Tropical Medicine Unit, Infectious Diseases Department, PROSICS (International Health Program of the Catalan Health Institute), Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Microbiology Department, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Trop Med Int Health. 2018 Jan;23(1):92-100. doi: 10.1111/tmi.13019. Epub 2017 Dec 21.
To understand Zika virus (ZIKV) dynamics in fluids of infected individuals and the risk of sexual transmission.
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.
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 (IQR 30-45). 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.
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.
了解感染个体体液中的寨卡病毒（ZIKV）动态及其性传播风险。
在西班牙的两个中心进行前瞻性研究。按照研究方案，对疑似或确诊寨卡病毒感染的患者进行临床随访，并采集唾液、血清、尿液和精液或阴道分泌物等体液样本。非旅行者性伴侣也受邀参与。
2016 年 1 月至 12 月，我们共纳入了 11 例旅行者患者和 6 例性接触者。6 例患者为男性，中位年龄为 38 岁（IQR 30-45）。共进行了 61 次 RT-PCR 检测，其中 7 次结果为阳性。阳性结果来自血清、尿液、精液和阴道分泌物。4 名女性中有 1 名在症状出现后 45 天内采集的阴道拭子中检测到寨卡病毒 RNA 呈阳性。病毒清除发生在症状出现后第 37 天至第 69 天之间。5 名男性中有 1 名在症状出现后 45 天内采集的精液中检测到寨卡病毒 RNA 呈阳性。病毒清除发生在症状出现后第 23 天至第 107 天之间。6 例患者在规定期间有过性行为。所有接受检测的患者血清学检测均为寨卡病毒感染阴性。
在从疫区返回后，大量出现症状的患者的生殖器分泌物中仍持续存在寨卡病毒。我们在 3 名接受调查的男性接触者中均未发现任何寨卡病毒血清学转换。诊断算法可能需要更新，以包括生殖器腔液标本的检测。
