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

Authors

  • Tania Regina Tozetto-Mendoza Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Vivian Iida Avelino-Silva Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias https://orcid.org/0000-0002-6660-3088
  • Silvia Fonseca Hospital São Francisco
  • Ingra Morales Claro Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias
  • Anderson Vicente de Paula Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Anna Sara Levin Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Ester Cerdeira Sabino Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Maria Cassia Mendes-Correa Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Walter Manso Figueiredo Universidade de São Paulo, Faculdade de Saúde Pública, Serviço Especial de Saúde de Araraquara
  • Alvina Clara Felix Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Nathalia C. Santiago Souza Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Angela Aparecida Costa Universidade de São Paulo, Faculdade de Saúde Pública, Serviço Especial de Saúde de Araraquara
  • Marta Inenami Universidade de São Paulo, Faculdade de Saúde Pública, Serviço Especial de Saúde de Araraquara
  • Rosangela M. Gasparetto da Silva Universidade de São Paulo, Faculdade de Saúde Pública, Serviço Especial de Saúde de Araraquara
  • José Eduardo Levi Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Camila Malta Romano Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Glaucia Paranhos-Baccalà Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Aluisio Cotrim Segurado Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo
  • Philippe Mayaud London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases

DOI:

https://doi.org/10.1590/S1678-9946201961019

Keywords:

Zika virus, Differential diagnosis, Kinetics, Body fluids, Polymerase chain reaction, Real-Time Polymerase Chain Reaction, Serology, Brazil

Abstract

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.

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Published

2019-04-01

Issue

Section

Original Articles

How to Cite

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. (2019). Revista Do Instituto De Medicina Tropical De São Paulo, 61, e19. https://doi.org/10.1590/S1678-9946201961019