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Observation | Clinical Science and Epidemiology

Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil

Andres Moreira-Soto, Renata Cabral, Celia Pedroso, Monika Eschbach-Bludau, Alexandra Rockstroh, Ludy Alexandra Vargas, Ignacio Postigo-Hidalgo, Estela Luz, Gilmara Souza Sampaio, Christian Drosten, Eduardo Martins Netto, Thomas Jaenisch, Sebastian Ulbert, Manoel Sarno, Carlos Brites, Jan Felix Drexler
Glenn Randall, Editor
Andres Moreira-Soto
Institute of Virology, University of Bonn Medical Centre, Bonn, GermanyCharité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
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Renata Cabral
Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, Brazil
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Celia Pedroso
Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Monika Eschbach-Bludau
Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
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Alexandra Rockstroh
Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
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Ludy Alexandra Vargas
Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Ignacio Postigo-Hidalgo
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
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Estela Luz
Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Gilmara Souza Sampaio
Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Christian Drosten
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, GermanyGerman Centre for Infection Research (DZIF)‡
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Eduardo Martins Netto
Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Thomas Jaenisch
German Centre for Infection Research (DZIF)‡Department for Infectious Diseases (Section Clinical Tropical Medicine), Heidelberg University Hospital, Heidelberg, Germany
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Sebastian Ulbert
Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
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Manoel Sarno
Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, BrazilComplexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Carlos Brites
Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
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Jan Felix Drexler
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, GermanyGerman Centre for Infection Research (DZIF)‡
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Glenn Randall
University of Chicago
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DOI: 10.1128/mSphere.00278-18
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    FIG 1 

    Seroprevalence rates of cases and controls. Seroprevalence rates are shown with adjusted Wald confidence intervals (column lines). Asterisks denote a P value of <0.05. Fisher’s exact tests were done when any cell count was below 5; otherwise, χ2 tests were done to compare seroprevalence rates.

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  • TABLE 1 

    Seroprevalence rates in cases and controls

    PathogenSeroprevalence
    cases (%)
    95% CIaSeroprevalence
    controls (%)
    95% CIOdds
    ratiob
    95% CIPd
    ZIKV93.878.8–99.367.859.9–74.87.1c1.6–31.10.002
    CHIKV20.79.5–38.88.25.2–14.82.9c1.0–8.40.039
    DENV74.155.1–87.189.179.2–95.60.30.0–1.00.100
    RUBV90.675.0–97.597.593.5–99.20.20.0–1.20.092
    HSV-193.878.8–99.395.090.3–97.60.80.1–3.90.673
    HSV-228.115.4–45.547.132.1–47.10.60.3–1.40.230
    VZV87.571.3–95.694.489.5–97.20.40.1–1.50.236
    CMV96.982.9–100.096.992.7–99.01.00.1–8.91.000
    PV-B1931.317.8–48.735.628.6–43.30.80.4–1.80.635
    C. trachomatis46.930.9–63.648.140.5–55.80.90.4–2.00.897
    B. pertussis56.339.3–71.959.451.8–66.70.90.4–1.90.742
    T. pallidum0.00.0–9.31.30.0–4.70.90.0–20.81.000
    T. gondii53.136.5–69.158.751.0–66.10.80.4–1.70.556
    • ↵a CI, confidence interval.

    • ↵b Data represent results from bivariate comparisons.

    • ↵c In conditional logistic regression analyses, odds ratios were as follows: ZIKV (P = 0.030; odds ratio, 4.0 [95% CI, 1.1 to 14.1]) and CHIKV (P = 0.084; odds ratio, 2.8 [95% CI, 0.1 to 9.2]).

    • ↵d Data were calculated using χ2 tests and Fisher’s exact tests when any cell count was below 5. Bold type denotes statistical significance.

Supplemental Material

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  • TABLE S1 

    Characteristics of suspected congenital Zika syndrome in cases. Download TABLE S1, PDF file, 0.1 MB.

    Copyright © 2018 Moreira-Soto et al.

    This content is distributed under the terms of the Creative Commons Attribution 4.0 International license.

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Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil
Andres Moreira-Soto, Renata Cabral, Celia Pedroso, Monika Eschbach-Bludau, Alexandra Rockstroh, Ludy Alexandra Vargas, Ignacio Postigo-Hidalgo, Estela Luz, Gilmara Souza Sampaio, Christian Drosten, Eduardo Martins Netto, Thomas Jaenisch, Sebastian Ulbert, Manoel Sarno, Carlos Brites, Jan Felix Drexler
mSphere Aug 2018, 3 (4) e00278-18; DOI: 10.1128/mSphere.00278-18

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Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil
Andres Moreira-Soto, Renata Cabral, Celia Pedroso, Monika Eschbach-Bludau, Alexandra Rockstroh, Ludy Alexandra Vargas, Ignacio Postigo-Hidalgo, Estela Luz, Gilmara Souza Sampaio, Christian Drosten, Eduardo Martins Netto, Thomas Jaenisch, Sebastian Ulbert, Manoel Sarno, Carlos Brites, Jan Felix Drexler
mSphere Aug 2018, 3 (4) e00278-18; DOI: 10.1128/mSphere.00278-18
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KEYWORDS

Brazil
TORCH
Zika virus
microcephaly
parturient

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