Zika Persistence

Summary and Comment |
February 24, 2017

Zika Persistence

  1. Richard T. Ellison III, MD

The Zika virus is detectable in serum up to 80 days and in semen up to 125 days after symptom onset.

  1. Richard T. Ellison III, MD

Clear evidence associates mosquito-borne Zika virus with birth defects and the Guillain-Barré syndrome. Because the virus is also transmitted through sexual contact and blood transfusion, more detailed data on its persistence in body fluids is urgently needed. To this end, researchers working with the Centers for Disease Control and Prevention report interim results in 150 of 350 participants with infection diagnosed by reverse transcriptase polymerase chain reaction (RT-PCR) from a prospective cohort study in Puerto Rico on the kinetics of Zika virus in serum, urine, saliva, semen, and vaginal secretions.

Among 127 symptomatic participants with acute febrile illness identified by screening in emergency departments or outpatient clinics and 23 household contacts of these index subjects (4 asymptomatic), the median time from symptom onset to loss of Zika virus (ZIKV) RNA detection was 14 days in serum, 8 days in urine, and 34 days in semen. The 95th percentile of time to RNA clearance was 54 days in serum, 39 days in urine, and 81 days in semen. The maximum observed durations were 80 days in serum in a pregnant woman, and 125 days in semen. ZIKV RNA was found in at least one saliva sample in 10% of subjects and in vaginal secretions in only 1 of 50 women. Anti-ZIKV IgM antibodies were detected in 140 of 143 tested subjects.


The authors note that these estimates of viral persistence are subject to change, as a number of participants still had detectable RNA at the time that the last sample was collected. In addition, these results represent the presence of Zika virus RNA and not necessarily infectious virus. Still, these interim findings will help to better define optimal approaches to diagnosing Zika virus infection, protecting the blood supply, and counseling individuals on the risk for sexual transmission.

Editor Disclosures at Time of Publication

  • Disclosures for Richard T. Ellison III, MD at time of publication Consultant / Advisory board Philips Healthcare Grant / Research support Philips Healthcare


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