Detection of Zika Virus in Urine - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

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Detection of Zika Virus in Urine - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 1—January 2015

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Detection of Zika Virus in Urine

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Ann-Claire Gourinat1, Olivia O’Connor1, Elodie Calvez, Cyrille Goarant, and Myrielle Dupont-Rouzeyrol 

Author affiliations: Institut Pasteur, Noumea, New Caledonia

Suggested citation for this article

Abstract

We describe the kinetics of Zika virus (ZIKV) detection in serum and urine samples of 6 patients. Urine samples were positive for ZIKV >10 days after onset of disease, which was a notably longer period than for serum samples. This finding supports the conclusion that urine samples are useful for diagnosis of ZIKV infections.

Zika virus (ZIKV) is an emerging mosquito-borne pathogen (family Flaviviridae, genus Flavivirus) that was isolated in 1947 from a rhesus monkey in the Zika forest in Uganda (1). ZIKV is believed to be transmitted to humans by infected Aedes spp. mosquitoes (2,3). Studies have demonstrated that ZIKV is endemic to Africa and Southeast Asia (4). Before 2007, few cases of human infection with ZIKV had been reported. In 2007, an epidemic of ZIKV infection in humans occurred in Yap, Federated States of Micronesia, in the Pacific region. A seroprevalence survey determined that ≤70% of the population had been infected (5). During 2007–2013, the few cases of infection with ZIKV reported were in travelers returning from Africa (6) or Southeast Asia (7).

In humans, ZIKV infection is characterized by mild fever (37.8°C–38.5°C); arthralgia, notably of small joints of hands and feet; myalgia, headache; retroorbital pain; conjunctivitis; and cutaneous maculopapular rash. ZIKV infection is believed to be asymptomatic or mildly symptomatic in most cases (5). Thus, Zika can be misdiagnosed during the acute (viremic) phase because of nonspecific influenza-like signs and symptoms. Hemorrhagic signs have not been reported in ZIKV-infected patients (5–7). However neurologic complications, including Guillain-Barré syndrome, have been observed (8).

Biological confirmation of ZIKV infections is based mostly on detection of virus RNA in serum by using reverse transcription PCR (RT-PCR). Although IgM against ZIKV can be detected by ELISA, few laboratories have this ability. Thus, in addition to the nonspecific clinical features of infection with ZIKV, laboratory diagnosis is challenging because of low viremia and cross-reactivity of ZIKV antibodies with other flaviviruses (including dengue), which require confirmation by neutralization assays (8) and make rapid serologic confirmation difficult. We investigated the diagnostic utility of urine as a source for detection of ZIKV RNA by real-time RT-PCR.

Dr. Gourinat is a clinical pathologist and head of the Serology, Immunology, and Molecular Biology Unit at the Institut Pasteur, Noumea, New Caledonia. Her research interests are diagnostic and biological surveillance of arboviruses.

Acknowledgment

We thank the staff of the Institut Pasteur in New Caledonia and M. Richard for providing technical support and I. Leparc-Goffart for providing Zika virus stock for the RT-PCR. Sequencing experiments were performed on La-Plateforme-du-Vivant (Noumea, New Caledonia).

References

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Figure

• Figure. Detection of Zika virus in blood and urine specimens of 6 patients by using real-time reverse transcription PCR with primers/probe 1086/1162c/1107-Cy5 (11) New Caledonia, 2014. A) Patient 1; B)...

Table

• Table. Characteristics of 6 patients infected with Zika virus, New Caledonia, 2014

Suggested citation for this article: Gourinat AC, O’Connor O, Calvez E, Goarant C, Dupont-Rouzeyrol M. Detection of Zika virus in urine. Emerg Infect Dis [Internet]. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140894

DOI: 10.3201/eid2101.140894

1These authors contributed equally to this article.