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Volume 23, Number 3—March 2017

Research

Zika Virus RNA Replication and Persistence in Brain and Placental Tissue

Julu BhatnagarComments to Author , 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 R. Zaki
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J. Bhatnagar, D.B. Rabeneck, R.B. Martines, S. Reagan-Steiner, Y. Ermias, L.B.C. Estetter, T. Suzuki, J. Ritter, M.K. Keating, G. Hale, J. Gary, A. Muehlenbachs, T. Oduyebo, D. Meaney-Delman, W. Shieh, S.R. Zaki); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (A. Lambert, R. Lanciotti); Patología Hospital Universitario de Neiva, Neiva, Colombia (F. Bolaños); Instituto Nacional de Salud, Bogota, Colombia (E.A. Parra Saad)

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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.

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