RESUMO
BACKGROUND: Diagnostic requests for both Zika virus (ZIKV) and dengue virus (DENV) infections in returning travelers have significantly increased during the recent ZIKV outbreak in the Americás. These flaviviruses have overlapping clinical syndromes and geographical distribution, but diagnostic differentiation is important because of different clinical consequences. As flaviviruses are known to have a short viremic period, diagnostics often rely on serological methods, which are challenging due to extensive cross-reactive antibodies. OBJECTIVE: To re-evaluate the performance of DENV serological assays in laboratory confirmed ZIKV-infected travelers. STUDY DESIGN: The extent of cross-reactivity of the DENV NS1 antigen, IgM and IgG ELISA was analyzed in 152 clinical blood samples collected from 69 qRT-PCR and 24 virus neutralization titer (VNT) confirmed ZIKV-infected travelers. RESULTS: The majority of travelers in the presented cohort returned to the Netherlands from Suriname and presented with symptoms of fever and rash. Twenty-three percent of the female travelers were pregnant. None of the 39 ZIKV RNA positive blood samples were cross-reactive in the DENV NS1 antigen ELISA. The rates of cross-reactivity of the DENV IgM and IgG ELISÁs were 31% and 54%, respectively, after excluding travelers with (potential) previous DENV exposure. CONCLUSIONS: Although the DENV NS1 antigen assay was highly specific in this cohort of laboratory confirmed ZIKV-infected travelers, we demonstrate high percentages of cross-reactivity of DENV IgM and IgG ELISÁs of which diagnostic laboratories should be aware. In addition, the high rate of DENV IgG background of >25% complicates a proper serological diagnosis in this group.
Assuntos
Anticorpos Antivirais/sangue , Vírus da Dengue/imunologia , Vírus da Dengue/isolamento & purificação , Dengue/diagnóstico , Doença Relacionada a Viagens , Infecção por Zika virus/diagnóstico , Zika virus/imunologia , Adulto , Estudos de Coortes , Reações Cruzadas , Dengue/virologia , Vírus da Dengue/genética , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Países Baixos , RNA Viral/sangue , Reação em Cadeia da Polimerase em Tempo Real , Testes Sorológicos , Suriname , Proteínas não Estruturais Virais/sangue , Proteínas não Estruturais Virais/imunologia , Zika virus/genética , Zika virus/isolamento & purificação , Infecção por Zika virus/virologiaRESUMO
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.
Assuntos
RNA/análise , Análise do Sêmen/métodos , Sêmen/química , Viagem , Infecção por Zika virus/virologia , Zika virus/isolamento & purificação , Barbados , Progressão da Doença , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos , Carga Viral , Zika virus/genética , Infecção por Zika virus/diagnósticoRESUMO
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...(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Sorologia/estatística & dados numéricos , Virologia/estatística & dados numéricos , Transmissão de Doença Infecciosa , Infecção por Zika virus/sangue , Infecção por Zika virus/transmissão , Barbados/epidemiologiaRESUMO
We present three patients from Suriname who were diagnosed with Guillain-Barré syndrome (GBS) during the Zika virus (ZIKV) outbreak in this country. One patient had a positive ZIKV urine real-time RT-PCR (qRT-PCR) result. The other two patients had a negative ZIKV urine qRT-PCR but a positive virus neutralization test and presence of IgG antibodies against ZIKV in the serum. Considering the evidence of a past ZIKV infection and absence of evidence for recent infections with the most common preceding infections of GBS, it is very likely that these GBS cases were triggered by ZIKV.