Epidemiological and clinical suspicion of congenital Zika virus infection: Serological findings in mothers and children from Brazil

Giulietta Venturi, Claudia Fortuna, Rita Maria Alves, Ana Gabriela Passos do Prado Paschoal, Pedro José da Silva Júnior, Maria Elena Remoli, Eleonora Benedetti, Antonello Amendola, Everton da Silva Batista, Deijamile Virginia Novais Gama, Davi Hasselmann Barros, Cristiano Fiorentini, Giovanni Rezza, Janeusa Rita Leite Primo Chagas

Research output: Contribution to journalArticlepeer-review


The emergence of Zika virus in the Americas has caused an increase of babies born with microcephaly or other neurological malformations. The differential diagnosis of Zika infection, particularly serological diagnosis, is an important but complex issue. In this study, we describe clinical manifestations of 94 suspected cases of congenital Zika from Bahia state, Brazil, and the results of serological tests performed on children and/or their mothers at an average of 71 days after birth. Anti-Zika immunoglobulin M (IgM) antibodies were detected in 44.4% and in 7.1% of samples from mothers and children, respectively. Nearly all the IgM, and 92% of immunoglobulin G positive results were confirmed by neutralization test. Zika specific neutralizing antibodies were detected in as much as 90.4% of the cases. Moreover, dengue specific neutralizing antibodies were detected in 79.0% of Zika seropositive mothers. In conclusion, Zika IgM negative results should be considered with caution, due to a possible rapid loss of sensitivity after birth, while the NS1-based Zika IgM enzyme-linked immunosorbent assay test we have used has demonstrated to be highly specific. In a high percentage of cases, Zika specific neutralizing antibodies were detected, which are indicative of a past Zika infection, probably occurred during pregnancy in this population.

Original languageEnglish
Pages (from-to)1577-1583
Number of pages7
JournalJournal of Medical Virology
Issue number9
Publication statusPublished - Sep 2019


  • Adult
  • Antibodies, Neutralizing/blood
  • Antibodies, Viral/blood
  • Brazil/epidemiology
  • Child, Preschool
  • Diagnostic Imaging
  • Humans
  • Immunoglobulin M/blood
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical/statistics & numerical data
  • Neutralization Tests
  • Phenotype
  • Public Health Surveillance
  • Serologic Tests
  • Zika Virus
  • Zika Virus Infection/diagnosis


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