Tereza Magalhaes1, Clarice N L Morais2, Iracema J A A Jacques3, Elisa A N Azevedo2, Ana M Brito3, Priscilla V Lima2, Gabriella M M Carvalho2, Andreza R S Lima2, Priscila M S Castanha4,5, Marli T Cordeiro2, Andre L S Oliveira6, Thomas Jaenisch7,8,9, Molly M Lamb7,8, Ernesto T A Marques4, Brian D Foy1. 1. Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Pathology and Immunology, Colorado State University, Fort Collins, Colorado, USA. 2. Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil. 3. Department of Collective Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil. 4. Infectious Disease and Microbiology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 5. Faculty of Medical Science, University of Pernambuco, Recife, Brazil. 6. Statistics and Geoprocessing Laboratory, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil. 7. Center for Global Health, University of Colorado School of Public Health, Aurora, Colorado, USA. 8. Department of Epidemiology, University of Colorado School of Public Health, Aurora, Colorado, USA. 9. Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany.
Abstract
BACKGROUND: Zika virus (ZIKV) is a mosquito-borne virus that is also transmitted sexually; however, the epidemiological relevance of ZIKV sexual transmission in endemic regions is unclear. METHODS: We performed a household-based serosurvey in Northeast Brazil to evaluate the differential exposure to ZIKV and chikungunya virus (CHIKV) among households. Individuals who participated in our previous arboviral disease cohort (indexes) were recontacted and enrolled, and their household members were newly enrolled. RESULTS: The relative risk of sexual partners being ZIKV-seropositive when living with a ZIKV-seropositive index participant was significantly higher, whereas this was not observed among nonsexual partners of the index. For CHIKV, both sexual and nonsexual partner household members living with a CHIKV-seropositive index had a significantly higher risk of being seropositive. In the nonindex-based dyadic and generalized linear mixed model analyses, the odds of sexual dyads having a concordant ZIKV plaque reduction neutralization test result was significantly higher. We have also analyzed retrospective clinical data according to the participants' exposure to ZIKV and CHIKV. CONCLUSIONS: Our data suggest that ZIKV sexual transmission may be a key factor for the high ZIKV seroprevalence among households in endemic areas and raises important questions about differential disease from the 2 modes of transmission.
BACKGROUND:Zika virus (ZIKV) is a mosquito-borne virus that is also transmitted sexually; however, the epidemiological relevance of ZIKV sexual transmission in endemic regions is unclear. METHODS: We performed a household-based serosurvey in Northeast Brazil to evaluate the differential exposure to ZIKV and chikungunya virus (CHIKV) among households. Individuals who participated in our previous arboviral disease cohort (indexes) were recontacted and enrolled, and their household members were newly enrolled. RESULTS: The relative risk of sexual partners being ZIKV-seropositive when living with a ZIKV-seropositive index participant was significantly higher, whereas this was not observed among nonsexual partners of the index. For CHIKV, both sexual and nonsexual partner household members living with a CHIKV-seropositive index had a significantly higher risk of being seropositive. In the nonindex-based dyadic and generalized linear mixed model analyses, the odds of sexual dyads having a concordant ZIKV plaque reduction neutralization test result was significantly higher. We have also analyzed retrospective clinical data according to the participants' exposure to ZIKV and CHIKV. CONCLUSIONS: Our data suggest that ZIKV sexual transmission may be a key factor for the high ZIKV seroprevalence among households in endemic areas and raises important questions about differential disease from the 2 modes of transmission.
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