) scientists have discovered that severe birth defects related to infection with the Zika virus (ZIKV) occurred much earlier than in 2016, when the connection was first made between the virus and an increased likelihood of microcephaly during outbreaks of ZIKV infection in Brazil and Puerto Rico.

UH scientists published their findings this month in the scientific journal PLOS Neglected Tropical Diseases (http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005262), adding to the potential evidence of a link between ZIKV infection and microcephaly, a congenital condition associated with incomplete brain development and characterized by an abnormal smallness of the head.

Patient information and blood samples were collected voluntarily from mothers in Honolulu who delivered babies between 2007 and 2013 at Kapiʻolani Medical Center for Women and Children, a Hawaiʻi Pacific Health hospital affiliated with the UH John A. Burns School of Medicine (JABSOM). The samples were collected and stored at University of Hawaiʻi Biorepository (UHB) after obtaining written informed consent from the mothers.

?As per the information in the UHB, no mothers gave birth to babies with microcephaly in 2007 and 2008,? said Vivek R. Nerurkar, PhD, Chair of UH-JABSOM Department of Tropical Medicine, Medical Microbiology and Pharmacology. ?However, from 2009 onwards, we identified six mothers who gave birth to babies with microcephaly. Of the six, ZIKV antibodies were detected in three (50%) of the mothers who delivered babies with microcephaly, suggesting presence of positive Zika virus cases and associated microcephaly in the United States as early as 2009 ? he said.

Dr. Nerurkar believes the growing evidence of an association between ZIKV infection and the devastating brain damage in infants justifies a new practice in women?s health. ?We need to be more proactive in tracking pregnant women and testing for the ZIKV ahead of time (before birth). ?It may be time for health care professionals to routinely caution newly pregnant mothers (or those planning to become pregnant) about the ZIKV, and offer pre-natal tests to detect for the presence of the virus,? he said. Ideally, Nerurkar said, families can plan for safe pregnancies by avoiding travel to areas of known ZIKV outbreaks. (In 2016, the U.S. Centers for Disease Control and Prevention and World Health Organization have issued travel alerts about locations with confirmed, locally acquired Zika virus infections.)

The UH researchers expressed their gratitude for the women who agreed to voluntarily donate blood and placenta samples to build the UH Biorepository archive. ?This has been an indispensible resource in our research,? said Dr. Nerurkar.

Dr. Nerurkar leads a team of scientists at UH working to develop a vaccine for ZIKV infection as well as robust diagnostic assays to rapidly detect ZIKV and other mosquito-borne viral infections. After the award of a Zika emergency response grant this year from the National Institutes of Health, his team members are also working to understand how ZIKV infection in men makes them susceptible to transmit the virus to their sexual partners, (See: http://jabsom.hawaii.edu/uh-medical...and-how-the-zika-virus-is-spread-through-sex/) even though the men may appear symptom-free.

Leading research: Earlier this year, Dr. Nerurkar and his UH colleagues reported on one 2015 case of microcephaly related to ZIKV infection. Their report in the journal Clinical Infectious Diseases (http://cid.oxfordjournals.org/content/early/2016/06/17/cid.ciw324 ) was the first scientific article about a ZIKV-related microcephaly case in the United States. The mother of the infant, born with microcephaly in Hawaiʻi in late 2015, had traveled to Brazil, location associated with the current ZIKV outbreak.

Where did the 2009 infections originate? Except for travel-related ZIKV cases, ZIKV outbreak has not occurred in Hawaiʻi. Nerurkar notes that there was a confirmed Zika outbreak in 2007 in Yap, Micronesia and one in French Polynesia in 2013.

The authors hypothesize that pregnant women may have been exposed to ZIKV during their visit to Pacific Island Nations. Due to close proximity and historic ties between the islands, travel to various islands in the Pacific from Hawai?i is relatively frequent and the duration of stay is comparatively long. The majority of travelers from Hawaiʻi to these islands are visiting friends and relatives. International studies suggest that these travelers experience a higher risk of contracting travel-related infectious diseases compared to other groups of international travelers.

About the research: This work was supported by a grant (P30GM114737) from the Centers of Biomedical Research Excellence, National Institute of General Medical Sciences, grants (U54MD007584, G12MD007601) from the National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, and Institutional funds. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The manuscript in PLOS (Public Library of Science) Neglected Tropical Diseases was published on December 20, 2016.

About JABSOM: The John A. Burns School of Medicine (JABSOM) at the University of Hawaiʻi honors its unique research environment to excel in science-based efforts to eliminate diseases that disproportionately affect people in Hawaiʻi and the Pacific region. Annually at JABSOM, more than 600 future physicians are learning medicine, JABSOM researchers secure $52 million in grants, and overall economic stimulus to Hawaiʻi from the school tops $456 million annually. JABSOM also confers degrees in Clinical Translational Research, Communication Sciences and Disorders, Tropical Medicine, Cell and Molecular Biology, Medical Technology and Developmental and Reproductive Biology. http://jabsom.hawaii.edu.

by Tina Shelton

Last Updated: 12/23/16

http://manoa.hawaii.edu/tropicalmedicine/?p=3070