RESUMO
OBJECTIVE: To identify newborns with congenital Zika infection (CZI) at a maternity hospital in Salvador, Brazil, during the 2016 microcephaly outbreak. METHODS: A prospective study enrolled microcephalic and normocephalic newborns with suspected CZI between January and December 2016. Serology (immunoglobulins IgM and IgG) and quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) for the Zika virus were performed. Demographic and clinical characteristics of newborns with and without microcephaly were compared. RESULTS: Of the 151 newborns enrolled, 32 (21.2%) were classified as microcephalic. The majority of these cases were born between January and May 2016. IgM and IgG Zika virus antibodies were detected in 5 (23.8%) and 17 (80.9%) microcephalic newborn blood samples, respectively. Six (24%) microcephalic newborns tested positive for Zika virus by RT-qPCR in urine or placenta samples. Thirteen (11.8%) normocephalic newborns also tested positive for Zika virus by PCR in urine, plasma, or placenta samples, while IgM antibodies against Zika were detected in 4 (4.2%) others. CONCLUSIONS: Identification of 17 normocephalic CZI cases, confirmed by IgM serology or RT-qPCR for Zika virus, provides evidence that CZI can present asymptomatically at birth. This finding highlights the need for prenatal and neonatal screening for Zika virus in endemic regions.
Assuntos
Microcefalia/epidemiologia , Complicações Infecciosas na Gravidez/etiologia , Infecção por Zika virus/etiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Surtos de Doenças , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Doenças do Recém-Nascido/epidemiologia , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Masculino , Microcefalia/sangue , Microcefalia/virologia , Triagem Neonatal/métodos , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Prospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Zika virus/isolamento & purificação , Infecção por Zika virus/sangue , Infecção por Zika virus/epidemiologiaRESUMO
Epidemias concomitantes de Dengue, Chikungunya e Zika vem ocorrendo no Brasil. Em maio de 2015 os primeiros casos de infecção por vírus Zika (ZIKV) foram confirmados no Brasil e após seis meses um surto de recém-nascidos com microcefalia foi notificado no Nordeste, sendo confirmada a associação com a infecção por ZIKV em gestantes e infecção congênita.