Department of Zoology, University of Oxford, Oxford, UK.
Instituto Nacional de Investigação em Saúde, Ministry of Health, Luanda, Angola.
Lancet Infect Dis. 2019 Oct;19(10):1138-1147. doi: 10.1016/S1473-3099(19)30293-2.
Zika virus infections and suspected microcephaly cases have been reported in Angola since late 2016, but no data are available about the origins, epidemiology, and diversity of the virus. We aimed to investigate the emergence and circulation of Zika virus in Angola.
Diagnostic samples collected by the Angolan Ministry of Health as part of routine arboviral surveillance were tested by real-time reverse transcription PCR by the Instituto Nacional de Investigação em Saúde (Ministry of Health, Luanda, Angola). To identify further samples positive for Zika virus and appropriate for genomic sequencing, we also tested samples from a 2017 study of people with HIV in Luanda. Portable sequencing was used to generate Angolan Zika virus genome sequences from three people positive for Zika virus infection by real-time reverse transcription PCR, including one neonate with microcephaly. Genetic and mobility data were analysed to investigate the date of introduction and geographical origin of Zika virus in Angola. Brain CT and MRI, and serological assays were done on a child with microcephaly to confirm microcephaly and assess previous Zika virus infection.
Serum samples from 54 people with suspected acute Zika virus infection, 76 infants with suspected microcephaly, 24 mothers of infants with suspected microcephaly, 336 patients with suspected dengue virus or chikungunya virus infection, and 349 samples from the HIV study were tested by real-time reverse transcription PCR. Four cases identified between December, 2016, and June, 2017, tested positive for Zika virus. Analyses of viral genomic and human mobility data suggest that Zika virus was probably introduced to Angola from Brazil between July, 2015, and June, 2016. This introduction probably initiated local circulation of Zika virus in Angola that continued until at least June, 2017. The infant with microcephaly in whom CT and MRI were done had brain abnormalities consistent with congenital Zika syndrome and serological evidence for Zika virus infection.
Our analyses show that autochthonous transmission of the Asian lineage of Zika virus has taken place in Africa. Zika virus surveillance and surveillance of associated cases of microcephaly throughout the continent is crucial.
Royal Society, Wellcome Trust, Global Challenges Research Fund (UK Research and Innovation), Africa Oxford, John Fell Fund, Oxford Martin School, European Research Council, Departamento de Ciência e Tecnologia/Ministério da Saúde/National Council for Scientific and Technological Development, and Ministério da Educação/Coordenação de Aperfeicoamento de Pessoal de Nível Superior.
自 2016 年底以来，安哥拉已报告寨卡病毒感染和疑似小头畸形病例，但尚无关于病毒起源、流行病学和多样性的数据。我们旨在调查寨卡病毒在安哥拉的出现和传播。
安哥拉卫生部作为常规虫媒病毒监测的一部分收集的诊断样本由安哥拉卫生部的 Instituto Nacional de Investigação em Saúde（罗安达）通过实时逆转录 PCR 进行检测。为了鉴定进一步的寨卡病毒阳性且适合基因组测序的样本，我们还测试了 2017 年罗安达艾滋病毒感染者研究中的样本。便携式测序用于从通过实时逆转录 PCR 检测到的 3 名寨卡病毒感染者（包括一名患有小头畸形的新生儿）中生成安哥拉寨卡病毒基因组序列。对患有小头畸形的儿童进行脑部 CT 和 MRI 以及血清学检测，以确认小头畸形并评估先前的寨卡病毒感染。
54 名疑似急性寨卡病毒感染患者、76 名疑似小头畸形婴儿、24 名疑似小头畸形婴儿母亲、336 名疑似登革热或基孔肯雅热病毒感染患者以及 349 名 HIV 研究样本通过实时逆转录 PCR 进行了检测。2016 年 12 月至 2017 年 6 月期间确诊的 4 例寨卡病毒阳性病例。病毒基因组和人类流动数据分析表明，寨卡病毒可能于 2015 年 7 月至 2016 年 6 月间从巴西传入安哥拉。这一引入可能在安哥拉引发了寨卡病毒的本地传播，该传播一直持续到至少 2017 年 6 月。对进行了 CT 和 MRI 的小头畸形婴儿的检测结果显示，其脑部异常与先天性寨卡综合征一致，并且存在寨卡病毒感染的血清学证据。
我们的分析表明，非洲已经发生了亚洲谱系寨卡病毒的本地传播。整个非洲大陆对寨卡病毒的监测和相关小头畸形病例的监测至关重要。
英国皇家学会、惠康信托基金会、全球挑战研究基金（英国研究与创新）、非洲牛津大学、约翰·费尔基金、牛津马丁学院、欧洲研究理事会、科学技术部/卫生部/国家科学技术发展理事会和教育部/高级人员培训协调部。
