What we know and what we don’t know about perinatal Zika virus infection

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Many challenges are still far from being solved regarding the epidemiology, case definition, clinical and laboratory diagnosis, and preventive measures. An approach using ‘omics’ and new biomarkers for diagnosis, and a [Zika virus infection] ZIKV vaccine for treatment, might finally give us the tools to solve these challenges.

This systematic review aimed to summarise recent and conclusive evidence of ZIKV infection in the gestational, perinatal, and early infant periods. One hundred and six studies were identified and included in a narrative synthesis. Study quality was not considered. The authors summarised the findings in the following areas: 1) Epidemiology, transmission, and incubation period; 2) Virology and pathogenesis; 3) Kinetics of the virus in the male genital tract – the case for sexual transmission; 4) Risk factors for congenital ZIKV syndrome (CZS)/ manifestations; 5) Congenital phenotypic signs and follow-up of these infants; 6) Neuroimaging; 7) Laboratory diagnosis; 8) Anti-viral treatment; and 9) Vaccines. The authors summarised the evidence and identified the evidence gaps.

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