Abstract
A widespread epidemic of Zika fever, caused by Zika virus (ZIKAV) has spread throughout the Pacific islands, the Americas and Southeast Asia. The increased incidences of ocular anomalies observed in ZIKAV-infected infants and adults may be associated with the rapid spread of ZIKAV. The objective of this study was to check if ZIKAV could be detected in human tears after the first week of infection. Twenty-nine patients with PCR confirmed ZIKAV infection during the Singapore August 2016 ZIKAV outbreak were enrolled for the study. Detection and quantification of ZIKAV RNA was performed on conjunctival swabs collected from both eyes of these patients at the late convalescent phase (30 days post-illness). Efficiency of viral isolation from swab samples was confirmed by the limit of detection (as low as 0.1 PFU/µL, equivalent to copy number of 4.9) in spiked swabs with different concentrations of ZIKAV (PFU/µL). Samples from three patients were found positive by qRT-PCR for ZIKAV and the viral RNA copy numbers detected in conjunctival swabs ranged from 5.2 to 9.3 copies respectively. ZIKAV could persist in the tears of infected patients for up to 30 days post-illness, and may therefore possess a potential public health risk of transmission.
Highlights
Zika virus (ZIKAV) is a mosquito-borne flavivirus which was first isolated in 1947 from a sentinel rhesus macaque in Uganda[1]
The re-emergence of ZIKAV has been associated with severe neurological complications: Guillain-Barré syndrome (GBS) in French Polynesia[12, 13] and microcephaly in Brazil[14,15,16]
We describe the detection of ZIKAV RNA from conjunctival swab samples of laboratory-confirmed ZIKAV cases collated during the 2016 ZIKAV outbreak in Singapore
Summary
Zika virus (ZIKAV) is a mosquito-borne flavivirus which was first isolated in 1947 from a sentinel rhesus macaque in Uganda[1]. ZIKAV has remained in relative obscurity for nearly 60 years until the unprecedented 2007 outbreak in the Western Pacific island of Yap Federated States of Micronesia[2]. This was followed by a larger epidemic in French Polynesia in 2013 and 20143. In an earlier report from China, ZIKAV was found on swabs from the conjunctiva (superficial mucosa covering the globe)[22]. It was unclear if ZIKAV could be localized after the first week of infection. We describe the detection of ZIKAV RNA from conjunctival swab samples of laboratory-confirmed ZIKAV cases collated during the 2016 ZIKAV outbreak in Singapore
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