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Vol 5 Issue 1 (2018)

Original Articles

  • TD Davidson, I Vickers, CDC Christie
    Before the emergence of Zika in 2016 and Chikungunya in 2014, there have been numerous Dengue outbreaks in the Caribbean. Despite this, there is a paucity of published studies on Dengue in children from this region. The potential for exponential spread of the Aedes aegypti dengue vector and its deleterious outcomes in children underlines the importance of this paper.
  • T James-Powell, Y Brown, CDC Christie, R Melbourne-Chambers, JT Moore, O Morgan, B Butler, K Swaby, A Garbutt, J Anzinger, RB Pierre, A Onyonyor, L Bryan, PM Palmer, P Mitchell, P Johnson, K Bishop, JR Jaggon, W De La Haye
    Newborns with the characteristics of congenital syndrome associated with Zika virus (CSAZ) are being born in urban hospitals after the 2016 Zika virus epidemic in Jamaica. Phenotypic features include microcephaly, craniofacial disproportion, neuro-imaging and neuro-pathological findings and arthrogryposis. A trend towards babies being delivered with small head circumferences, but not yet in the range of microcephaly and others with normal head sizes who were born to women who were symptomatic in pregnancy is also being observed. While, most babies with probable CSAZ are being born to asymptomatic women who did not report any symptoms related to arbovirus illness in pregnancy. Diagnosis is challenged by serological cross-reactivity between circulating flaviviruses. Team management is multidisciplinary to maximize the neuro-developmental potential of this vulnerable patient population.
  • CDC Christie, C Giaquinto
    Zika virus causes Guillain-Barre Syndrome and microcephaly. Clinical and laboratory diagnosis is complicated. Population-based research can elucidate ZIKV epidemiology, vertical transmission, fetal risks of maternal ZIKV infection and natural history of congenital and non-congenital ZIKV infection provided by the activities in “ZIKAction” research consortium, recently funded by the European Commission.
  • KR Webster-Kerr, CDC Christie, A Grant, D Chin, H Burrowes, K Clarke, I Wellington, K Shaw, W De La Haye
    The Zika virus epidemic in Jamaica is evolving and includes cases of Guillain-Barré Syndrome and reports in pregnant women. Zika may become endemic in Jamaica, similar to dengue and Chikungunya. Safe and effective Dengue, Chikungunya fever and ZIKV vaccines are needed to mitigate the devastating effects of these three diseases.
  • R Melbourne-Chambers, CDC Christie, E Greenaway, R Bullock
    This case series suggests a unique clinical pattern of neuro-inflammation in Jamaican adolescents occurring during the ZIKV epidemic and questions the role of the three circulating arbo-viruses in the pathogenesis.
  • CDC Christie, R Melbourne-Chambers, J Ennevor, S Young-Peart, T Buchanan, P Scott-Brown, N McNeil-Beecher, T Fulford-Ramdial, M Richards-Dawson, T James-Powell, ST Jackson
    The Chikungunya fever epidemic had significant public health and economic impact in Jamaica. In children, there were characteristic presentations in neonates and young infants and in children six months to six years. Neurologic involvement was common but other organ dysfunction was rare.

Case Reports

  • B Nelson, R Melbourne-Chambers, CDC Christie
    Zika Virus is neurotropic. We report two children from the Caribbean Island of Grenada, a three-year-old with acute neuro-inflammation who had intractable seizures, meningo-encephalitis, CSF pleocytosis and Zika IgM positive acute serology and a four-year-old with acute demyelinating encephalomyelitis manifesting as generalized seizures, optic neuritis, diffuse cerebral dysfunction, encephalopathy, impaired speech and ataxia who also had CSF pleocytosis as well as Zika IgM and Dengue IgM positive acute serologies. Both cases occurred during the 2016 Zika and Dengue fever epidemic in Grenada. Both children recovered completely. The aetiologic role of the Zika and Dengue arboviruses is discussed.
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