Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil

Nogueira, Maurício Lacerda; Júnior, N. R.R. Nery; Estofolete, Cássia Fernanda; Terzian, Ana Carolina Bernardes; Guimarães, Georgia; Zini, Nathalia; Silva, R. Alves da; Silva, G. C. Dutra; Franco, L. C. Junqueira; Rahal, Paula; Bittar, Cíntia; Carneiro, Bruno Moreira; Vasconcelos, Pedro F. C.; Henriques, Daniele Freitas; Barbosa, Deusenia Machado Ulisses; Rombola, Patrícia Lopes; Grande, L. de; Reis, Andréia Francesli Negri; Palomares, S. A.; Catelan, M. Wakai; Cruz, Lilian Elisa Arão Antônio; Necchi, S. H.; Mendonça, R.; Santos, Izalco Nuremberg Penha dos; Caron, Samuel; Costa, Federico; Bozza, Fernando A.; Souza, Antônio Soares; Mattos, Cinara Cássia Brandão de; Mattos, L. C. de; Vasilakis, Nikos; Oliani, António Hélio; Oliani, Denise Cristina Mós Vaz; Ko, Albert Icksang

doi:10.1016/j.cmi.2017.11.004

Cited by 71 publications

(80 citation statements)

References 22 publications

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“…ZIKV-positive urine is a transient occurrence (Zhang et al 2016) and may have been no longer present in some of the positive cases. Our findings complement previous investigations highlighting the variable consequences for newborns of having a mother who is ZIKV-positive (Wheeler et al 2018) as well as the occurrence of adverse neurological consequences in babies whose mothers did not have detectable ZIKV during their gestation (Nogueira et al 2018). The rates of detection of ZIKV in maternal or neonatal urine in our study population is consistent with what has been reported previously (Gourinat et al 2015) and is most likely a consequence of the transient nature of ZIKV infection at this site (Zhang et al 2016).…”

Section: Discussionsupporting

confidence: 91%

Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

et al. 2019

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Paired maternal and newborn urine and amniotic fluid from 138 subjects collected during a Zika virus (ZIKV) outbreak was analyzed for ZIKV by gene amplification (RT-qPCR), and the findings were correlated with clinical symptoms and neurological anomalies in the babies. ZIKV was detected in 1 of 9 symptomatic women (11.1%) and in 19 of 129 asymptomatic women (14.7%). Neurological manifestations were present in 19 babies (13.7%), 10 of 20 (50%) positive and 9 of 119 (7.6%) negative (p < 0.001) for ZIKV. Twelve (8.6%) urines collected during gestation were ZIKV-positive; only 2 remained positive for ZIKV postpartum. Six (4.1%) newborn urines collected within 1 day of delivery were ZIKV-positive cases. In 3 of these cases, ZIKV was detected in mother's urine pre-and postpartum and in both mother's urine and babies' urine. Four of the amniotic fluid samples (2.9%) were ZIKV-positive. Among ZIKV-negative babies with neurological sequel, 87.5% were female; in contrast, 72.7% ZIKV-positive babies with neurological abnormalities were male (p = 0.019). We conclude that during a ZIKVoutbreak, clinical symptoms and ZIKV detection in biological fluids are poor predictors of infection and adverse neurologic sequel in newborns.

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Section: Discussionsupporting

confidence: 91%

Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

et al. 2019

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“…Reports 3,11,12 regarding the prevalence of microcephaly and adverse birth outcomes found that these ranged from 3-4% in Rio de Janeiro and 5-42% in the USA. A 2017 study 13 in São Paulo, Brazil, found adverse outcomes in 15 (28%) of 54 infants (95% CI 17-41) of pregnant women infected with Zika virus, but these outcomes appeared to be substantially milder than those observed in the Rio de Janeiro study, 3 causing speculation of possible variation in risk across regions. However, case-control, prospective cohort, and enhanced surveillance investigations have not yet yielded insights on why a small fraction of fetuses of infected mothers develop microcephaly and severe sequelae.…”

Section: Zika Virus and Microcephaly: Where Do We Go From Here?mentioning

confidence: 94%

Zika virus and microcephaly: where do we go from here?

Costa

2018

The Lancet Infectious Diseases

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“…Similarly, for infections with WNV, which is estimated to have infected 7 million people in the USA [11,12], the predominate infection outcome is asymptomatic with CDC reporting infection of >46,000 people and more than 2,000 fatalities [12][13][14][15][16][17][18]. The closely related Zika virus, first identified in Uganda in 1947 [19], has recently expanded to South America leading to widespread infection including Guillain-Barré syndrome and more than 6,700 cases of microcephaly and neurological abnormalities in newborns [20][21][22][23][24][25]. As for the other flaviviruses, the majority of infected individuals are asymptomatic or develop mild disease, however Zika virus has been shown to infect fetal brains and neurons and lead to cell death and microcephaly [26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Single cell immune profiling of dengue virus patients reveals intact immune responses to Zika virus with enrichment of innate immune signatures

et al. 2020

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The genus Flavivirus contains many mosquito-borne human pathogens of global epidemiological importance such as dengue virus, West Nile virus, and Zika virus, which has recently emerged at epidemic levels. Infections with these viruses result in divergent clinical outcomes ranging from asymptomatic to fatal. Myriad factors influence infection severity including exposure, immune status and pathogen/host genetics. Furthermore, pre-existing infection may skew immune pathways or divert immune resources. We profiled immune cells from dengue virus-infected individuals by multiparameter mass cytometry (CyTOF) to define functional status. Elevations in IFNβ were noted in acute patients across the majority of cell types and were statistically elevated in 31 of 36 cell subsets. We quantified response to in vitro (re)infection with dengue or Zika viruses and detected a striking pattern of upregulation of responses to Zika infection by innate cell types which was not noted in response to dengue virus. Significance was discovered by statistical analysis as well as a neural network-based clustering approach which identified unusual cell subsets overlooked by conventional manual gating. Of public health importance, patient cells showed significant enrichment of innate cell responses to Zika virus indicating an intact and robust anti-Zika response despite the concurrent dengue infection.

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Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil

Cited by 71 publications

References 22 publications

Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

Zika virus and microcephaly: where do we go from here?

Single cell immune profiling of dengue virus patients reveals intact immune responses to Zika virus with enrichment of innate immune signatures

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