Fatal Zika virus infection in the Americas: A systematic review

• Type of Material: Article
• Authors: Jaime A. Cardona-Ospina, Universidad Tecnológica de Pereira; Valentina Henao-SanMartin, Universidad Tecnológica de Pereira; Wilmer F. Acevedo-Mendoza, Universidad Tecnológica de Pereira; Katherinn Melissa Nasner-Posso, Universidad Tecnológica de Pereira; Dayron F. Martinez-Pulgarin, Universidad Tecnológica de Pereira; Abril Restrepo-Lopez, Universidad Tecnológica de Pereira; Valentina Valencia-Gallego, Fundación Universitaria Autónoma de las Américas; Matthew Collins, Emory University; Alfonso J. Rodriguez-Morales, Universidad Tecnológica de Pereira
• Language: English
• Date: 2019-11-01
• Publisher: Elsevier: Creative Commons Attribution Non-Commercial No-Derivatives License
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Author(s)
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ijid.2019.08.033
• Title of Journal or Parent Work: International Journal of Infectious Diseases
• ISSN: 1201-9712
• Volume: 88
• Start Page: 49
• End Page: 59
• Grant/Funding Information: Universidad Tecnológica de Pereira, Risaralda, Colombia, and Emory University, Atlanta, GA, United States of America.; This article published with support from Emory Libraries' Open Access Publishing Fund.
• Keywords: Fatal; DISEASE; Life Sciences & Biomedicine; Science & Technology; Americas; EPIDEMIC; Severe; Infectious Diseases; Zika; Epidemiology; MODEL; Complications
• Research Categories: Health Sciences, Immunology; Health Sciences, Epidemiology

Abstract

Introduction: While death due to Zika virus (ZIKV) infection has been described, reports of fatal cases have been infrequent and no systematic reviews on the subject have been published. Methods: A systematic review of the literature in four databases was performed to assess fatal outcomes of postnatal ZIKV infection and the available evidence that links ZIKV infection to death. Results: Three hundred and eleven articles were retrieved; 20 of them were epidemiological reports from surveillance agencies and ministries of health. After screening by abstract and title, 59 articles were selected for full-text assessment. Of these, 35 were excluded (with reasons) and 24 were finally included for qualitative analysis. A total of 51 reported deaths associated with ZIKV infection in nine countries were identified. The majority of cases (56.9%) were not related to Guillain–Barré syndrome. Cases from three countries accounted for 67.6% of the deaths. ZIKV infection was laboratory-confirmed in the majority of cases (64.7%). Discussion: ZIKV was not considered to be a dangerous, and much less a lethal pathogen, until very recently. However, an increasing number of fatalities have been published in the literature since the first death was reported in 2016. Additional research is needed to elucidate factors that may mediate the pathogenesis of severe, atypical, and fatal disease.