The Oropouche virus (OROV) is an emerging arbovirus grouped under Orthobunyavirus genus of Peribunyaviridae family, first identified in Trinidad and Tobago in 1955, and re-emerged as a serious public health concern in the Central and South Americas. Recently, numbers of OROV cases are on the rise with the 2024 outbreak documenting over 12,000 cases across endemic and newly affected regions, including first-time detections in Caribbean nations and imported cases in the United States, Canada, and Italy. The OROV has caused over 5,00,000 cases globally, with substantial underreporting owing to clinical similarities with Zika, chikungunya and dengue. The virus is mainly transmitted by midges viz. Culicoides paraensis (Goeldi), though alternative vectors such as Culex quinquefasciatus Say and Aedes serratus (Theobald) have also been identified. Clinical manifestations range from acute febrile illness with biphasic fever in approximately 60% of cases to severe complications including haemorrhagic symptoms along with neurological sequelae such as meningitis, encephalitis, and Guillain-Barre syndrome. The virus exhibits complex transmission cycles (urban and sylvatic) and reassortment-driven evolution. The evidence of vertical transmission has emerged, with documented cases of fetal microcephaly, stillbirths, and congenital malformations. Pathogenesis involves modulation of host innate immunity, particularly interferon responses. The virus demonstrates neuroinvasive potential through blood-brain barrier penetration and has been shown to persist in various tissues. Diagnostic challenges arise from non-specific clinical signs and limited access to specialized laboratory tests. At present, no specific treatment or vaccines against the OROV are available and management limited to supportive care. However, promising vaccine candidates such as live-attenuated, inactivated, and recombinant protein-based platforms are undergoing preclinical and clinical evaluation, offering hope for future preventive strategies against this neglected tropical disease.
Oropouche Virus, Epidemiology, Vertical Transmission, Neurological Complications, Diagnosis, Vaccines
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