Zika virus infection among symptomatic patients from two healthcare centers in Sao Paulo State, Brazil: prevalence, clinical characteristics, viral detection in body fluids and serodynamics

• Published in: Revista do Instituto de Medicina Tropical de São Paulo Vol. 61; pp. e19 - 9
• Main Authors: Tozetto-Mendoza, Tania Regina, Avelino-Silva, Vivian Iida, Fonseca, Silvia, Claro, Ingra Morales, Paula, Anderson Vicente de, Levin, Anna Sara, Sabino, Ester Cerdeira, Mendes-Correa, Maria Cassia, Figueiredo, Walter Manso, Felix, Alvina Clara, Souza, Nathalia C Santiago, Costa, Angela Aparecida, Inenami, Marta, Silva, Rosangela M Gasparetto da, Levi, José Eduardo, Romano, Camila Malta, Paranhos-Baccalà, Glaucia, Segurado, Aluisio Cotrim, Mayaud, Philippe
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Instituto de Medicina Tropical de Sao Paulo 01.01.2019; Instituto de Medicina Tropical; Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo (USP)
• Subjects: Adult; Bodily Secretions - virology; Body fluids; Brazil; Brazil - epidemiology; Diagnosis, Differential; Differential diagnosis; Enzymes; Female; Fluids; Guillain-Barre syndrome; Health care; Humans; Immunoassay; Infections; Investigations; Kinetics; Male; Middle Aged; Original; Polymerase chain reaction; Pregnancy; Prevalence; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Serology; TROPICAL MEDICINE; Urine; Viral Load; Zika virus; Zika Virus - isolation & purification; Zika Virus Infection - diagnosis; Zika Virus Infection - epidemiology; Brazil; Polymerase chain reaction; Body fluids; Brazil; Zika virus; Differential diagnosis; Serology; Kinetics; Real-Time Polymerase Chain Reaction
• ISSN: 1678-9946; 0036-4665; 1678-9946
• DOI: 10.1590/S1678-9946201961019

Zika virus (ZIKV) clinical presentation and frequency/duration of shedding need further clarification. Symptomatic ZIKV-infected individuals identified in two hospitals in Sao Paulo State, Brazil, were investigated regarding clinical characteristics, shedding in body fluids, and serodynamics. Ninety-four of 235 symptomatic patients (Site A: 58%; Site B: 16%) had Real-Time PCR-confirmed ZIKV infection; fever, headache and gastrointestinal symptoms were less frequent, and rash was more frequent compared to ZIKV-negative patients. Real-Time PCR in serum had worse performance compared to plasma, while urine had the highest sensitivity. Shedding in genital fluids and saliva was rare. IgM positivity was the highest <14 days after the symptoms onset (86%), decreasing >28 days (24%); IgG positivity increased >14 days (96%) remaining positive in 94% of patients >28 days. ZIKV prevalence varied importantly in two neighboring cities during the same transmission season. Urine Real-Time PCR can improve diagnostic sensitivity; serum testing is less useful. Accurate serological tests are needed to improve diagnosis and surveillance.