Human immunal response against zika
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Transcript of Human immunal response against zika
1DISCOVERY AND ISSUES
ZIKV first isolated from Rhesus monkeys in
Uganda in 1947 which causes ZIKA fever
Propagated to Pacific in 2007 and 2013
Then to the Americas and Africa in 2015
Now more than 13 countries in the America
have reported sporadic Zika virus infections
indicating rapid geographic expansion of Zika
virus
2TAXANOMY AND NOMENCLATURE
Family Flaviviridae
Order Unassingned
Genus Flavivirus
Species Zika virus
It is so called ldquoZIKArdquo where it is found
Zika virus bears a striking resemblance to
chikungunya
Same clade of ZIKA are Spondweni virus St Louis
encephalitis virus Ilheus virus and Rocio virus
3STRUCTURE AND COMPOSITION
It is an enveloped virus with icosahedral structure
Contains non segmented Single-stranded positive
sense RNA
Complete genome sequence of ZIKA has been
published
The open reading frame of the Zika virus reads as
follows
5prime-C-prM-E-NS1-NS2A-NS2B-NS3-NS4A-NS4B-NS5-
3prime
3STRUCTURE AND COMPOSITION-CONTD
Fig 31 ZIKA VIRUS
4TRANSMISSION
Transmitted by Aedes species mosquitoes
Major contribution by A aegypti
This is the same mosquito that transmits dengue
chikungunya and yellow fever
This usually bite during the morning and late
afternoonevening hours
Incubation period is about three to 12 days after the
bite of an infected mosquito
4TRANSMISSION-CONTD
Fig 41
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
2TAXANOMY AND NOMENCLATURE
Family Flaviviridae
Order Unassingned
Genus Flavivirus
Species Zika virus
It is so called ldquoZIKArdquo where it is found
Zika virus bears a striking resemblance to
chikungunya
Same clade of ZIKA are Spondweni virus St Louis
encephalitis virus Ilheus virus and Rocio virus
3STRUCTURE AND COMPOSITION
It is an enveloped virus with icosahedral structure
Contains non segmented Single-stranded positive
sense RNA
Complete genome sequence of ZIKA has been
published
The open reading frame of the Zika virus reads as
follows
5prime-C-prM-E-NS1-NS2A-NS2B-NS3-NS4A-NS4B-NS5-
3prime
3STRUCTURE AND COMPOSITION-CONTD
Fig 31 ZIKA VIRUS
4TRANSMISSION
Transmitted by Aedes species mosquitoes
Major contribution by A aegypti
This is the same mosquito that transmits dengue
chikungunya and yellow fever
This usually bite during the morning and late
afternoonevening hours
Incubation period is about three to 12 days after the
bite of an infected mosquito
4TRANSMISSION-CONTD
Fig 41
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
3STRUCTURE AND COMPOSITION
It is an enveloped virus with icosahedral structure
Contains non segmented Single-stranded positive
sense RNA
Complete genome sequence of ZIKA has been
published
The open reading frame of the Zika virus reads as
follows
5prime-C-prM-E-NS1-NS2A-NS2B-NS3-NS4A-NS4B-NS5-
3prime
3STRUCTURE AND COMPOSITION-CONTD
Fig 31 ZIKA VIRUS
4TRANSMISSION
Transmitted by Aedes species mosquitoes
Major contribution by A aegypti
This is the same mosquito that transmits dengue
chikungunya and yellow fever
This usually bite during the morning and late
afternoonevening hours
Incubation period is about three to 12 days after the
bite of an infected mosquito
4TRANSMISSION-CONTD
Fig 41
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
3STRUCTURE AND COMPOSITION-CONTD
Fig 31 ZIKA VIRUS
4TRANSMISSION
Transmitted by Aedes species mosquitoes
Major contribution by A aegypti
This is the same mosquito that transmits dengue
chikungunya and yellow fever
This usually bite during the morning and late
afternoonevening hours
Incubation period is about three to 12 days after the
bite of an infected mosquito
4TRANSMISSION-CONTD
Fig 41
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
4TRANSMISSION
Transmitted by Aedes species mosquitoes
Major contribution by A aegypti
This is the same mosquito that transmits dengue
chikungunya and yellow fever
This usually bite during the morning and late
afternoonevening hours
Incubation period is about three to 12 days after the
bite of an infected mosquito
4TRANSMISSION-CONTD
Fig 41
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
4TRANSMISSION-CONTD
Fig 41
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5MECHANISM OF INFECTION
This ZIKA has enzootic mosquito-monkey-mosquito
cycle with only occasional transmission to humans
Dermal fibroblasts epidermal keratinocytes are
permissible to ZIKV
The virion attaches to host cell membrane receptors
via envelope protein E which induces virion
endocytosis
The virus membrane fuses with the endosomal
membrane
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5MECHANISM OF INFECTION-CONTDhellip
The ssRNA genome of the virus is released into the
cytoplasm
It is then translated into a polyprotein Translation
takes place by viral initiation
Replication follows the positive stranded RNA virus
replication model and takes place as a cytoplasmic
viral factory in the endoplasmic reticulum resulting in
a dsRNA genome
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5MECHANISM OF INFECTION-CONTDhellip
The dsRNA genome is then transcribed to ssRNA
New virions are transported to the Golgi apparatus
and then excreted by budding into the intracellular
space where the new virions cause infection
ZIKV activates an antiviral innate immune
response with type 1 interferon in infected cells
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5MECHANISM OF INFECTION-CONTDhellip
