Laboratory findings in Zika infection: The experience of a reference centre in North-West Italy

• Published in: Journal of clinical virology 2018-04, Vol.101, p.18-22
• Main Authors: Burdino, Elisa, Milia, Maria Grazia, Allice, Tiziano, Gregori, Gabriella, Ruggiero, Tina, Calleri, Guido, Lipani, Filippo, Lucchini, Anna, Venturi, Giulietta, Di Perri, Giovanni, Ghisetti, Valeria
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Americas; Antibodies, Viral - blood; Blood; Female; Fever; Humans; Italy; Male; Real time RT-PCR; RNA, Viral - genetics; Travel - statistics & numerical data; Travelers; Urine; Young Adult; Zika virus; Zika Virus - genetics; Zika Virus - immunology; Zika Virus - isolation & purification; Zika Virus Infection - blood; Zika Virus Infection - diagnosis; Zika Virus Infection - transmission; Zika Virus Infection - urine
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2018.01.010

•IKV imported infection was identified in 13 patients (11.6%), 12 travelers and the sexual partner of a traveler, in Piemonte, Italy North West (January–September 2016).•ZIKV RNA was detected in the blood in 4 out of 9 patients within 7 days from symptom onset and in 5 patients in urine. ZIKV IgM was reactive in 9 patients.•The sensitivity of two real time PCR assays was probed against the reference strain ZIKV virus H/PF/2013; for specificity, QCMD controls were used.•Febrile travelers are sentinels of a rapidly changing epidemiology. Zika virus (ZIKV) remains a public health concern due to its association with fetal malformation and neurologic disease. To report a reference centre experience on ZIKA virus (ZIKV) infection in travelers from epidemic countries from January 1 to September, 30, 2016 in Italy North-West (a geographic area covering 4.424 million inhabitants, corresponding to almost 73% of Italy North-West area). One hundred and twelve febrile travelers were studied to rule out a tropical fever [e.g. malaria, dengue (DENV), chikungunya (CHIKV), West Nile (WNV) and ZIKV]. Molecular tests for detecting ZIKV RNA were applied on serum or urine as well as IgG and IgM specific serology. ZIKV was the most frequent “tropical infection (11.6%) with 12 infected travelers and one sexual partner of an infected traveler. At the time of the diagnosis, ZIKV RNA was detected in the blood from 9 patients (69%) within 7 days from symptom onset; afterwards, the virus was detected only in urine (5 patients) and ZIKV IgM was reactive in 9 patients (69%). Travelers with ZIKV infection tested negative for DENV, CHIKV, WNV and malaria and completely recovered. Other infections identified in travelers were DENV (5 patients, 4.5%), CHIKV (1, 0.9%), malaria (Plasmodium vivax, 1, 0.9%), measles (1, 0.9%) and tuberculosis (1, 0.9%). The etiologic diagnosis of a febrile illness in travelers where ZIKV is endemic is highly desirable as they are sentinel of a challenging epidemiology including the risk of autochthonous transmission in non endemic countries where the competent or carrier vector is present.