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Challenges for molecular and serological ZIKV infection confirmation

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Abstract

Background

Zika Virus (ZIKV), member of Flaviviridae family and Flavivirus genus, has recently emerged as international public health emergency after its association with neonatal microcephaly cases. Clinical diagnosis hindrance involves symptom similarities produced by other arbovirus infections, therefore laboratory confirmation is of paramount importance.

Discussion

The most reliable test available is based on ZIKV RNA detection from body fluid samples. However, short viremia window periods and asymptomatic infections diminish the success rate for RT-PCR positivity. Beyond molecular detection, all serology tests in areas where other Flavivirus circulates proved to be a difficult task due to the broad range of cross-reactivity, especially with dengue pre-exposed individuals.

Conclusion

Altogether, lack of serological diagnostic tools brings limitations to any retrospective evaluation. Those studies are central in the context of congenital infection that could occur asymptomatically and mask prevalence and risk rates.

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Acknowledgements

We thank Fernandes Figueira Institute Pediatric Infectious Disease Team for helpful discussions during this work and field expertise from ZIKVIRUSIFF Cohort study registered on clinicaltrials.gov with identifier NCT03255369.

Funding

This work was supported by Fernandes Figueira Institute Research Program (Programa de Incentivo a Pesquisa II), Rio de Janeiro State Research Grant (Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro—grant E-26/201.840/2017), National Research Grant (Conselho Nacional de Desenvolvimento Científico e Tecnológico—grant 441098/2016-9), and CAPES/FIOCRUZ fellowship (Plano Brasil sem Miséria).

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Authors and Affiliations

  1. Fernandes Figueira Institute, Fiocruz, Avenida Rui Barbosa 716, Flamengo, Rio de Janeiro, 22250-020, Brazil

    Zilton Farias Meira de Vasconcelos, Nathália Thompson, Leonardo Gomes, Letícia Guida & Maria Elisabeth Lopes Moreira

  2. Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Renata Campos Azevedo

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  1. Zilton Farias Meira de Vasconcelos
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Correspondence to Zilton Farias Meira de Vasconcelos.

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de Vasconcelos, Z.F.M., Azevedo, R.C., Thompson, N. et al. Challenges for molecular and serological ZIKV infection confirmation. Childs Nerv Syst 34, 79–84 (2018). https://doi.org/10.1007/s00381-017-3641-5

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