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
• Main Authors: Tania Regina Tozetto-Mendoza, Vivian Iida Avelino-Silva, Silvia Fonseca, Ingra Morales Claro, Anderson Vicente de Paula, Anna Sara Levin, Ester Cerdeira Sabino, Maria Cassia Mendes-Correa, Walter Manso Figueiredo, Alvina Clara Felix, Nathalia C. Santiago Souza, Angela Aparecida Costa, Marta Inenami, Rosangela M. Gasparetto da Silva, José Eduardo Levi, Camila Malta Romano, Glaucia Paranhos-Baccalà, Aluisio Cotrim Segurado, Philippe Mayaud
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2019
• Subjects: Zika virus; Differential diagnosis; Kinetics; Body fluids; Polymerase chain reaction; Real-Time Polymerase Chain Reaction; Serology; Brazil; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946201961019; https://doaj.org/article/53fe8d3827384082af2573c8165e3822

ABSTRACT 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.