Zika virus shedding in semen of symptomatic infected men

Paul S. Mead, Nisha K. Duggal, Sarah A. Hook, Mark Delorey, Marc Fischer, Dana Olzenak McGuire, Heidi Becksted, Ryan J. Max, Michael Anishchenko, Amy M. Schwartz, Wen Pin Tzeng, Christina A. Nelson, Erin M. McDonald, John T. Brooks, Aaron Brault, Alison F. Hinckley

Research output: Contribution to journalArticle

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Abstract

BACKGROUND Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that has been linked to adverse birth outcomes. Previous reports have shown that person-to-person transmission can occur by means of sexual contact. METHODS We conducted a prospective study involving men with symptomatic ZIKV infection to determine the frequency and duration of ZIKV shedding in semen and urine and to identify risk factors for prolonged shedding in these fluids. Specimens were obtained twice per month for 6 months after illness onset and were tested by realtime reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for ZIKV RNA and by Vero cell culture and plaque assay for infectious ZIKV. RESULTS A total of 1327 semen samples from 184 men and 1038 urine samples from 183 men were obtained 14 to 304 days after illness onset. ZIKV RNA was detected in the urine of 7 men (4%) and in the semen of 60 (33%), including in semen samples from 22 of 36 men (61%) who were tested within 30 days after illness onset. ZIKV RNA shedding in semen decreased substantially during the 3 months after illness onset but continued for 281 days in 1 man (1%). Factors that were independently associated with prolonged RNA shedding included older age, less frequent ejaculation, and the presence of certain symptoms at the time of initial illness. Infectious ZIKV was isolated from 3 of 78 semen samples with detectable ZIKV RNA, all obtained within 30 days after illness onset and all with at least 7.0 log10 ZIKV RNA copies per milliliter of semen. CONCLUSIONS ZIKV RNA was commonly present in the semen of men with symptomatic ZIKV infection and persisted in some men for more than 6 months. In contrast, shedding of infectious ZIKV appeared to be much less common and was limited to the first few weeks after illness onset. (Funded by the Centers for Disease Control and Prevention.)

Original languageEnglish (US)
Pages (from-to)1377-1385
Number of pages9
JournalNew England Journal of Medicine
Volume378
Issue number15
DOIs
StatePublished - Apr 12 2018
Externally publishedYes

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Virus Shedding
Semen
RNA
Sick Leave
Urine
Zika Virus
Flavivirus
Ejaculation
Vero Cells
Centers for Disease Control and Prevention (U.S.)
Culicidae
Reverse Transcriptase Polymerase Chain Reaction
Cell Culture Techniques

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mead, P. S., Duggal, N. K., Hook, S. A., Delorey, M., Fischer, M., McGuire, D. O., ... Hinckley, A. F. (2018). Zika virus shedding in semen of symptomatic infected men. New England Journal of Medicine, 378(15), 1377-1385. https://doi.org/10.1056/NEJMoa1711038

Zika virus shedding in semen of symptomatic infected men. / Mead, Paul S.; Duggal, Nisha K.; Hook, Sarah A.; Delorey, Mark; Fischer, Marc; McGuire, Dana Olzenak; Becksted, Heidi; Max, Ryan J.; Anishchenko, Michael; Schwartz, Amy M.; Tzeng, Wen Pin; Nelson, Christina A.; McDonald, Erin M.; Brooks, John T.; Brault, Aaron; Hinckley, Alison F.

In: New England Journal of Medicine, Vol. 378, No. 15, 12.04.2018, p. 1377-1385.

Research output: Contribution to journalArticle

Mead, PS, Duggal, NK, Hook, SA, Delorey, M, Fischer, M, McGuire, DO, Becksted, H, Max, RJ, Anishchenko, M, Schwartz, AM, Tzeng, WP, Nelson, CA, McDonald, EM, Brooks, JT, Brault, A & Hinckley, AF 2018, 'Zika virus shedding in semen of symptomatic infected men', New England Journal of Medicine, vol. 378, no. 15, pp. 1377-1385. https://doi.org/10.1056/NEJMoa1711038
Mead PS, Duggal NK, Hook SA, Delorey M, Fischer M, McGuire DO et al. Zika virus shedding in semen of symptomatic infected men. New England Journal of Medicine. 2018 Apr 12;378(15):1377-1385. https://doi.org/10.1056/NEJMoa1711038
Mead, Paul S. ; Duggal, Nisha K. ; Hook, Sarah A. ; Delorey, Mark ; Fischer, Marc ; McGuire, Dana Olzenak ; Becksted, Heidi ; Max, Ryan J. ; Anishchenko, Michael ; Schwartz, Amy M. ; Tzeng, Wen Pin ; Nelson, Christina A. ; McDonald, Erin M. ; Brooks, John T. ; Brault, Aaron ; Hinckley, Alison F. / Zika virus shedding in semen of symptomatic infected men. In: New England Journal of Medicine. 2018 ; Vol. 378, No. 15. pp. 1377-1385.
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abstract = "BACKGROUND Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that has been linked to adverse birth outcomes. Previous reports have shown that person-to-person transmission can occur by means of sexual contact. METHODS We conducted a prospective study involving men with symptomatic ZIKV infection to determine the frequency and duration of ZIKV shedding in semen and urine and to identify risk factors for prolonged shedding in these fluids. Specimens were obtained twice per month for 6 months after illness onset and were tested by realtime reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for ZIKV RNA and by Vero cell culture and plaque assay for infectious ZIKV. RESULTS A total of 1327 semen samples from 184 men and 1038 urine samples from 183 men were obtained 14 to 304 days after illness onset. ZIKV RNA was detected in the urine of 7 men (4{\%}) and in the semen of 60 (33{\%}), including in semen samples from 22 of 36 men (61{\%}) who were tested within 30 days after illness onset. ZIKV RNA shedding in semen decreased substantially during the 3 months after illness onset but continued for 281 days in 1 man (1{\%}). Factors that were independently associated with prolonged RNA shedding included older age, less frequent ejaculation, and the presence of certain symptoms at the time of initial illness. Infectious ZIKV was isolated from 3 of 78 semen samples with detectable ZIKV RNA, all obtained within 30 days after illness onset and all with at least 7.0 log10 ZIKV RNA copies per milliliter of semen. CONCLUSIONS ZIKV RNA was commonly present in the semen of men with symptomatic ZIKV infection and persisted in some men for more than 6 months. In contrast, shedding of infectious ZIKV appeared to be much less common and was limited to the first few weeks after illness onset. (Funded by the Centers for Disease Control and Prevention.)",
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AU - Mead, Paul S.

