Persistent Zika Virus Detection in Semen in a Traveler Returning to the United Kingdom from Brazil, 2016

Katherine M. Gaskell; Catherine Houlihan; Eleni Nastouli; Anna M. Checkley


Emerging Infectious Diseases. 2017;23(1) 

In This Article

Abstract and Introduction


Zika virus is normally transmitted by mosquitos, but cases of sexual transmission have been reported. We describe a patient with symptomatic Zika virus infection in whom the virus was detected in semen for 92 days. Our findings support recommendations for 6 months of barrier contraceptive use after symptomatic Zika virus infection.


Zika virus is a mosquito-transmitted flavivirus that was first isolated from mosquitos in the Zika Forest in Uganda. Since its introduction into Brazil in May 2015, the virus has spread rapidly through the Americas, and transmission is now widespread in South America, Central America, the Caribbean, the Pacific islands, Singapore, and Thailand.[1] The virus is transmitted mainly by Aedes aegypti mosquitos and causes symptoms in ≈20% of persons infected,[2] usually manifesting as a mild illness consisting of fever, arthralgia, myalgia, conjunctivitis, and pruritic rash. Infection in pregnancy can lead to congenital Zika syndrome, which consists of multiple developmental abnormalities, including microcephaly and cerebral calcification, and fetal loss. Zika virus infection is also associated with Guillain-Barré syndrome.[3]

Although by far the most common route of Zika virus transmission is by mosquito, the virus can also be transmitted sexually (from male to female, female to male, and male to male).[4–8] Zika virus RNA has been detected in semen and vaginal fluid.[9–12] We describe a case in which Zika virus persisted in semen for 92 days after symptom onset.