Oropouche virus infection: clinical spectrum, geographic expansion, and emerging maternal-fetal implications

Oropouche virus (OROV), an emerging arbovirus of the genus Orthobunyavirus, has become a growing public health concern following its recent expansion across the Americas and its potential to cause severe clinical outcomes in maternal and child health. Although Oropouche fever has classically been described as an acute self-limited febrile illness, accumulating evidence indicates that OROV is associated with meningitis and fatal infection, as well as evidence of vertical transmission associated with adverse fetal outcomes, including microcephaly and other congenital abnormalities, spontaneous abortion, stillbirth, and neuropathological alterations resembling those observed in congenital Zika syndrome. The OROV presents two transmission cycles, namely sylvatic and urban, with Culicoides paraensis as its main vector. The absence of specific vaccines or treatments, together with the wide distribution of competent vectors and the possibility of sexual transmission, underscores the urgent need to strengthen epidemiological surveillance, elucidate the mechanisms of fetal pathogenesis, and develop effective prevention and control strategies to protect vulnerable populations.