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

2017; Centers for Disease Control and Prevention; Volume: 66; Issue: 24 Linguagem: Inglês

10.15585/mmwr.mm6624a3

1545-861X

Sarah Reagan-Steiner, Regina M. Simeone, Elizabeth L. Simon, Julu Bhatnagar, Titilope Oduyebo, Rebecca J. Free, Amy M. Denison, D. Brett Rabeneck, Sascha Ellington, Emily E. Petersen, Joy Gary, Gillian Hale, M. Kelly Keating, Roosecelis B. Martines, Atis Muehlenbachs, Jana M. Ritter, Ellen Lee, Alexander Davidson, Erin E. Conners, Sarah Scotland, Kayleigh Sandhu, Andrea Bingham, Elizabeth Kassens, Lou C. Smith, Kirsten St. George, Nina Ahmad, Mary R. Tanner, Suzanne F. Beavers, Brooke Miers, Kelley VanMaldeghem, Sumaiya Khan, Ingrid B. Rabe, Carolyn Gould, Dana Meaney‐Delman, Margaret A. Honein, Wun‐Ju Shieh, Denise J. Jamieson, Marc Fischer, Sherif R. Zaki, Melissa Kretschmer, Kara Tarter, Hayley D. Yaglom, Shoruq Alhajmohammad, Dildeep Chhabra, Wendy Jilek, Meghana Madala, Sharon Messenger, Charsey Cole Porse, María Salas, Diana Singh, Sarah Skallet, Similoluwa Sowunmi, Natalie S. Marzec, K. Justin Davis, Andrea Morrison, M. Zachariah Fraser, Colleen Ann O'Connor, Wendy M. Chung, Folasuyi Richardson, Meredith E. Stocks, Amanda Marie Bundek, Jennifer L. Zambri, A. Mark Allen, Marie Ketty Etienne, Jennifer Jackson, Vanessa Landis, Teresa C. Logue, Nicole Muse, Juliana Prieto, Mercedes Rojas, Amanda Feldpausch, Teri Graham, Sylvia Mann, Sarah Y. Park, Debbie Freeman, Emily Potts, Taryn Stevens, Sean Simonson, Julius Tonzel, Shari Davis, Sara Robinson, Judie Hyun, Erin Jenkins, Catherine Brown, Susan Soliva, Elizabeth Schiffman, Paul Byers, Sheryl Hand, Christine L. Mulgrew, Jeff Hamik, Samir Koirala, Elizabeth Ludwig, Carolyn Fredette, Abigail Mathewson, Kristin Garafalo, K. J. Worthington, Abubakar Ropri, Danielle Bloch, Sandhya Clark, Hannah Cooper, Annie D. Fine, Gili Hrusa, Martha Iwamoto, Hannah Kubinson, Christopher T. Lee, Sally Slavinski, Eliza Wilson, Ann Winters, David Yi Yang, Julius N. Ade, Zahra S. Alaali, Kimberly J. Alvarez, P. Bryon Backenson, Debra Blog, Amy B. Dean, Elizabeth Dufort, Andrea Marias Furuya, Meghan Fuschino, Rene Hull, Matthew Kleabonas, Karen E. Kulas, Philip Kurpiel, Lou Ann Lance, Emaly Leak, Ronald J. Limberger, Stephanie Ostrowski, MaryJo Polfleit, Amy McConkey Robbins, Jemma V. Rowlands, Inderbir Sohi, Jamie N. Sommer, Jennifer L. White, Dorothy J. Wiley, Li Zeng, Ronna L. Chan, Jennifer MacFarquhar, Laura Cronquist, Leah Lind, Kumar Nalluswami, Dana Perella, Diane Brady, Michael Gosciminski, Patricia McAuley, Bridget Teevan, Daniel Drociuk, Vinita Leedom, Brian Witrick, Jan Bollock, Lon Kightlinger, Marie Bottomley Hartel, Loraine Swanson Lucinski, Morgan McDonald, Angela M. Miller, Tori Armand Ponson, Laura Price, Kelly Broussard, Amy Nance, Dallin Peterson, Brennan Martin, Shea Elizabeth Browne, LaToya A. Griffin-Thomas, Jennifer Macdonald, Jillian Neary, Hanna N. Oltean, Alys Adamski, Madelyn A. Baez-Santiago, Brigid C. Bollweg, Janet D. Cragan, Yokabed Ermias, Lindsey Estetter, Shannon Fleck‐Derderian, Cynthia S. Goldsmith, Matthew R. Groenewold, Heather Hayes, Irogue Igbinosa, Tiffany Gayle Jenkinson, Abbey M. Jones, Amanda Lewis, Cynthia A. Moore, Kimberly Newsome, Vaunita Parihar, Mitesh Patel, Anna Paulino, Sonja A. Rasmussen, Meghan Raycraft, Megan R. Reynolds, Dominique Rollin, Jeanine H. Sanders, Carrie K. Shapiro‐Mendoza, Luciana Silva‐Flannery, Pamela Spivey, Alphonse K. Tshiwala, Tonya Williams, William A. Bower, Elizabeth Davlantes, Terra R. Forward, Rena Fukunaga, Jonas Z. Hines, Shaohua Sean Hu, Jessica Leung, Lillianne Lewis, Stacey W. Martin, Lucy A. McNamara, John D. Omura, Candice L. Robinson, Kristine M Schmit, Julie L. Self, Minesh Shah, Anne Straily, Elizabeth A. Van Dyne, Milan Vu, Charnetta Williams,

Viral Infections and Vectors

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.