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Case Series of Adverse Pregnancy Outcomes Associated with Oropouche Virus Infection
Daniele Barbosa de Almeida Medeiros1,2, Juarez Antônio Simões Quaresma3,4, Raimunda do Socorro da Silva Azevedo1
1Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Rodovia BR-316 km 7 s/n-Levilândia, Ananindeua 67030-000, Pará, Brazil.
Abstract:
The Oropouche virus (OROV) is an arbovirus (Peribunyaviridae: Orthobunyavirus) that traditionally causes febrile outbreaks in Latin America's Amazon region. Previously, OROV was not associated with severe pregnancy outcomes. During the 2022-2024 outbreak in Brazil, OROV expanded geographically, revealing links to adverse pregnancy outcomes. This study describes six cases with varied fetal outcomes, including miscarriage, antepartum, intrauterine fetal demise (IFD), and normal development, correlating with maternal symptoms but not symptom severity. Vertical transmission was confirmed by detecting OROV through RT-qPCR, ELISA, and immunohistochemistry in fetal tissues. Genome sequencing from an IFD case identified a novel reassortment pattern reported in the 2022-2024 outbreak. Severe encephalomalacia, meningoencephalitis, vascular compromise, and multi-organ damage were evident, underscoring the significant risk OROV poses to fetal development and emphasizing the need for further investigation.
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