Excretion of West Nile Virus in Urine During Acute Infection

Abstract

Detection of West Nile virus (WNV) RNA in urine has been anecdotally described and proposed for the diagnosis of WNV infection. This study reports the routine use of real-time reverse-transcription polymerase chain reaction for the detection of WNV RNA in urine to support diagnosis of WNV infection during the large outbreak that occurred in northeastern Italy in 2012. Fourteen of 32 patients (43.8%) with symptomatic WNV infection, defined as neuroinvasive disease and fever, had detectable WNV RNA in urine at the time of diagnosis, at a higher rate and load and for a longer time than detection of WNV RNA in blood. Detection of WNV RNA in urine was less frequent (2 of 14 patients [14.2%]) in blood donors in whom WNV infection was identified by WNV nucleic acid amplification testing. Infectious virus was isolated from the urine of a patient with neuroinvasive disease and a high WNV RNA load in urine.

Zika virus disease: a current review of the literature

“…However, it is advantageous because of being non-invasive, and one study reported even higher sensitivity in testing [59]. Similar to other flaviviruses, urine may also be used to detect ZIKV RNA [93,94]. In fact, ZIKV may stay in the urine and remain positive for a longer duration than in the serum [51,58].…”

Advantage of urine based molecular diagnosis of Zika virus

“…Diagnosis of other viral infections in urine and saliva samples has been reported for human immunodeficiency virus (HIV), Hepatitis A, B, and C, and rubella [14][15][16][17][18][19][20], and more recently in other flaviviruses, West-Nile virus (WNV) [21][22][23] and Dengue (DENV) serotypes -1, -2, -3, and -4 [24][25][26][27][28][29][30][31][32][33][34][35]. WNV can be detected longer in urine than serum [21] and can be isolated from urine [22,23].…”

“…WNV can be detected longer in urine than serum [21] and can be isolated from urine [22,23]. Some studies also suggest that like WNV, DENV can be detected for a longer time in urine than saliva or serum [25,29,31,32].…”

Neurological manifestations of Chikungunya and Zika infections

“…Therefore, the results should be interpreted with caution 37,38 . Urine samples for the detection of viral genomes by RT-PCR may be the diagnostic method of choice, since the disappearance of the genome in serum has been shown to be within 10 days for ZIKV, but in urine samples it can be detected until fifteen days after the onset of infection 58,59,60 (Table 2). Appropriate diagnostic specimens for RT-PCR testing include plasma/serum, urine, CSF, amniotic fluid and placental tissue.…”

“…Appropriate diagnostic specimens for RT-PCR testing include plasma/serum, urine, CSF, amniotic fluid and placental tissue. Serology is usually performed on serum; however, viral antibodies may also be detected in the CSF 58,59,60 .…”