Control and Prevention of HIV/AIDS, STDs & STIs

Since 2016, United States (US) Zika virus (ZIKV) transmission provoked our pathology residents, and pathologists' assistant students to follow fetal and placental tissue sampling protocols recommended by the Center for Disease Control (CDC). As tissue collection increased at our institution located in Texas, an ongoing local transmitter and inundated by Hurricane Harvey which offered additional breeding grounds for vectors, unpublished data emerged at our insitution suggesting viral presence in fetal and placental tissue without maternal viral positivity implying the importance of adequate training regarding prosection and sampling. Current research demonstrated that ZIKV persisted in fetal tissue resulting in Congenital Zika Syndrome. Unbeknownst of recent findings, learners procuring samples required repeated updated protocol review and often questioned purpose behind submission to the CDC. In response, we designed two traditional algorithms combining our work flow and resources beginning with identifying presumed ZIKV transmitted specimens to receiving verification of ZIKV infection and the repercussions thereafter. This systematic approach was presented during resident and pathologists' assistant student orientation and reviewed during macrosopic inspection and prosection, known as grossing, of placentas, products of conception and autopsy organ blocks. As a result, residents and pathologists' assistant students proffered adequate sampling and understood its gravity. In our lab, all past medical histories of received specimens were evaluated by pathology staff without relying only upon the submitting physician’s direction to retain tissue. More suspected tissue was sequestered for possible studies when, in the past, this tissue may have otherwise been disposed of following standard final diagnosis. In conclusion, our algorithms became indispensable learning devices for our trainees and will remain as a dynamic teaching tool . By generating a well-defined, customized, condensed ZIKV transmitted tissue protocol specific to our institution to include current emerging discoveries, gross inspectors and autopsy prosectors will remain updated and continue their vital role in continuity of care for those afflicted by ZIKV.