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

• Autor(a) principal: Tozetto-Mendoza, Tania Regina
• Data de Publicação: 2019
• Outros Autores: 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
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
• Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/156330
• topic: Zika virus; Differential diagnosis; Kinetics; Body fluids; Polymerase chain reaction; Real-Time Polymerase Chain Reaction; Serology; Brazil

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.