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. 2020 Feb;26(1):70-76.
doi: 10.1007/s13365-019-00797-0. Epub 2019 Sep 9.

Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

Danila Vedovello  1 , Steven S Witkin  2   3 , Andrea Cristina Botelho Silva  4 , Thamirys Cosmo Gillo Fajardo  4 , Alexandra Siqueira Mello  4 , Ana Paula Antunes Pascalicchio Bertozzi  4   2 , Alify Bertoldo da Silva  2 , Nemésio Florence Vieira Filho  2 , Maria Manoela Duarte Rodrigues  2 , Rosa Estela Gazeta  2 , Antônio Fernandes Moron  5 , Stéphanno Gomes Pereira Sarmento  6 , Antonio Soriano-Arandes  7 , Saulo Duarte Passos  4   2
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Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

Danila Vedovello et al. J Neurovirol. 2020 Feb.

Abstract

Paired maternal and newborn urine and amniotic fluid from 138 subjects collected during a Zika virus (ZIKV) outbreak was analyzed for ZIKV by gene amplification (RT-qPCR), and the findings were correlated with clinical symptoms and neurological anomalies in the babies. ZIKV was detected in 1 of 9 symptomatic women (11.1%) and in 19 of 129 asymptomatic women (14.7%). Neurological manifestations were present in 19 babies (13.7%), 10 of 20 (50%) positive and 9 of 119 (7.6%) negative (p < 0.001) for ZIKV. Twelve (8.6%) urines collected during gestation were ZIKV-positive; only 2 remained positive for ZIKV postpartum. Six (4.1%) newborn urines collected within 1 day of delivery were ZIKV-positive cases. In 3 of these cases, ZIKV was detected in mother's urine pre- and postpartum and in both mother's urine and babies' urine. Four of the amniotic fluid samples (2.9%) were ZIKV-positive. Among ZIKV-negative babies with neurological sequel, 87.5% were female; in contrast, 72.7% ZIKV-positive babies with neurological abnormalities were male (p = 0.019). We conclude that during a ZIKV outbreak, clinical symptoms and ZIKV detection in biological fluids are poor predictors of infection and adverse neurologic sequel in newborns.

Keywords: Amniotic fluid; Neurological symptoms; Pregnancy; Urine; Zika virus.

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