Evaluation of Placental and Fetal Tissue Specimens for Zika Virus Infection - 50 States and District of Columbia, January-December, 2016.

Abstract

Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1), and detection of Zika virus RNA in clinical and tissue specimens can provide definitive laboratory evidence of recent Zika virus infection. Whereas duration of viremia is typically short, prolonged detection of Zika virus RNA in placental, fetal, and neonatal brain tissue has been reported and can provide key diagnostic information by confirming recent Zika virus infection (2). In accordance with recent guidance (3,4), CDC provides Zika virus testing of placental and fetal tissues in clinical situations where this information could add diagnostic value. This report describes the evaluation of formalin-fixed paraffin-embedded (FFPE) tissue specimens tested for Zika virus infection in 2016 and the contribution of this testing to the public health response. Among 546 live births with possible maternal Zika virus exposure, for which placental tissues were submitted by the 50 states and District of Columbia (DC), 60 (11%) were positive by Zika virus reverse transcription-polymerase chain reaction (RT-PCR). Among 81 pregnancy losses for which placental and/or fetal tissues were submitted, 18 (22%) were positive by Zika virus RT-PCR. Zika virus RT-PCR was positive on placental tissues from 38/363 (10%) live births with maternal serologic evidence of recent unspecified flavivirus infection and from 9/86 (10%) with negative maternal Zika virus immunoglobulin M (IgM) where possible maternal exposure occurred >12 weeks before serum collection. These results demonstrate that Zika virus RT-PCR testing of tissue specimens can provide a confirmed diagnosis of recent maternal Zika virus infection.

• Authors: Sarah Reagan-Steiner, Regina Simeone, Elizabeth Simon, Julu Bhatnagar, Titilope Oduyebo, Rebecca Free, Amy M Denison, Demi B Rabeneck, Sascha Ellington, Emily Petersen, Joy Gary, Gillian Hale, M Kelly Keating, Roosecelis B Martines, Atis Muehlenbachs, Jana Ritter, Ellen Lee, Alexander Davidson, Erin Conners, Sarah Scotland, Kayleigh Sandhu, Andrea Bingham, Elizabeth Kassens, Lou Smith, Kirsten St George, Nina Ahmad, Mary Tanner, Suzanne Beavers, Brooke Miers, Kelley VanMaldeghem, Sumaiya Khan, Ingrid Rabe, Carolyn Gould, Dana Meaney-Delman, Margaret A Honein, Wun-Ju Shieh, Denise J Jamieson, Marc Fischer, Sherif R Zaki, U.S. Zika Pregnancy Registry Collaboration, Zika Virus Response Epidemiology and Surveillance Task Force Pathology Team
• Journal: MMWR. Morbidity and mortality weekly report (MMWR Morb Mortal Wkly Rep) Vol. 66 Issue 24 Pg. 636-643 (Jun 23 2017) ISSN: 1545-861X [Electronic] United States
• PMID: 28640798 (Publication Type: Journal Article)

Topics

• District of Columbia
• Female
• Fetus (virology)
• Humans
• Placenta (virology)
• Pregnancy
• Pregnancy Complications, Infectious (diagnosis)
• Real-Time Polymerase Chain Reaction
• United States
• Zika Virus (isolation & purification)
• Zika Virus Infection (diagnosis)