AU - Duggal, Nisha K.

AU - Hook, Sarah A.

AU - Delorey, Mark

AU - Fischer, Marc

AU - McGuire, Dana Olzenak

AU - Becksted, Heidi

AU - Max, Ryan J.

AU - Anishchenko, Michael

AU - Schwartz, Amy M.

AU - Tzeng, Wen Pin

AU - Nelson, Christina A.

AU - McDonald, Erin M.

AU - Brooks, John T.

AU - Brault, Aaron

AU - Hinckley, Alison F.

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N2 - BACKGROUND Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that has been linked to adverse birth outcomes. Previous reports have shown that person-to-person transmission can occur by means of sexual contact. METHODS We conducted a prospective study involving men with symptomatic ZIKV infection to determine the frequency and duration of ZIKV shedding in semen and urine and to identify risk factors for prolonged shedding in these fluids. Specimens were obtained twice per month for 6 months after illness onset and were tested by realtime reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for ZIKV RNA and by Vero cell culture and plaque assay for infectious ZIKV. RESULTS A total of 1327 semen samples from 184 men and 1038 urine samples from 183 men were obtained 14 to 304 days after illness onset. ZIKV RNA was detected in the urine of 7 men (4%) and in the semen of 60 (33%), including in semen samples from 22 of 36 men (61%) who were tested within 30 days after illness onset. ZIKV RNA shedding in semen decreased substantially during the 3 months after illness onset but continued for 281 days in 1 man (1%). Factors that were independently associated with prolonged RNA shedding included older age, less frequent ejaculation, and the presence of certain symptoms at the time of initial illness. Infectious ZIKV was isolated from 3 of 78 semen samples with detectable ZIKV RNA, all obtained within 30 days after illness onset and all with at least 7.0 log10 ZIKV RNA copies per milliliter of semen. CONCLUSIONS ZIKV RNA was commonly present in the semen of men with symptomatic ZIKV infection and persisted in some men for more than 6 months. In contrast, shedding of infectious ZIKV appeared to be much less common and was limited to the first few weeks after illness onset. (Funded by the Centers for Disease Control and Prevention.)

AB - BACKGROUND Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that has been linked to adverse birth outcomes. Previous reports have shown that person-to-person transmission can occur by means of sexual contact. METHODS We conducted a prospective study involving men with symptomatic ZIKV infection to determine the frequency and duration of ZIKV shedding in semen and urine and to identify risk factors for prolonged shedding in these fluids. Specimens were obtained twice per month for 6 months after illness onset and were tested by realtime reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay for ZIKV RNA and by Vero cell culture and plaque assay for infectious ZIKV. RESULTS A total of 1327 semen samples from 184 men and 1038 urine samples from 183 men were obtained 14 to 304 days after illness onset. ZIKV RNA was detected in the urine of 7 men (4%) and in the semen of 60 (33%), including in semen samples from 22 of 36 men (61%) who were tested within 30 days after illness onset. ZIKV RNA shedding in semen decreased substantially during the 3 months after illness onset but continued for 281 days in 1 man (1%). Factors that were independently associated with prolonged RNA shedding included older age, less frequent ejaculation, and the presence of certain symptoms at the time of initial illness. Infectious ZIKV was isolated from 3 of 78 semen samples with detectable ZIKV RNA, all obtained within 30 days after illness onset and all with at least 7.0 log10 ZIKV RNA copies per milliliter of semen. CONCLUSIONS ZIKV RNA was commonly present in the semen of men with symptomatic ZIKV infection and persisted in some men for more than 6 months. In contrast, shedding of infectious ZIKV appeared to be much less common and was limited to the first few weeks after illness onset. (Funded by the Centers for Disease Control and Prevention.)

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