Although animal manual of Zika virus (ZIKV) apparently accounts for few of the epidemiologic characteristics of the accepted outbreak,1 accessible infection of abundant women is a above concern. The best appear continuance of apparent ZIKV RNA in berry is at atomic 188 canicule afterwards the access of symptoms.2 Thus, the Centers for Ache Control and Blockage has recommended the use of condoms for 6 months afterwards infection to abstain animal transmission.3 However, best appear studies on this affair accept been based on a distinct berry sample from one ZIKV-infected patient, and few accept included aftereffect of assorted patients afterwards the access of affection until berry negativity for ZIKV.
In this abstraction in French Guiana involving 12 men with ZIKV infection for whom berry samples were available, we bent the prevalence of ZIKV RNA, the continuance of ZIKV persistence, and abeyant alternate ZIKV excretion. All the men were abrogating for dengue and chikungunya viruses. ZIKV infection was aboriginal diagnosed in a serum or urine sample, and the virus was quantified in serum, urine, and berry by agency of real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) appraisal (RealStar Zika Virus RT-PCR Kit 1.0, Altona Diagnostics). (Details are provided in the Methods area in the Supplementary Appendix, accessible with the abounding argument of this letter at NEJM.org.) This abstraction was accustomed by an absolute belief board (Comité de Protection des Personnes Sud-Méditerranée I in Marseille, France), which provided the allotment for anniversary accommodating center. All the patients provided accounting abreast consent.
The capital presenting affection were cutaneous adventurous (in 12 men), conjunctivitis (in 11), asthenia (in 11), pruritus (in 10), cephalalgia (in 8), retro-orbital affliction (in 8), arthromyalgia (in 8), agitation (in 6), polyadenopathy (in 6), and macrohematospermia (in 1). Four of the men (33%; 95% aplomb breach [CI], 10 to 65) had no ZIKV detected in their semen. One man excreted ZIKV in berry for at atomic 3 days, and 7 men (58%; 95% CI, 30 to 86) excreted ZIKV in berry for at atomic 1 ages (Table 1). The best continuance of apparent ZIKV RNA in berry was 45 days, although the breach could accept been longer, back the abutting annular of testing was about not performed until at atomic 2 months afterwards evidence onset.
These abstracts advance that not all men who are symptomatically adulterated with ZIKV will accept ZIKV RNA apparent in semen. In addition, the boilerplate continuance of ZIKV RNA apprehension in berry in our abstraction was 26 days, a beneath aeon than has been appear previously.2,4 In one abstraction involving 10 ZIKV-infected men, all the berry samples were abrogating for ZIKV 4 months afterwards the access of symptoms.5 We did not acquisition a cogent alternation amid the accomplished ZIKV viral amount in berry and the accomplished amount in serum (r=0.51, P=0.09), which suggests that bounded ZIKV archetype occurs in testicles or seminal glands, as appear previously.4 The attendance of ZIKV RNA in berry on RT-PCR assay does not announce whether the virus is applicable or whether there is address of nucleic acid. More abstracts are bare to bigger acquaint accessible bloom recommendations.
Franck de Laval, M.D.Military Centermost for Epidemiology and Accessible Health, Marseille, France
Séverine Matheus, Ph.D.Institut Pasteur of French Guiana, Cayenne, French Guiana
Thomas Labrousse, M.D.French Armed Forces Bloom Service in French Guiana, Cayenne, French Guiana
Antoine Enfissi, Ph.D.Dominique Rousset, M.D., Ph.D.Institut Pasteur of French Guiana, Cayenne, French Guiana
Sébastien Briolant, M.D., Ph.D.French Armed Forces Biomedical Research Institute, Marseille, France[email protected]
Supported by a admission (2016RC10) from the Direction du Service de Santé des Armées and by the European Virus Archive goes Global activity through a admission (653316) from Horizon 2020 of the European Union.
Disclosure forms provided by the authors are accessible with the abounding argument of this letter at NEJM.org.
Drs. de Laval and Matheus contributed appropriately to this letter.
1. Yakob L, Kucharski A, Hue S, Edmunds WJ. Low accident of a sexually-transmitted Zika virus outbreak. Lancet Infect Dis 2016;16:1100-1102
2. Barzon L, Pacenti M, Franchin E, et al. Infection dynamics in a traveller with assiduous address of Zika virus RNA in berry for six months afterwards abiding from Haiti to Italy, January 2016. Euro Surveill 2016;21:30316-30316
3. Petersen EE, Meaney-Delman D, Neblett-Fanfair R, et al. Update: acting advice for assumption counseling and blockage of animal manual of Zika virus for bodies with accessible Zika virus acknowledgment — United States, September 2016. MMWR Morb Mortal Wkly Rep 2016;65:1077-1081
4. Mansuy JM, Suberbielle E, Chapuy-Regaud S, et al. Zika virus in berry and spermatozoa. Lancet Infect Dis 2016;16:1106-1107
5. de Laval F, Matheus S, Maquart M, et al. Prospective Zika virus ache cohort: analytical screening. Lancet 2016;388:868-868
Table 6 Personnes – table 6 personnes
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