Detection of Zika Virus in Urine - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC
Volume 21, Number 1—January 2015
Detection of Zika Virus in Urine
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.
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).
- Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952;46:509–20.
- Haddow AJ, Williams MC, Woodall JP, Simpson DI, Goma LK. Twelve isolations of Zika virus from Aedes (Stegomyia) africanus (Theobald) taken in and above a Uganda forest. Bull World Health Organ. 1964;31:57–69 .
- Wong PS, Li MZ, Chong CS, Ng LC, Tan CH. Aedes (Stegomyia) albopictus (Skuse): a potential vector of Zika virus in Singapore. PLoS Negl Trop Dis.2013;7:e2348.
- Hayes EB. Zika virus outside Africa. Emerg Infect Dis. 2009;15:1347–50.
- Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009;360:2536–43.
- Kwong JC, Druce JD, Leder K. Zika virus infection acquired during brief travel to Indonesia. Am J Trop Med Hyg. 2013;89:516–7 and.
- Foy BD, Kobylinski KC, Chilson Foy JL, Blitvich BJ, Travassos da Rosa A, Haddow AD, Probable non-vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis. 2011;17:880–2.
- Oehler E, Watrin L, Larre P, Leparc-Goffart I, Lastere S, Valour F, Zika virus infection complicated by Guillain-Barré syndrome - case report, French Polynesia, December 2013. Euro Surveill. 2014;19:20720 .
- Cao-Lormeau VM, Roche C, Teissier A, Robin E, Berry AL, Mallet HP, Zika virus, French Polynesia, South Pacific, 2013. Emerg Infect Dis.2014;20:1085–6.
- Health situation in New Caledonia—Zika, 2014 [in French] [cited 2014 Sep 9].http://www.dass.gouv.nc/portal/page/portal/dass/observatoire_sante/veille_sanitaire/Zika
- Lanciotti RS, Kosoy OL, Laven JJ, Velez JO, Lambert AJ, Johnson AJ, Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008;14:1232–9.
- Kuno G, Chang GJ, Tsuchiya KR, Karabatsos N, Cropp CB. Phylogeny of the genus Flavivirus. J Virol. 1998;72:73–83 .
- Kutsuna S, Kato Y, Takasaki T, Moi M, Kotaki A, Uemura H, Two cases of Zika fever imported from French Polynesia to Japan, December 2013 to January 2014. Euro Surveill. 2014;19:20683 .
- Hirayama T, Mizuno Y, Takeshita N, Kotaki A, Tajima S, Omatsu T, Detection of dengue virus genome in urine by real-time reverse transcriptase PCR: a laboratory diagnostic method useful after disappearance of the genome in serum. J Clin Microbiol. 2012;50:2047–52.
- Barzon L, Pacenti M, Franchin E, Pagni S, Martello T, Cattai M, Excretion of West Nile virus in urine during acute infection. J Infect Dis.2013;208:1086–92 .
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
1These authors contributed equally to this article.