Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/17780
Title: Zika virus infection in pregnant women in Rio de Janeiro
Authors: Brasil, Patricia
Pereira Jr., José P.
Moreira, M. E.
Nogueira, Rita M. Ribeiro
Damasceno, Luana
Wakimoto, Mayumi
Rabello, R. S.
Valderramos, Stephanie G.
Halai, U.-A.
Salles, T. S.
Zin, A. A.
Horovitz, D.
Daltro, P.
Boechat, M.
Gabaglia, Claudia Raja
Sequeira, Patrícia de Carvalho de
Pilotto, J. H.
Medialdea-Carrera, R.
Cunha, Denise Cotrim da
Carvalho, Liege M. Abreu de
Pone, M.
Siqueira, André Machado
Calvet, Guilherme A.
Baião, Ana E. Rodrigues
Neves, Elizabeth S.
Carvalho, Paulo R. Nassar de
Hasue, R. H.
Marschik, P. B.
Einspieler, C.
Janzen, Carla
Cherry, James D.
Filippis, Ana M. Bispo de
Nielsen-Saines, Karin
Affilliation: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
David Geffen UCLA School of Medicine, Los Angeles, EUA.
David Geffen UCLA School of Medicine, Los Angeles, EUA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
David Geffen UCLA School of Medicine, Los Angeles, EUA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Biomedical Research Institute of Southern California. Oceanside, California, EUA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP.
Karolinska Institutet, Stockholm.
Medical University of Graz, Graz, Austria.
David Geffen UCLA School of Medicine, Los Angeles, EUA.
David Geffen UCLA School of Medicine, Los Angeles, EUA.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
David Geffen UCLA School of Medicine, Los Angeles, EUA.
Abstract: BACKGROUND: Zika virus (ZIKV) has been linked to central nervous system malformations in fetuses. To characterize the spectrum of ZIKV disease in pregnant women and infants, we followed patients in Rio de Janeiro to describe clinical manifestations in mothers and repercussions of acute ZIKV infection in infants. METHODS: We enrolled pregnant women in whom a rash had developed within the previous 5 days and tested blood and urine specimens for ZIKV by reverse-transcriptase–polymerasechain-reaction assays. We followed women prospectively to obtain data on pregnancy and infant outcomes. RESULTS: A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P<0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P<0.001). Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly. Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester). CONCLUSIONS: Despite mild clinical symptoms in the mother, ZIKV infection during pregnancy is deleterious to the fetus and is associated with fetal death, fetal growth restriction, and a spectrum of central nervous system abnormalities. (Funded by Ministério da Saúde do Brasil and others.).
Keywords: Zika Virus
Microcephaly
ZIKV disease in pregnancy
Aedes aegypti
keywords: Vírus Zika
Microcefalia
Doença ZIKV na gravidez
Aedes aegypti
DeCS: Aedes
Microcefalia
Issue Date: 2016
Publisher: Massachusetts Medical Society
Citation: BRASIL, Pereira et al. Zika virus infection in pregnant women in Rio de Janeiro. The New England Journal of Medicine, Massachusetts, v. 375, n. 24, p. 2321-2334, December 15, 2016.
Description: Artigo liberado em acesso aberto como parte do acordo para tornar público todos os dados produzidos sobre o vírus zika - Compartilhamento de dados em emergências de saúde pública - http://www.wellcome.ac.uk/News/Media-office/Press-releases/2016/WTP060169.htm
Versão preliminar - handle https://www.arca.fiocruz.br/handle/icict/13063
ISSN: 0028-4793
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos
IFF - Artigos de Periódicos
INI - Artigos de Periódicos

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