Zika virus dynamics in body fluids and risk of sexual transmission in a non‐endemic area

Abstract

Abstractobjective To understand Zika virus (ZIKV) dynamics in fluids of infected individuals and the risk of sexual transmission.methods Prospective study at two centres in Spain. Patients with probable or confirmed diagnosis of ZIKV infection were clinically followed up, and fluid samples were collected from saliva, serum, urine and semen or vaginal secretion following the study protocol. Non-traveller-sexual partners were offered to participate.results From January 2016 to December 2016, we included a total of 11 traveller patients and six sexual contacts. Six patients were male, with a median age of 38 years . We performed 61 RT-PCR determinations, seven of which were positive. Positive results were retrieved from serum, urine, semen and vaginal tract. One of four women tested positive for ZIKV RNA in vaginal swabs collected during the first 45 days after symptoms onset. Clearance occurred between day 37 and day 69 after symptoms onset. One of five men tested positive for ZIKV RNA in semen collected during the first 45 days after symptoms onset. Clearance occurred between day 23 and 107 after symptoms onset. Six patients had sexual relations during the defined period. All tested patients were negative for ZIKV infection by serological testing.conclusion ZIKV shedding persistence in genital fluids occurs in a significant number of symptomatic patients after visiting an endemic area. We did not find any ZIKV seroconversion among the three male contacts who were investigated. Diagnostic algorithms may be updated to include genital tract fluid specimens in the diagnostic process.

Zika virus infection in the genital tract of non-pregnant females: a systematic review

“…The majority of the studies evaluated ZIKV shedding in FGT of non-pregnant women using lower genital tract samples (LGT) 21,25,[35][36][37][44][45][46][47][48] . Very few samples from the upper genital tract (UGT) have been studied 42,49 (Table 1).…”

“…Subsequently, some studies have reported the presence and persistence of ZIKV RNA in the vaginal and/or cervical samples of non-pregnant women 21,25,36,37,[44][45][46][47][48] . In these studies, the authors reported data on the symptoms, and the variability on the period of viral RNA detection and persistence in vaginal and/or cervical samples.…”

“…Besides, serum (7 dpo), urine (up to 27 dpo), cerebrospinal fluid (6 dpo) and saliva (up to 13 dpo) were positive for ZIKV RNA. Sánchez-Montalvá et al 25 performed a prospective study in two Spanish centers in 2016. Among four non-pregnant women, one tested positive for ZIKV RNA in vaginal swabs collected during the first 45 dpo and the viral clearance occurred between 37 and 69 dpo.…”

“…ZIKV ribonucleic acid (RNA) has been detected in the blood, saliva, urine, cerebrospinal fluid, semen, breast milk 18,19 , vagina and cervix, but ZIKV dynamics in body fluids is not well understood 20,21 . In the context of ZIKV sexual transmission, there are several reports of male-tofemale 16,17,[22][23][24][25] and male-to-male 26 transmission, but few studies showing female-to-male transmission 27 .…”

Neuroimaging Findings of Zika Virus–Associated Neurologic Complications in Adults

“…No other arboviruses are thought to be transmitted sexually, and the transmission can occur before, during, or after the onset of symptoms and from asymptomatic patients. 2,3 The first major reported outbreaks of ZIKV infection were described in French Polynesia in 2013 and 2015. At that time, some neurologic disabilities in infants of infected pregnant women were observed; however, the maternal-fetal transmission was not suspected at that time.…”