• Adrián Sánchez-Montalvá, Diana Pou, Elena Sulleiro, Fernando Salvador, Cristina Bocanegra, Begoña Treviño, Ariadna Rando, Núria Serre, Tomàs Pumarola, Benito Almirante, and Israel Molina.
• Tropical Medicine Unit, Infectious Diseases Department, PROSICS (International Health Program of the Catalan Health Institute), Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
• Trop. Med. Int. Health. 2018 Jan 1; 23 (1): 92-100.

ObjectiveTo understand Zika virus (ZIKV) dynamics in fluids of infected individuals and the risk of sexual transmission.MethodsProspective study at two centres in Spain. Patients with probable or confirmed diagnosis of ZIKV infection were clinically followed up, and fluid samples were collected from saliva, serum, urine and semen or vaginal secretion following the study protocol. Non-traveller-sexual partners were offered to participate.ResultsFrom January 2016 to December 2016, we included a total of 11 traveller patients and six sexual contacts. Six patients were male, with a median age of 38 years (IQR 30-45). We performed 61 RT-PCR determinations, seven of which were positive. Positive results were retrieved from serum, urine, semen and vaginal tract. One of four women tested positive for ZIKV RNA in vaginal swabs collected during the first 45 days after symptoms onset. Clearance occurred between day 37 and day 69 after symptoms onset. One of five men tested positive for ZIKV RNA in semen collected during the first 45 days after symptoms onset. Clearance occurred between day 23 and 107 after symptoms onset. Six patients had sexual relations during the defined period. All tested patients were negative for ZIKV infection by serological testing.ConclusionZIKV shedding persistence in genital fluids occurs in a significant number of symptomatic patients after visiting an endemic area. We did not find any ZIKV seroconversion among the three male contacts who were investigated. Diagnostic algorithms may be updated to include genital tract fluid specimens in the diagnostic process.© 2017 John Wiley & Sons Ltd.

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