- Open Access
The expanding spectrum of modes of transmission of Zika virus: a global concern
© Rodriguez-Morales et al. 2016
- Received: 19 February 2016
- Accepted: 24 February 2016
- Published: 3 March 2016
During recent years, but particularly since 2015, concern on Zika virus has grown for multiple reasons, such as its association with the occurrence of Guillain–Barré syndrome and microcephaly [1, 2]. Nevertheless, in addition to all epidemiological implications of the outbreak in Latin America  the number of affected cases continue to rise and expected to reach over four million in 2016, adding to this the possibility of new modes of transmission.
Zika virus is predominantly a vector-borne disease (Fig. 1), although after the epidemics in the Pacific region it was clear that transplacental and perinatal transmission [7, 8] could also occur. However, the associated risk of microcephaly has been identified and highlighted much more recently as evidences continue to be added in different studies (Fig. 1) [8, 9].
Before the current epidemics not a single study raised that relationship, and, right now a significant number of pregnant women and their newborns are being monitored in Brazil , Colombia and other countries in the region for central nervous system anomalies. Zika has been detected in newborns, placenta and umbilical cords, as well in pregnant women by RT-PCR [8, 9]. There have been no reports detecting viable and potentially infective virus in breast milk up to now.
In addition to mother-to-child transmission, during the last decade, cases of sexual transmission have been reported [10–12], representing a non-vector borne form of transmission of Zika virus (Fig. 1). Zika virus has been detected in human saliva , blood, semen and urine . It has been recently detected in semen and urine of, respectively, a patient after 62 days of infection  and another patient after 14 days of infection . Also spread of the virus through blood transfusion and organ transplantation have been reported or suspected . Zika virus infections have been documented through laboratory exposure .
Summarizing, Zika virus is primarily a vector-borne disease (mainly by A. aegypti), but there are also secondary modes of transmission (mother-to-child, sexual, blood transfusion, transplantation, non-human primate bites) (Fig. 1). This imply that prevention and control should consider all these ways of transmission, providing strategies to reduce new infections from this arbovirus that still need further basic, epidemiological and clinical assessment in order to clarify and understand its real impact on human health. Zika represents a real challenge for the medical and scientific community as well as for the world .
ARM coordinated the writing of the manuscript, wrote initial draft and performed review of the literature. AB edited manuscript and performed review of the literature. CFP edited manuscript. All authors read and approved the final manuscript.
The authors declare that they have no competing interests.
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.
- Heymann DL, Hodgson A, Sall AA, Freedman DO, Staples JE, Althabe F, Baruah K, Mahmud G, Kandun N, Vasconcelos PFC, et al. Zika virus and microcephaly: why is this situation a PHEIC? Lancet. 2016;387(10020):719–21.View ArticlePubMedGoogle Scholar
- Rodriguez-Morales AJ. Zika and microcephaly in Latin America: an emerging threat for pregnant travelers? Travel Med Infect Dis. 2016;14(1):5–6.View ArticlePubMedGoogle Scholar
- Campos GS, Bandeira AC, Sardi SI. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis. 2015;21(10):1885–6.View ArticlePubMedPubMed CentralGoogle Scholar
- Rodriguez-Morales AJ. Zika: the new arbovirus threat for Latin America. J Infect Dev Ctries. 2015;9(6):684–5.View ArticlePubMedGoogle Scholar
- Dick GW. Zika virus. II. Pathogenicity and physical properties. Trans R Soc Trop Med Hyg. 1952;46(5):521–34.View ArticlePubMedGoogle Scholar
- Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952;46(5):509–20.View ArticlePubMedGoogle Scholar
- Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. Euro Surveill. 2014;19(13):20751.View ArticlePubMedGoogle Scholar
- Mlakar J, Korva M, Tul N, Popovic M, Poljsak-Prijatelj M, Mraz J, Kolenc M, Resman Rus K, Vesnaver Vipotnik T, Fabjan Vodusek V et al. Zika virus associated with microcephaly. N Engl J Med 2016.Google Scholar
- Schuler-Faccini L, Ribeiro EM, Feitosa IM, Horovitz DD, Cavalcanti DP, Pessoa A, Doriqui MJ, Neri JI, Neto JM, Wanderley HY, et al. Possible association between Zika virus infection and microcephaly—Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(3):59–62.View ArticlePubMedGoogle Scholar
- Patino-Barbosa AM, Medina I, Gil-Restrepo AF, Rodriguez-Morales AJ. Zika: another sexually transmitted infection? Sex Transm Infect. 2015;91(5):359.PubMedGoogle Scholar
- Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis. 2015;21(2):359–61.View ArticlePubMedPubMed CentralGoogle Scholar
- Foy BD, Kobylinski KC, Chilson Foy JL, Blitvich BJ, Travassos da Rosa A, Haddow AD, Lanciotti RS, Tesh RB. Probable non-vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis. 2011;17(5):880–2.View ArticlePubMedPubMed CentralGoogle Scholar
- Musso D, Roche C, Nhan TX, Robin E, Teissier A, Cao-Lormeau VM. Detection of Zika virus in saliva. J Clin Virol. 2015;68:53–5.View ArticlePubMedGoogle Scholar
- Gourinat AC, O’Connor O, Calvez E, Goarant C, Dupont-Rouzeyrol M. Detection of Zika virus in urine. Emerg Infect Dis. 2015;21(1):84–6.View ArticlePubMedPubMed CentralGoogle Scholar
- Barry A, Pasco H, Babak A, Sarah L, Daniel C, Emma JA, Andrew JS, Timothy JB, Roger H. Detection of Zika virus in semen. Emerg Infect Dis. 2016. doi:10.3201/eid2205.160107.
- de M Campos R, Cirne-Santos C, Meira GLS, Santos LLR, de Meneses MD, Friedrich J, Jansen S, Ribeiro MS, da Cruz IC, Schmidt-Chanasit J et al. Prolonged detection of Zika virus RNA in urine samples during the ongoing Zika virus epidemic in Brazil. J Clin Virol. 2016;77(4):69–70.Google Scholar
- Marano G, Pupella S, Vaglio S, Liumbruno GM, Grazzini G. Zika virus and the never-ending story of emerging pathogens and transfusion medicine. Blood transfus. 2015. doi:10.2450/2015.0066-15.Google Scholar
- Hennessey M, Fischer M, Staples JE. Zika Virus spreads to new areas—region of the Americas, May 2015–January 2016. MMWR Morb Mortal Wkly Rep. 2016;65(3):55–8.View ArticlePubMedGoogle Scholar
- Leung GH, Baird RW, Druce J, Anstey NM. Zika virus infection in Australia following a monkey bite in Indonesia. Southeast Asian J Trop Med Public Health. 2015;46(3):460–4.PubMedGoogle Scholar
- Rodriguez-Morales AJ, Villamil-Gomez W. The challenge of Zika in Colombia and Latin America: an international health emergency. Infectio. 2016;20(2):59–61.View ArticleGoogle Scholar