Evaluation of Placental and Fetal Tissue Specimens for Zika Virus Infection — 50 States and District of Columbia, January–December, 2016
Authors: Sarah Reagan-Steiner, Regina Simeone, Elizabeth Simon, Julu Bhatnagar, Titilope Oduyebo, Rebecca Free, Amy M. Denison, Demi B. Rabeneck, Sascha Ellington, Emily Petersen, Joy Gary, Gillian Hale, M. Kelly Keating, Roosecelis B. Martines, Atis Muehlenbachs, Jana Ritter, Ellen Lee, Alexander Davidson, Erin Conners, Sarah Scotland, Kayleigh Sandhu, Andrea Bingham, Elizabeth Kassens, Lou Smith, Kirsten St. George, Nina Ahmad, Mary Tanner, Suzanne Beavers, Brooke Miers, Kelley VanMaldeghem, Sumaiya Khan, Ingrid Rabe, Carolyn Gould, Dana Meaney-Delman, Margaret A. Honein, Wun-Ju Shieh, Denise J. Jamieson, Marc Fischer, Sherif R. Zaki, Melissa Kretschmer, Kara Tarter, Hayley Yaglom, Shoruq Alhajmohammad, Dildeep Chhabra, Wendy Jilek, Meghana Madala, Sharon Messenger, Charsey Cole Porse, Maria Salas, Diana Singh, Sarah Skallet, Similoluwa Sowunmi, Natalie S. Marzec, Karin Davis, Brenda Esponda-Morrison, M. Zachariah Fraser, Colleen Ann O'Connor, Wendy M. Chung, Folasuyi Richardson, Meredith E. Stocks, Amanda Marie Bundek, Jennifer L. Zambri, Ashley Allen, Marie Ketty Etienne, Jennifer Jackson, Vanessa Landis, Teresa Logue, Nicole Muse, Juliana Prieto, Mercedes Rojas, Amanda Feldpausch, Teri Graham, Sylvia Mann, Sarah Y. Park, Debbie Freeman, Emily J. Potts, Taryn Stevens, Sean Simonson, Julius L. Tonzel, Shari Davis, Sara Robinson, Judie K. Hyun, Erin Maureen Jenkins, Catherine Brown, Susan Soliva, Elizabeth Schiffman, Paul Byers, Sheryl Hand, Christine L. Mulgrew, Jeff Hamik, Samir Koirala, Elizabeth Ludwig, Carolyn R. Fredette, Abigail A. Mathewson, Kristin Garafalo, Karen Worthington, Abubakar Ropri, Danielle Bloch, Sandhya Clark, Hannah Cooper, Annie D. Fine, Gili Hrusa, Martha Iwamoto, Hannah Kubinson, Christopher T. Lee, Sally Slavinski, Eliza Wilson, Ann Winters, David Yi Yang, Julius N. Ade, Zahra Alaali, Kimberly Alvarez, P. Bryon Backenson, Debra Blog, Amy Dean, Elizabeth Dufort, Andrea Marias Furuya, Meghan Fuschino, Rene Hull, Matthew Kleabonas, Karen Kulas, Philip Kurpiel, Lou Ann Lance, Emaly Leak, Ronald J. Limberger, Stephanie Ostrowski, MaryJo Polfleit, Amy Robbins, Jemma V. Rowlands, Inderbir Sohi, Jamie N. Sommer, Jennifer White, Dorothy Wiley, Li Zeng, Ronna L. Chan, Jennifer MacFarquhar, Laura Cronquist, Leah Lind, Kumar Nalluswami, Dana Perella, Diane S. Brady, Michael Gosciminski, Patricia McAuley, Bridget E. Teevan, Daniel Drociuk, Vinita Leedom, Brian Witrick, Jan Bollock, Lon Kightlinger, Marie Bottomley Hartel, Loraine Swanson Lucinski, Morgan McDonald, Angela M. Miller, Tori Armand Ponson, Laura Price, Kelly Broussard, Amy E. Nance, Dallin Peterson, Brennan Martin, Shea Browne, LaToya A. Griffin-Thomas, Jennifer O. Macdonald, Jillian Neary, Hanna Oltean, Alys Adamski, Madelyn Baez-Santiago, Brigid C. Bollweg, Janet D. Cragan, Yokabed Ermias, Lindsey B. C. Estetter, Shannon Fleck-Derderian, Cynthia S. Goldsmith, Matthew R. Groenewold, Heather Hayes, Irogue Igbinosa, Tiffany Gayle Jenkinson, Abbey M. Jones, Amanda Lewis, Cynthia A. Moore, Kimberly B. Newsome, Vaunita Parihar, Mitesh M. Patel, Anna Paulino, Sonja A. Rasmussen, Meghan Raycraft, Megan R Reynolds, Dominique C. Rollin, Jeanine H. Sanders, Carrie Shapiro-Mendoza, Luciana Silva-Flannery, Pamela Spivey, Alphonse K. Tshiwala, Tonya R. Williams, William A. Bower, Elizabeth Davlantes, Terra R. Forward, Rena Fukunaga, Jonas Hines, Shaohua Sean Hu, Jessica Leung, Lillianne Lewis, Stacey Martin, Lucy McNamara, John D. Omura, Candice L. Robinson, Kristine Schmit, Julie L. Self, Minesh Shah, Anne Straily, Elizabeth A. Van Dyne, Milan Vu, Charnetta Williams
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1), and detection of Zika virus RNA in clinical and tissue specimens can provide definitive laboratory evidence of recent Zika virus infection. Whereas duration of viremia is typically short, prolonged detection of Zika virus RNA in placental, fetal, and neonatal brain tissue has been reported and can provide key diagnostic information by confirming recent Zika virus infection (2). In accordance with recent guidance (3,4), CDC provides Zika virus testing of placental and fetal tissues in clinical situations where this information could add diagnostic value. This report describes the evaluation of formalin-fixed paraffin-embedded (FFPE) tissue specimens tested for Zika virus infection in 2016 and the contribution of this testing to the public health response. Among 546 live births with possible maternal Zika virus exposure, for which placental tissues were submitted by the 50 states and District of Columbia (DC), 60 (11%) were positive by Zika virus reverse transcription-polymerase chain reaction (RT-PCR). Among 81 pregnancy losses for which placental and/or fetal tissues were submitted, 18 (22%) were positive by Zika virus RT-PCR. Zika virus RT-PCR was positive on placental tissues from 38/363 (10%) live births with maternal serologic evidence of recent unspecified flavivirus infection and from 9/86 (10%) with negative maternal Zika virus immunoglobulin M (IgM) where possible maternal exposure occurred >12 weeks before serum collection. These results demonstrate that Zika virus RT-PCR testing of tissue specimens can provide a confirmed diagnosis of recent maternal Zika virus infection.