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Table of Contents    
CORRESPONDENCE
Year : 2017  |  Volume : 65  |  Issue : 2  |  Page : 440-441

Author's Reply: Zika virus: Some interesting points


1 Department of Internal Medicine, IPGMER, Kolkata, West Bengal, India
2 Department of Accident and Emergency, Lady Hardinge Medical College, New Delhi, India
3 NMB Diagnostic Centre, Serampore, West Bengal, India

Date of Web Publication10-Mar-2017

Correspondence Address:
Adrija Hajra
Department of Internal Medicine, IPGMER, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.201875

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How to cite this article:
Hajra A, Bandyopadhyay D, Hajra SK. Author's Reply: Zika virus: Some interesting points. Neurol India 2017;65:440-1

How to cite this URL:
Hajra A, Bandyopadhyay D, Hajra SK. Author's Reply: Zika virus: Some interesting points. Neurol India [serial online] 2017 [cited 2017 Apr 28];65:440-1. Available from: http://www.neurologyindia.com/text.asp?2017/65/2/440/201875


Sir,

First of all, I want to thank the authors of the article “Neurological Problem due to Zika Virus Infection: What Should be Discussed?” The authors have raised some pertinent questions in their article. We are trying to focus on some new and interesting points regarding the points mentioned in the article mentioned above.

In our previous article, we have already mentioned some points regarding neurological involvement related to Zika virus (ZIKV) infection.[1]

ZIKV associated microcephaly has been detected mainly from Brazil. There is very limited data from Asia. The Ministry of Public Health of Thailand confirmed two cases of ZIKV related microcephaly on 30 September 2016. This is the first time that ZIKV related microcephaly has been established in Southeast Asia. There was no history of travel of these affected mothers to areas outside of Thailand.[2] We apprehend that further cases will be detected in the Asian population. However, more data are needed to have a clear understanding regarding this regional distribution of ZIKV related microcephaly. Currently, the exact reason behind the increased occurrence of microcephaly in Brazil but not in Asia cannot be explained. The Director of Information and Health Analysis at Brazil's Ministry of Health has proposed that some factors other than ZIKV may play a role in determining this high prevalence and severity of cases.[3] Bovine-like viral diarrhea virus has been found in ZIKV RNA positive brain tissues. Researches is currently underway to determine whether or not a co-infection can play an additive role in the causation of microcephaly in endemic areas outside of Asia.[3]

Regarding Guillain-Barré syndrome (GBS) in ZIKV, we totally agree with the authors that a delay in diagnosing these cases is due to lack of clinical experience in managing cases infected by ZIKV. As most of the cases of ZIKV are asymptomatic, an adequate clinical suspicion will help to detect ZIKV as the etiology behind post-infectious GB syndrome.

Regarding the association of GBS with pregnancy, one case has been reported to have GBS related ZIKV infection at 26 weeks of gestation.[4] Again, more data are needed to charter the course of the disease during pregnancy.

 
  References Top

1.
Hajra A, Bandyopadhyay D, Hajra SK. Zika virus: New interest in Neurology. Neurol India 2016; 64:1102-4.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Zika virus, Microcephaly and Guillain-Barré syndrome. Emergencies. Zika situation report. World Health Organization; 2016. Available form: http://www.who.int/emergencies/zika-virus/situation-report/6-october-2016/en/. [Last accessed on 2017 Jan 24].  Back to cited text no. 2
    
3.
Butler D. Brazil asks whether Zika acts alone to cause birth defects. Nature 2016;535:475–47. Available from: http://www.nature.com/news/brazil-asks-whether-zika-acts-alone-to-cause-birth-defects.[Last accessed on 2017 Jan 24].  Back to cited text no. 3
    
4.
Reyna-Villasmil E, López-Sánchez G, Santos-Bolívar J. Síndrome de Guillain-Barré debido al virus del Zika durante el embarazo. Med Clin (Barc) 2016;146:331-32.  Back to cited text no. 4
    




 

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