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Juan Sanchez, MD

Training Years: 2017-2018

Training Site: Universidad Peruana Cayetano Heredia (UPCH)

Country: Peru

Mentors: Andres G. Lescano, PhD, MHS; Robert H. Gilman MD, DTM&H

Title: Cytokine levels and arboviral infections in mother-newborn pairs before and after Zika emergence in a dengue endemic area of Peru

Project Objectives: Arboviruses are virus transmitted by arthropods and these infections are spread around the world. Three arboviruses have gained great importance recently: dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV), and all are transmitted by Aedes aegypti and cause substantial burden of disease in the Americas. We will focus on DENV, CHIKV and ZIKV, but other arboviruses can be tested and studied.

Aim 1: We will compare the prevalence of arbovirus infections in pregnant women and their newborns in a DENVendemic region during the emergence of ZIKV in Peru. We will test blood and placenta collected from two cohorts of mother-newborn pairs were enrolled on January 2016 (pre Zika emergence) and September 2016 (post Zika emergence), and a third cohort to be enrolled in September 2017 (post Zika outbreak). ELISA and PCR will be used for diagnosis. The identification of asymptomatic infections is critical, especially by ZIKV,because the Zika congenital syndrome has been reported frequently in asymptomatic maternal infections (6).

Aim 2: We will compare the cognitive and neurological development at 6 and 12 months of infants born to mothers infected with arboviruses during pregnancy compared to children of non-infected mothers. In September 2016we followed the first cohort of infants enrolled on January 2016 and a new follow-up for the second cohort will be conducted on March 2017. A new enrollment will be done on September 2017 and the follow-up will be done six months later (March 2018). During this survey we collected demographic, epidemiological and clinical information about the cognitive and neurological development of the children. We will analyze these data to find association with arbovirus infections and the child development. All the information will be collected following the Guidelines from the Peruvian Ministry of Health about Health Child Development.

Aim 3: We will compare the cytokines levels of placenta samples from mothers and newborns infected with any arbovirus infection during pregnancy versus women without confirmed arbovirus infections matched 1:1 based on age, parity and other covariates as feasible. Testing will take place at the laboratory of Dr. Irina Burd in the Johns Hopkins Hospital (JHH). Cytokine level ratios will be assessed overall and by virus type depending on sample size, and the correlation with health outcomes in the children will be explored.

NIH Support:  Fogarty fellows postdoctoral training award

Juan Sanchez Headshot