Zika virus infection in pregnancy: Establishing a case definition for clinical research on  pregnant women with rash in an active transmission setting

by Ricardo Arraes de Alencar Ximenes, Dem ócrito de Barros Miranda-Filho, Elizabeth B. Brickley, Ulisses Ramos Montarroyos, Celina Maria Turchi Martelli, Thalia Velho Barreto de Araújo, Laura C. Rodrigues, Maria de Fatima Pessoa Militão de Albuquerque, Wayner Vieira de Souza, Priscila Mayrelle da Silva Castanha, Rafael F. O. França, Raf ael Dhália, Ernesto T. A. Marques, on behalf of the Microcephaly Epidemic Research Group (MERG) Defining cases of Zika virus (ZIKV) infection is a critical challenge for epidemiological research. Due to ZIKV’s overlapping clinical features and potential immunologic cross-reactivity with other flaviviruses and the current lack of an optimal ZIKV-specific diagnostic assay, varying approaches for identifying ZIKV infections have been employed to date. This paper presents the laboratory results and diagnostic criteria developed by the Microcephaly Epidemic Research Group for defining cases of maternal ZIKV infection in a cohort of pregnant women with rash (N = 694) recruited during the d eclining 2015–2017 epidemic in northeast Brazil. For this investigation, we tested maternal sera for ZIKV by quantitative reverse transcription polymerase chain reaction (qRT-PCR), Immunoglobulin (Ig) M and IgG3 enzyme-linked immunosorbent assays (ELISAs), and Plaque Reduction Neutralization Test (PRNT50). Overall, 23.8% of participants tested positive by qRT-PCR during pregnancy (range of detection: 0 –72 days after rash onset). However, the inter-ass...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research