Zika virus epidemic in Brazil. II. post-mortem analyses of neonates with microcephaly, stillbirths, and miscarriage

Raimunda S.S. Azevedo, Marialva T. Araujo, Consuelo S. Oliveira, Arnaldo Jorge Martins Filho, Bruno T.D. Nunes, Daniele F. Henriques, Eliana V.P. Silva, Valéria L. Carvalho, Jannifer O. Chiang, Lívia C. Martins, Barbara C.B. Vasconcelos, Jorge R. Sousa, Fernanda Montenegro C. Araujo, Erlane M. Ribeiro, Andrezza R.P. Castro, Maria G.L. de Queiroz, Mariana P. Verotti, Márcio R.T. Nunes, Ana C.R. Cruz, Sueli G. RodriguesPei Yong Shi, Juarez A.S. Quaresma, Robert Tesh, Pedro F.C. Vasconcelos

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number96
JournalJournal of Clinical Medicine
Volume7
Issue number12
DOIs
StatePublished - Dec 1 2018

Keywords

  • Congenital syndrome
  • Microcephaly
  • Zika virus
  • ZIKV antigen
  • ZIKV RNA

ASJC Scopus subject areas

  • Medicine(all)

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