@article{31785,
  keywords = {Neglected tropical diseases (NTDs), Zika virus, Nicaragua},
  author = {Burger-Calderon R and Gonzalez K and Ojeda S and Zambrana JV and Sanchez N and Cerpas Cruz C and Suazo Laguna H and Bustos F and Plazaola M and Lopez Mercado B and Elizondo D and Arguello S and Carey Monterrey J and Nuñez A and Coloma J and Waggoner JJ and Gordon A and Kuan G and Balmaseda A and Harris E},
  title = {Zika virus infection in Nicaraguan households.},
  abstract = {<p>Zika virus (ZIKV) infection recently caused major epidemics in the Americas and is linked to congenital birth defects and Guillain-Barré Syndrome. A pilot study of ZIKV infection in Nicaraguan households was conducted from August 31 to October 21, 2016, in Managua, Nicaragua. We enrolled 33 laboratory-confirmed Zika index cases and their household members (109 contacts) and followed them on days 3-4, 6-7, 9-10, and 21, collecting serum/plasma, urine, and saliva specimens along with clinical, demographic, and socio-economic status information. Collected samples were processed by rRT-PCR to determine viral load (VL) and duration of detectable ZIKV RNA in human bodily fluids. At enrollment, 11 (10%) contacts were ZIKV rRT-PCR-positive and 23 (21%) were positive by IgM antibodies; 3 incident cases were detected during the study period. Twenty of 33 (61%) index households had contacts with ZIKV infection, with an average of 1.9 (range 1-6) positive contacts per household, and in 60% of these households, ≥50% of the members were positive for ZIKV infection. Analysis of clinical information allowed us to estimate the symptomatic to asymptomatic (S:A) ratio of 14:23 (1:1.6) among the contacts, finding 62% of the infections to be asymptomatic. The maximum number of days during which ZIKV RNA was detected was 7 days post-symptom onset in saliva and serum/plasma and 22 days in urine. Overall, VL levels in serum/plasma, saliva, and urine specimens were comparable, with means of 5.6, 5.3 and 4.5 log10 copies/ml respectively, with serum attaining the highest VL peak at 8.1 log10 copies/ml. Detecting ZIKV RNA in saliva over a similar time-period and level as in serum/plasma indicates that saliva could potentially serve as a more accessible diagnostic sample. Finding the majority of infections to be asymptomatic emphasizes the importance of silent ZIKV transmission and helps inform public health interventions in the region and globally.</p>
},
  year = {2018},
  journal = {PLoS neglected tropical diseases},
  volume = {12},
  pages = {e0006518},
  issn = {1935-2735},
  url = {http://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006518&type=printable},
  doi = {10.1371/journal.pntd.0006518},
  language = {eng},
}