[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Rev Inst Med Trop Sao Paulo. 2019;61:e19. doi: 10.1590/S1678-9946201961019. Epub 2019 Apr 4.
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.
Tozetto-Mendoza TR1, Avelino-Silva VI2, Fonseca S3, Claro IM2, Paula AV1, Levin AS1,2, Sabino EC1,2, Mendes-Correa MC1,2, Figueiredo WM4, Felix AC1, Souza NCS1, Costa AA4, Inenami M4, Silva RMGD4, Levi JE1, Romano CM1, Paranhos-Baccalà G1,5, Segurado AC1,2, Mayaud P1,6.
Author information: 1 Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil. 2 Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil. 3 Hospital São Francisco, Ribeirão Preto, São Paulo, Brazil. 4 Universidade de São Paulo, Faculdade de Saúde Pública, Serviço Especial de Saúde de Araraquara, Araraquara, São Paulo, Brazil. 5 Medical Diagnostic Discovery Department (MD3), bioMérieux SA, Marcy l’Etoile, France. 6 London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, United Kingdom.
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.
PMID: 30970110 DOI: 10.1590/S1678-9946201961019
Keywords: Zika Virus; Brazil; Seroprevalence.