Longitudinal follow-up of Zika virus RNA in semen of a traveller returning from Barbados to the Netherlands with Zika virus disease, March 2016

Abstract

We report the longitudinal follow-up of Zika virus (ZIKV) RNA in semen of a traveller who developed ZIKV disease after return to the Netherlands from Barbados, March 2016. Persistence of ZIKV RNA in blood, urine, saliva and semen was followed until the loads reached undetectable levels. RNA levels were higher in semen than in other sample types and declined to undetectable level at day 62 post onset of symptoms.

Kinetics of Zika virus persistence in semen

“…Our findings confirm earlier reports [8][9][10][11] . Follow-up was too short to exclude the possibility of recurrence, but the decline of ZIKV-RNA levels in semen observed in our patients suggests elimination of the virus.…”

“…A case report documenting longitudinal follow-up of semen with ZIKV RNA levels declining to undetectable at day 62 post infection, was recently published 11 . ZIKV replication competence was demonstrated by isolation of the virus from semen, more than two weeks after the onset of ZVD 4 .…”

Detection of Zika virus RNA in whole blood of imported Zika virus disease cases up to 2 months after symptom onset, Israel, December 2015 to April 2016

“…Future studies should investigate the possibility, raised by our study that Zika virus could circulate in the blood of infected patients for up to 2 months. Diagnosis of recent Zika virus infection is important even after a patient's full recovery, not only because of the possible risk to the fetus in pregnant women, but also considering reports that sexual transmission of the virus from men to women has likely occurred [16] and the finding of the virus in semen for several weeks following infection [17,18]. Although our study establishes the utility of WB in the routine diagnosis of Zika infection, more studies are required to precisely determine the time frame of presence as well as the amounts of Zika virus RNA in WB following infection.…”

Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Persons with Possible Zika Virus Exposure — United States, September 2016

“…However, detection of Zika virus RNA in semen might not indicate the presence of infectious virus and thus the potential for sexual transmission. Reports indicate that concentrations of detectable Zika virus RNA in semen decrease after infection (17,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Zika virus RNA was detected in semen of five men more than 90 days after symptom onset, with the longest period of reported detection 188 days after symptom onset (20,26,29,30).…”