巴西寨卡病毒疫情。二、小头畸形、死产和流产新生儿的尸检分析
Zika Virus Epidemic in Brazil. II. Post-Mortem Analyses of Neonates with Microcephaly, Stillbirths, and Miscarriage.
作者信息
Azevedo Raimunda S S, Araujo Marialva T, Oliveira Consuelo S, Filho Arnaldo Jorge Martins, Nunes Bruno T D, Henriques Daniele F, Silva Eliana V P, Carvalho Valéria L, Chiang Jannifer O, Martins Lívia C, Vasconcelos Barbara C B, Sousa Jorge R, Araujo Fernanda Montenegro C, Ribeiro Erlane M, Castro Andrezza R P, de Queiroz Maria G L, Verotti Mariana P, Nunes Márcio R T, Cruz Ana C R, Rodrigues Sueli G, Shi Pei-Yong, Quaresma Juarez A S, Tesh Robert B, Vasconcelos Pedro F C
机构信息
Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, RodoviaBR-316, km-07, Ananindeua67030-000, Pará, Brazil.
Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará,Travessa Perebebuí, 2623, Belém66087-670, Pará, Brazil.
出版信息
J Clin Med. 2018 Nov 28;7(12):496. doi: 10.3390/jcm7120496.
INTRODUCTION
The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barré syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection.
METHODS
Twelve fatal cases of neonates, whose mothers were infected with ZIKV during pregnancy, were examined; cases included nine neonatal deaths due to microcephaly, one miscarriage, and two stillbirths. Tissue samples were obtained from all cases at necropsy and were submitted for virological investigation (RT-qPCR and virus isolation) and/or histopathology (hematoxylin and eosin staining) and immunohistochemical assay for the detection of ZIKV antigens.
RESULTS
ZIKV antigens and/or ZIKV RNA were detected in tissue samples of all 12 cases examined. ZIKV was recovered in one case. Results of the virological and immunohistochemical analyses, as well as the anatomic abnormalities and histopathologic changes observed at necropsy on the 12 fatal cases, are presented.
CONCLUSIONS
Data from these 12 cases provide strong evidence of the causal relationship between ZIKV and congenital disease in fetuses of women who were infected with the virus during pregnancy.
引言
近期巴西的寨卡病毒（ZIKV）疫情呈现出一系列不同的临床表现，尤其是小头畸形、吉兰-巴雷综合征和死亡。在此背景下，我们确定了致命小头畸形病例与ZIKV感染之间的因果关系。
方法
对12例母亲在孕期感染ZIKV的新生儿死亡病例进行了检查；病例包括9例因小头畸形导致的新生儿死亡、1例流产和2例死产。在尸检时从所有病例获取组织样本，并提交进行病毒学调查（逆转录定量聚合酶链反应和病毒分离）和/或组织病理学检查（苏木精和伊红染色）以及免疫组织化学检测以检测ZIKV抗原。
结果
在所有12例检查病例的组织样本中均检测到ZIKV抗原和/或ZIKV RNA。在1例中分离出ZIKV。本文展示了这12例致命病例的病毒学和免疫组织化学分析结果，以及尸检时观察到的解剖学异常和组织病理学变化。
结论
这12例病例的数据为孕期感染该病毒的女性胎儿中ZIKV与先天性疾病之间的因果关系提供了有力证据。
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