Hi Marie

Any thoughts on this latest Lancet Correspondence that reports the presence of infective Zika virus particles in breastmilk with substantial viral loads?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00624-3/fulltext?elsca1=etoc&elsca2=email&elsca3=0140-6736_20160312_387_10023_&elsca4=Public%20Health%7CInfectious%20Diseases%7CHealth%20Policy%7CInternal%2FFamily%20Medicine%7CGeneral%20Surgery%7CLancet

Dear Isabelle, Apologies for the delay. I am participating in a WHO technical consultation on this subject yesterday and today - I'll consult with the WHO team and get back to you asap once the meeting is finished. This is one of the evidence papers under review. Best regards, Marie

Dear Isabelle,
Note there is a lack of documented evidence regarding transmission of ZVD via breastfeeding or breastmilk, and the clinical consequences of any such transmission, and whether there is a protective element to breastfeeding in this context. Note also that the main mode of transmission of ZVD is via mosquito bite.

This Lancet note describes just one case. In general terms, infants of mothers with a Zika virus infection may be infected with Zika in utero, perinatally, by mosquito bite, via breastmilk. Whereas in this case Zika virus was present in the mother’s breastmilk, the article says that the serum of the neonate was “ambiguous”. Follow up with the author regarding this ambiguity explained further that one of the targets in the PCR test (the most sensitive) was positive and the other target was negative. This should be interpreted as negative (personal communication). Also note that the infant was clinically fine and showed no signs of infection.

Thank you!