Fig 51 flavivirus ndashhost cell interaction
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5HUMAN IMMUNE RESPONSE
Flavivirus cause acute sporadic disease and are
not persistent
The outcome of flavivirus infection in an animal is
determined by a balance between the speed of viral
replication and spread and the immune system
response
Flaviviruses have evolved specific tactics to evade
the innate and adaptive immune response
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses have genomic size constraints and are
unable to acquire exogenous genes
Smaller viruses evolve multifunctional genes that
regulate viral life cycle yet also modulate the host
response
The infected cells migrate to draining lymph nodes
where arise early immune response
Then reach secondary lymphoid tissues leading to
entry into the circulation via the efferent lymphatic
system and thoracic duct
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5HUMAN IMMUNE RESPONSE-CONTD
Now spread to visceral organs then to neurotropic
flaviviruses disseminate to the central nervous system
The mechanism by which flaviviruses avoid being
targeted by its entry into brain and spinal cord remains
unclear
There is an assumption that the virus enters via a
haematogenous route
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5HUMAN IMMUNE RESPONSE-CONTD
Flaviviruses may cross the bloodndashbrain barrier by
passive transport across the endothelium by active
replication in endothelial cells
Trojan horse mechanism in which the virus is
carried into the brain by infected inflammatory cells
The IFN-dependent innate immune response is
essential for protection against flavivirus infections
Type I and II IFN inhibit flavivirus infection in cell culture and in animals
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
5HUMAN IMMUNE RESPONSE-CONTD
Type I IFN block flavivirus infection by
preventing translation and replication of infectious viral RNA
Type II IFN inhibit flavivirus replication via the
generation of proinflammatory and antiviral
molecules including nitric oxide
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
6SYMPTOMS AND DISEASE
Fever
Skin rashes
Conjunctivitis
Muscle and joint pain
Malaise or headache
These symptoms normally last for 2-7 days
Affects nervous system egmicrocephaly in foetus
Fig 61 microcephaly head IMR
image
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
6SYMPTOMS AND DISEASE-CONTD
Fig 62 symptoms
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
6SYMPTOMS AND DISEASE-CONTD
Fig 63 skin rashes and Aedes spp mosquito
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
6SYMPTOMS AND DISEASE-CONTD
Fig 64
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
7DIAGNOSIS
Can be confirmed by presence Zika virus RNA in
the blood or other body fluids such as urine or saliva
Zika virus RNA has been detected in urine up to 10
days after onset of the disease
From day five post onset of disease serological
investigations can be conducted by detection of
Zika-specific IgM antibodies and confirmation by
neutralisation seroconversion or four-fold antibody
titer increase of Zika specific antibodies in paired
serum samples
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
8AVAILABLE TREATMENT
There is no vaccine or specific prophylactic
treatment
Bharat biotech international company of India
declared that they patented for medicine for ZIKV
The treatment is symptomatic and mainly based
on pain relief fever reduction and anti-histamines
for pruritic rash
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
9PREVENTION
The best form of prevention is protection against
mosquito bites
Repellents should contain DEET (N N-diethyl-3-
methylbenzamide) IR3535 (3-[N-acetyl-N-butyl]-
aminopropionic acid ethyl ester) or icaridin (1-
piperidinecarboxylic acid 2-(2-hydroxyethyl)-1-
methylpropylester)
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
10EXPERMENTAL TREATMENT
The Bharath biotech produced one inactivated and
one recombinant vaccines which are seeking for
patent
People sick with Zika virus get plenty of rest drink
enough fluids and treat pain and fever with common
medicines
Hypochlorite is a natural product for human
organism and elaborated by immune cells for
protection against infection
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
REFERENCES
1R M Kofler J H Aberle S W Aberle S L Allison F X Heinz and C W Mandl
Proc Natl Acad Sci USA 71951-1956 2004
2Evasion of innate and adaptive immunity by flavivirusesMichael
S Diamond11Departments of Medicine Molecular Microbiology and Pathology amp
Immunology Washington University School of Medicine Saint Louis Missouri USA
3 Oliveira Melo A S Malinger G Ximenes R Szejnfeld P O Alves Sampaio
S Bispo de Filippis A M (2016-01-01) Zika virus intrauterine infection causes
fetal brain abnormality and microcephaly tip of the iceberg Ultrasound in
Obstetrics amp Gynecology 47 (1) 6ndash7 doi101002uog15831 ISSN 1469-
0705 PMID 26731034
4 Tick-borne flaviviruses dissecting host immune responses and virus
countermeasures
Robertson SJ1 Mitzel DN Taylor RT Best SM Bloom ME
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA
REFERENCES5 Immune evasion strategies of flaviviruses
Ye J1 Zhu B Fu ZF Chen H Cao S
6 Evasion of innate and adaptive immunity by
S Diamond1Departments of Medicine Molecular
Microbiology and Pathology amp Immunology Washington
University School of Medicine Saint Louis Missouri USA