TY - JOUR
T1 - Zika virus epidemic in Brazil. II. post-mortem analyses of neonates with microcephaly, stillbirths, and miscarriage
AU - Azevedo, Raimunda S.S.
AU - Araujo, Marialva T.
AU - Oliveira, Consuelo S.
AU - Filho, Arnaldo Jorge Martins
AU - Nunes, Bruno T.D.
AU - Henriques, Daniele F.
AU - Silva, Eliana V.P.
AU - Carvalho, Valéria L.
AU - Chiang, Jannifer O.
AU - Martins, Lívia C.
AU - Vasconcelos, Barbara C.B.
AU - Sousa, Jorge R.
AU - Araujo, Fernanda Montenegro C.
AU - Ribeiro, Erlane M.
AU - Castro, Andrezza R.P.
AU - de Queiroz, Maria G.L.
AU - Verotti, Mariana P.
AU - Nunes, Márcio R.T.
AU - Cruz, Ana C.R.
AU - Rodrigues, Sueli G.
AU - Shi, Pei Yong
AU - Quaresma, Juarez A.S.
AU - Tesh, Robert B.
AU - Vasconcelos, Pedro F.C.
N1 - Publisher Copyright:
© 2018 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Introduction: The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barré syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection. Methods: Twelve fatal cases of neonates, whose mothers were infected with ZIKV during pregnancy, were examined; cases included nine neonatal deaths due to microcephaly, one miscarriage, and two stillbirths. Tissue samples were obtained from all cases at necropsy and were submitted for virological investigation (RT-qPCR and virus isolation) and/or histopathology (hematoxylin and eosin staining) and immunohistochemical assay for the detection of ZIKV antigens. Results: ZIKV antigens and/or ZIKV RNA were detected in tissue samples of all 12 cases examined. ZIKV was recovered in one case. Results of the virological and immunohistochemical analyses, as well as the anatomic abnormalities and histopathologic changes observed at necropsy on the 12 fatal cases, are presented. Conclusions: Data from these 12 cases provide strong evidence of the causal relationship between ZIKV and congenital disease in fetuses of women who were infected with the virus during pregnancy.
AB - Introduction: The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barré syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection. Methods: Twelve fatal cases of neonates, whose mothers were infected with ZIKV during pregnancy, were examined; cases included nine neonatal deaths due to microcephaly, one miscarriage, and two stillbirths. Tissue samples were obtained from all cases at necropsy and were submitted for virological investigation (RT-qPCR and virus isolation) and/or histopathology (hematoxylin and eosin staining) and immunohistochemical assay for the detection of ZIKV antigens. Results: ZIKV antigens and/or ZIKV RNA were detected in tissue samples of all 12 cases examined. ZIKV was recovered in one case. Results of the virological and immunohistochemical analyses, as well as the anatomic abnormalities and histopathologic changes observed at necropsy on the 12 fatal cases, are presented. Conclusions: Data from these 12 cases provide strong evidence of the causal relationship between ZIKV and congenital disease in fetuses of women who were infected with the virus during pregnancy.
KW - Congenital syndrome
KW - Microcephaly
KW - ZIKV RNA
KW - ZIKV antigen
KW - Zika virus
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U2 - 10.3390/jcm7120496
DO - 10.3390/jcm7120496
M3 - Article
AN - SCOPUS:85069907204
SN - 2077-0383
VL - 7
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 12
M1 - 96
ER -