Persistence of Zika Virus in Body Fluids-Final Report

BACKGROUND To estimate the frequency and duration of detectable Zika virus (ZIKV) RNA in human body fluids, we prospectively assessed a cohort of recently infected participants in Puerto Rico. METHODS We evaluated samples obtained from 295 participants (including 94 men who provided semen specimens) in whom ZIKV RNA was detected on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay in urine or blood at an enhanced arboviral clinical surveillance site. We collected serum, urine, saliva, semen, and vaginal secretions weekly for the first month and at 2, 4, and 6 months. All specimens were tested by means of RT-PCR, and serum was tested with the use of anti-ZIKV IgM enzyme-linked immunosorbent assay. Among the participants with ZIKV RNA in any specimen at week 4, collection continued every 2 weeks thereafter until all specimens tested negative. We used parametric Weibull regression models to estimate the time until the loss of ZIKV RNA detection in each body fluid and reported the findings in medians and 95th percentiles. RESULTS The medians and 95th percentiles for the time until the loss of ZIKV RNA detection were 15 days (95% confidence interval [CI], 14 to 17) and 41 days (95% CI, 37 to 44), respectively, in serum; 11 days (95% CI, 9 to 12) and 34 days (95% CI, 30 to 38) in urine; and 42 days (95% CI, 35 to 50) and 120 days (95% CI, 100 to 139) in semen. Less than 5% of participants had detectable ZIKV RNA in saliva or vaginal secretions. CONCLUSIONS The prolonged time until ZIKV RNA clearance in serum in this study may have implications for the diagnosis and prevention of ZIKV infection. In 95% of the men in this study, ZIKV RNA was cleared from semen after approximately 4 months.