Zika Virus epidemic in Brazil. II. Post-mortem analyses of neonates with microcephaly, stillbirths, and miscarriage
The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barr? syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection. Methods: Twelve...
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The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barr? 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. |