Oropouche Virus Infection: A Growing Global Public Health Concern

Sir,

Oropouche virus (OROV) is a single-stranded RNA virus belonging to Orthobunyavirus genus (Peribunyaviridae family), which spreads primarily by the bite of midges (Culicoides paraensis) and also by some mosquitoes. It was first detected in 1955 in the southern most countries of the Caribbean island. Recent outbreak of OROV infection has emerged as public health concern for pregnant women not just for America but also for rest of the world due to multiple factors such as urbanization, international travel, and climate change.[1] More than 2/3^rd of the people become symptomatic, and the symptoms of OROV infection begin after 3 to 10 days of midge bite and are fever, headache, chills, myalgia, and arthralgia lasting for about a week. However, there is a risk of developing some serious complications such as meningitis and encephalitis.[1] Currently, no specific treatment of OROV is available; only symptomatic and conservative management is done, which includes rest, fluid replenishment, analgesic, and antipyretics. However, aspirin and NSAIDs are not used as they have the potential of increasing the risk of hemorrhage. Patients having serious complications should be hospitalized. Geriatric population, immunocompromised people (PLHIV, organ transplant patients or on steroids), and having comorbidities such as diabetes, hypertension, or heart disease are identified as high-risk population for OROV.[2] Based on available literature and data from Brazil and Cuba on OROV infection, instances of vertical transmission resulting in still birth, spontaneous abortions, and congenital abnormalities like microcephaly have been reported.[2]

A multidisciplinary strategy is necessary to address the information gaps regarding its etiology, method of transmission, diagnosis, and therapy. Diagnostic tools, including RT-PCR and serological tests, should be developed based on animal research to get further information on the interaction between OROV and maternal-fetal tissues as it was taken with the Zika Virus.[3]

Currently, Centers of Disease Control and Prevention (CDC) suggest that people with positive history of travel in these areas and abovementioned symptoms are defined as “Suspect Case” of OROV. Testing should be conducted using CLIA-validated real-time RT-PCR to identify viral RNA and/or plaque-reduction neutralization test (PRNT) to detect neutralizing antibodies in blood and/or cerebrospinal fluid specimens. The CDC is encouraging for voluntary reporting to ArboNET, the national arboviral surveillance system, to keep a watch on outbreak of OROV.[4]

Integrated vector control measures such as use of insecticides and mosquito repellents, wearing full length cloths, and increasing awareness about OROV can help us preventing an outbreak.

OROV has endangered about 5 million individuals in America, rendering it one of the most significant new diseases, particularly due to its correlation with adverse fetal outcomes, including stillbirth and congenital abnormalities.[5]

OROV is going to become a global public threat as currently, we do not have any treatment for it. Along with international travels and climate change, its spread is going to reach different continents. Considering this, there is an urgent need of developing new avenues of laboratory diagnosis and surveillance for further prevention and control of OROV disease.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.