Excretion of infectious Zika virus in urine

FC Zhang, XF Li, YQ Deng, YG Tong… - The Lancet Infectious …, 2016 - thelancet.com
FC Zhang, XF Li, YQ Deng, YG Tong, CF Qin
The Lancet Infectious Diseases, 2016thelancet.com
Zika virus unexpectedly emerged in the Americas in 2015, and its continuous spread into
more countries is anticipated. On Feb 12, 2016, a Chinese man aged 28 years, returning
from Venezuela to Guangzhou, China, was diagnosed with Zika virus by the Chinese Center
for Disease Control and Prevention (the second imported case to mainland China). The
patient had fever (38· 5 C), sore throat, conjunctival injection and facial redness, and
massive maculopapular rashes on the trunk and limbs. CT scanning revealed enlarged …
Zika virus unexpectedly emerged in the Americas in 2015, and its continuous spread into more countries is anticipated. On Feb 12, 2016, a Chinese man aged 28 years, returning from Venezuela to Guangzhou, China, was diagnosed with Zika virus by the Chinese Center for Disease Control and Prevention (the second imported case to mainland China). The patient had fever (38· 5 C), sore throat, conjunctival injection and facial redness, and massive maculopapular rashes on the trunk and limbs. CT scanning revealed enlarged lymph nodes in the armpit (appendix). Decreased white blood cell count (3· 45× 109 per L) was recorded on day 4. The patient made a rapid recovery and was discharged on Feb 25, 2016 (timelines are shown in figure A). Viraemia could only be detected on day 2 after the disease onset by realtime RT-PCR, although persistent shedding of high loads of Zika virus RNA in urine was detected until 13 days after the onset of symptoms (figure B). The full genome sequence of Zika virus (GenBank number KU740184) was compiled by highthroughput sequencing of RNA directly recovered from mixed urine specimens. Serial serum and urine specimens positive for Zika virus RNA were used to inoculate Vero cells and 2-day-old suckling Balb/C mice, and a Zika strain (named GZ01) was finally obtained from urine collected on day 4. GZ01 grew well in mosquito C6/36 cells with a peak titre of about 10⁶ plaque forming units per mL. Immunofluorescence staining showed GZ01 was reactive to the convalescent serum from the patient. Zika virusspecific IgM and IgG antibodies appeared on days 5 and 7, respectively (figure C). A plaque reduction neutralisation test showed anti-Zika neutralisation titres reached 1/80 on day 13. The full genome of GZ01 was then obtained by routine Sanger sequencing (number KU820898).
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