Probable sexual transmission of Zika virus from a vasectomised man

Arsuaga, Marta; Bujalance, Silvia García; Díaz‐Menéndez, Marta; Vázquez, Ana; Arribas, José Ramón

doi:10.1016/s1473-3099(16)30320-6

Cited by 128 publications

(110 citation statements)

References 3 publications

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“…This recommendation was a conservative estimate for symptomatic men given the maximum reported persistence of Zika virus RNA in semen (62 days) at the time the WHO guidelines were issued (May 2016). Our data, together with other recent case reports ( 12 , 18 – 20 , 25 , 32 , 36 ), show that Zika virus RNA is sometimes detectable beyond 62 days, with the maximum period of RNA detection observed to date being approximately 6 months ( 20 ). However, our understanding of the dynamics for virus or viral RNA clearance are still nascent, and further data are required to assess the validity of current recommendations.…”

Section: Discussionsupporting

confidence: 82%

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Presence and Persistence of Zika Virus RNA in Semen, United Kingdom, 2016

Atkinson¹,

Thorburn²,

Petridou³

et al. 2017

Emerg. Infect. Dis.

101

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Zika virus RNA has been detected in semen collected several months after onset of symptoms of infection. Given the potential for sexual transmission of Zika virus and for serious fetal abnormalities resulting from infection during pregnancy, information regarding the persistence of Zika virus in semen is critical for advancing our understanding of potential risks. We tested serial semen samples from symptomatic male patients in the United Kingdom who had a diagnosis of imported Zika virus infection. Among the initial semen samples from 23 patients, Zika virus RNA was detected at high levels in 13 (56.5%) and was not detected in 9 (39.1%); detection was indeterminate in 1 sample (4.4%). After symptomatic infection, a substantial proportion of men have detectable Zika virus RNA at high copy numbers in semen during early convalescence, suggesting high risk for sexual transmission. Viral RNA clearance times are not consistent and can be prolonged.

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Section: Discussionsupporting

confidence: 82%

“…A recent publication reported Zika virus RNA in the ejaculate of a vasectomized man 96 days after onset of symptoms in addition to infectious virus cultured at 69 days ( 25 ), suggesting that previous vasectomy does not necessarily preclude the possibility of viral RNA or infectious virions in the semen.…”

Section: Discussionmentioning

confidence: 99%

Presence and Persistence of Zika Virus RNA in Semen, United Kingdom, 2016

Atkinson¹,

Thorburn²,

Petridou³

et al. 2017

Emerg. Infect. Dis.

101

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“…There, a potentially sexual transmission to a partner has been discussed. However, the possibility of a mosquito-borne transmission in the wife cannot be entirely ruled out as she had accompanied the index patient on the visit to the Maldives, and her symptoms started only 18 days after their return [16]. Mansuy et al demonstrated the presence of ZIKV particles in the heads of spermatocytes [17].…”

Section: Discussionmentioning

confidence: 99%

Long-term kinetics of Zika virus RNA and antibodies in body fluids of a vasectomized traveller returning from Martinique: a case report

Fröschl

Huber²,

Sonnenburg³

et al. 2017

BMC Infect Dis

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BackgroundThe magnitude of the current Zika virus (ZIKV) epidemic has led to a declaration of a Public Health Emergency of International Concern by the WHO. Findings of viable viral particles in semen for several weeks are corroborating reports of sexual transmission of ZIKV. Serious consequences of a positive diagnostic result particularly in the pregnant patient are calling for precise diagnostic tools also at later time points after infection. Currently, recommendations suggest a diagnostic period of direct viral detection of 5 to 7 days after onset of symptoms in serum or plasma, and up to 3 weeks in urine samples.Case presentationA vasectomized 41-year-old German returning from Martinique presented at the outpatient clinic of the Department for Infectious Diseases and Tropical Medicine, Munich, with subfebrile temperature, rash, malaise, severe retro-orbital pain and occipital lymphadenopathy. The main complaints resolved after ten days without specific treatment. We are reporting on clinical course and results of direct and indirect detection methods of ZIKV in different sample types including whole blood, ejaculate, urine, serum, plasma and saliva samples up to 119 days post symptom onset. Ejaculate samples remained PCR positive for ZIKV until day 77, whole blood samples until day 101.ConclusionsThe case presentation adds to the still limited knowledge of kinetics of detection of ZIKV by direct as well as indirect methods. Here, a complete data set including results from PCR, serology and cell culture is provided allowing an improved evaluation of optimum diagnostic periods for testing a variety of sample types. Moreover, a high viral load of ZIKV RNA was detected in ejaculate of the vasectomized patient. This finding sheds new light on the possible localizations of ZIKV replication in the human male reproductive tract.

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“…Importantly, immunohistochemical labeling of the sloughed epithelial cells from the epididymis for ZIKV could indicate alternate cellular mechanisms of sexual transmission in addition to spermatozoa [36]. The finding of epithelial cells containing ZIKV antigen in the seminal fluid of the mouse may also provide elucidation of sexually transmitted ZIKV in a vasectomized male where sperm cells would not have comprised a potential source for viral transfer during intercourse [37]. …”

Section: Discussionmentioning

confidence: 99%

Tissue tropisms, infection kinetics, histologic lesions, and antibody response of the MR766 strain of Zika virus in a murine model

Kawiecki

Mayton

Dutuze

et al. 2017

Virol J

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BackgroundThe appearance of severe Zika virus (ZIKV) disease in the most recent outbreak has prompted researchers to respond through the development of tools to quickly characterize transmission and pathology. We describe here another such tool, a mouse model of ZIKV infection and pathogenesis using the MR766 strain of virus that adds to the growing body of knowledge regarding ZIKV kinetics in small animal models.MethodsWe infected mice with the MR766 strain of ZIKV to determine infection kinetics via serum viremia. We further evaluated infection-induced lesions via histopathology and visualized viral antigen via immunohistochemical labeling. We also investigated the antibody response of recovered animals to both the MR766 and a strain from the current outbreak (PRVABC59).ResultsWe demonstrate that the IRF3/7 DKO mouse is a susceptible, mostly non-lethal model well suited for the study of infection kinetics, pathological progression, and antibody response. Infected mice presented lesions in tissues that have been associated with ZIKV infection in the human population, such as the eyes, male gonads, and central nervous system. In addition, we demonstrate that infection with the MR766 strain produces cross-neutralizing antibodies to the PRVABC59 strain of the Asian lineage.ConclusionsThis model provides an additional tool for future studies into the transmission routes of ZIKV, as well as for the development of antivirals and other therapeutics, and should be included in the growing list of available tools for investigations of ZIKV infection and pathogenesis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12985-017-0749-x) contains supplementary material, which is available to authorized users.

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Probable sexual transmission of Zika virus from a vasectomised man

Cited by 128 publications

References 3 publications

Presence and Persistence of Zika Virus RNA in Semen, United Kingdom, 2016

Presence and Persistence of Zika Virus RNA in Semen, United Kingdom, 2016

Long-term kinetics of Zika virus RNA and antibodies in body fluids of a vasectomized traveller returning from Martinique: a case report

Tissue tropisms, infection kinetics, histologic lesions, and antibody response of the MR766 strain of Zika virus in a murine model

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