Autor(es):
Tozetto-Mendoza, Tania Regina ; Avelino-Silva, Vivian Iida ; Fonseca, Silvia ; Claro, Ingra Morales ; Paula, Anderson Vicente de ; Levin, Anna Sara ; Sabino, Ester Cerdeira ; Mendes-Correa, Maria Cassia ; Figueiredo, Walter Manso ; Felix, Alvina Clara ; Souza, Nathalia C. Santiago ; Costa, Angela Aparecida ; Inenami, Marta ; Silva, Rosangela M. Gasparetto da ; Levi, José Eduardo ; Romano, Camila Malta ; Paranhos-Baccalà, Glaucia ; Segurado, Aluisio Cotrim ; Mayaud, Philippe
Data: 2019
Origem: Oasisbr
Assunto(s): Zika virus; Differential diagnosis; Kinetics; Body fluids; Polymerase chain reaction; Real-Time Polymerase Chain Reaction; Serology; Brazil
Descrição
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.
