Zika virus vertical transmission in children with confirmed antenatal exposure

Patrícia Brasil,Stephanie L Gaw,James D Cherry,Tara Kerin,Zilton Farias Meira De Vasconcelos ,Letícia Da Cunha Guida ,Maria Elisabeth Lopes Moreira ,Ieda Pereira Ribeiro ,Elizabeth B Brickley ,L M De Carvalho ,José Paulo Pereira ,Marcos Vinícius Da Silva Pone ,Sheila Moura Pone ,Andréa Zin ,Jae U Jung ,Michael S Rocha ,Saba R Aliyari ,Denise Cotrim Da Cunha ,Kristina Adachi,Suan-Sin Foo,Luana Damasceno,Genhong Cheng,Lulan Wang,Claudia Raja Gabaglia,Myrna C Bonaldo,Weiqiang Chen,Irena Tsui,Karin Nielsen‐Saines

doi:10.1038/s41467-020-17331-0

Abstract

We report Zika virus (ZIKV) vertical transmission in 130 infants born to PCR+ mothers at the time of the Rio de Janeiro epidemic of 2015–2016. Serum and urine collected from birth through the first year of life were tested by quantitative reverse transcriptase polymerase chain reaction (PCR) and/or IgM Zika MAC-ELISA. Four hundred and seven specimens are evaluated; 161 sera tested by PCR and IgM assays, 85 urines by PCR. Sixty-five percent of children (N = 84) are positive in at least one assay. Of 94 children tested within 3 months of age, 70% are positive. Positivity declines to 33% after 3 months. Five children are PCR+ beyond 200 days of life. Concordance between IgM and PCR results is 52%, sensitivity 65%, specificity 40% (positive PCR results as gold standard). IgM and serum PCR are 61% concordant; serum and urine PCR 55%. Most children (65%) are clinically normal. Equal numbers of children with abnormal findings (29 of 45, 64%) and normal findings (55 of 85, 65%) have positive results, p = 0.98. Earlier maternal trimester of infection is associated with positive results (p = 0.04) but not clinical disease (p = 0.98). ZIKV vertical transmission is frequent but laboratory confirmed infection is not necessarily associated with infant abnormalities.

Highlights

We report Zika virus (ZIKV) vertical transmission in 130 infants born to polymerase chain reaction (PCR)+ mothers at the time of the Rio de Janeiro epidemic of 2015–2016
We reported outcomes of their children in the first months and years of life, including physical findings, neurologic examinations, neuroimaging results, complete eye exams, hearing assessments, and neurodevelopmental outcomes[2,3,4,5,6,7]. All infants in this prospective Zika cohort were exposed in utero to maternal ZIKV infection, it is difficult to ascertain the true rate of ZIKV vertical transmission without infant laboratory results, as the majority of ZIKV-exposed children are not born with severe clinical features of congenital Zika syndrome[8]
The duration of ZIKV viremia and viruria in congenitally infected children is unknown, and it is unclear if infants infected very a Positive PCR tests in infants p = 0.87 b

Summary

Introduction

We report Zika virus (ZIKV) vertical transmission in 130 infants born to PCR+ mothers at the time of the Rio de Janeiro epidemic of 2015–2016. With the onset of the ZIKV epidemic, we established a longitudinal cohort of pregnant women who presented with a rash within the prior 5 days and were found to be ZIKV positive in blood or urine by quantitative reverse transcriptase polymerase chain reaction (QRT-PCR) at the time of presentation[2]. We followed these women throughout pregnancy to delivery and reported on pregnancy outcomes[2]. We analyzed whether positive infant results for ZIKV were associated with abnormal pediatric outcomes

Methods

Results

Conclusion