Abstract
Data on the duration of detectable Zika virus–specific IgM in infected persons are limited. Neutralizing antibody cross-reactivity occurs between Zika virus and related flaviviruses, but the degree to which this confounds diagnosis is uncertain. We tested serum specimens collected 12–19 months after illness onset from patients with confirmed Zika virus disease for Zika virus IgM and Zika virus and dengue virus neutralizing antibodies. Among 62 participants, 45 (73%) had detectable Zika virus IgM and 12 (19%) had an equivocal result. Although all patients tested had Zika virus neutralizing antibodies, 39 (63%) also had neutralizing antibodies against dengue virus; of those, 12 (19%) had <4-fold difference between Zika virus and dengue virus titers, and 5 (8%) had dengue virus titer >4-fold higher than Zika virus titer. Prolonged detection of IgM and neutralizing antibody cross-reactivity make it difficult to determine the timing of Zika virus infection and differentiate between related flaviviruses.
Highlights
Data on the duration of detectable Zika virus–specific IgM in infected persons are limited
Zika virus is a flavivirus closely related to dengue, West Nile, Japanese encephalitis, and yellow fever viruses [1,2]
RNA detection is most sensitive during the acute phase of illness and confirms Zika virus infection, but sensitivity declines after the first week of illness and a negative result does not exclude infection
Summary
Data on the duration of detectable Zika virus–specific IgM in infected persons are limited. We collected serum specimens from patients with Zika virus infection confirmed by molecular testing to determine the proportion of patients with detectable Zika virus IgM and the ratio of Zika virus and dengue virus neutralizing antibodies at 12–19 months after their acute illness. Methods Eligible participants were residents of Miami–Dade County, Florida, USA, who had Zika virus disease confirmed by real-time reverse transcription PCR (rRT-PCR) and symptom onset during June–October 2016.
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