Volume 23, Number 3—March 2017
Research
Zika Virus RNA Replication and Persistence in Brain and Placental Tissue
, Demi B. Rabeneck, Roosecelis B. Martines, Sarah Reagan-Steiner, Yokabed Ermias, Lindsey B.C. Estetter, Tadaki Suzuki, Jana M. Ritter, M. Kelly Keating, Gillian Hale, Joy Gary, Atis Muehlenbachs, Amy J. Lambert, Robert Lanciotti, Titilope Oduyebo, Dana Meaney-Delman, Fernando Bolaños, Edgar Alberto Parra Saad, Wun-Ju Shieh, and Sherif Zaki
Table 2
Symptom onset trimester, pregnancy outcomes and Zika virus tissue RT-PCR results of 52 case-patients*
| Pregnancy or infant outcome | No. (%) case-patients, n = 52 | Trimester of maternal symptom onset |
Zika virus–positive case-patients, by tissue RT-PCR, no. (%), n = 32 | |
|---|---|---|---|---|
| First, no. (%), n = 27 | Second or third, no. (%), n = 24 | |||
| Spontaneous abortion | 11 (21) | 11 (41) | NA | 9 (82) |
| Elective termination | 3 (6) | 3 (11) | NA | 3 (100) |
| Intrauterine fetal demise† | 3 (6) | 1 (4) | 2 (8) | 0 |
| Infant with microcephaly (fatal outcome)‡ | 8 (15) | 8 (29) | NA | 8 (100) |
| Infant with microcephaly (nonfatal outcome)§ | 5 (10) | 3 (11) | 1 (4) | 4 (80) |
| Apparently healthy infant | 22 (42) | 1 (4) | 21 (88) | 8 (36) |
*Of 32 case-patients with positive Zika virus tissue RT-PCR results, maternal serology (IgM and plaque-reduction neutralization test) results were consistent with recent flavivirus infection (9 case-patients) and consistent with recent Zika virus infection (4 case-patients). Zika virus infection was confirmed for 5 patients by RT-PCR at a state laboratory. For the remaining 14 case-patients, no maternal testing was performed. Of 20 case-patients with negative Zika virus tissue RT-PCR results, maternal serology (IgM and plaque-reduction neutralization test) results were consistent with recent flavivirus infection for 12 case-patients (11 who had live-born, apparently healthy, infants, and 1 who had intrauterine fetal demise). For 2 case-patients, maternal serology results were negative for Zika virus IgM, and for 6 case-patients, no maternal serologic testing was performed. Zika virus infection was confirmed for 1 case-patient by RT-PCR at a state laboratory. NA, not available; RT-PCR, reverse transcription PCR.
†Including 1 with microcephaly.
‡Died postnatally.
§Information about timing of symptom onset was unavailable for 1 case-patient with Zika virus–positive tissue RT-PCR results. Nonfatal, according to the information received from the case submitters as of the date of testing.