Case Series of Laboratory-Associated Zika Virus Disease, United States, 2016–2019

Susan L. Hills; Andrea Morrison; Shawna Stuck; Kayleigh Sandhu; Krystal L. Mason; Danielle Stanek; Julie Gabel; Matthew A. Osborne; Betsy A. Schroeder; Edhelene Rico; Cherie L. Drenzek; Glen R. Gallagher; Jennifer Fiddner; Lea A. Heberlein-Larson; Catherine M. Brown; Marc Fischer

Disclosures

Emerging Infectious Diseases. 2021;27(5):1296-1300. 

In This Article

Abstract and Introduction

Abstract

Zika virus diagnostic testing and laboratory research increased considerably when Zika virus began spreading through the Americas in 2015, increasing the risk for potential Zika virus exposure of laboratory workers and biomedical researchers. We report 4 cases of laboratory-associated Zika virus disease in the United States during 2016–2019. Of these, 2 were associated with needlestick injuries; for the other 2 cases, the route of transmission was undetermined. In laboratories in which work with Zika virus is performed, good laboratory biosafety practices must be implemented and practiced to reduce the risk for infection among laboratory personnel.

Introduction

Zika virus is a flavivirus that was first isolated in 1947 from a rhesus macaque in the Zika Forest in Uganda. Zika virus is primarily transmitted to humans by infected mosquitoes, but other confirmed transmission modes include intrauterine, sexual, and intrapartum transmission, and probable modes include transmission through blood transfusion and breastfeeding.[1] Laboratory-associated infection also has been reported in a small number of cases; one of the earliest reports of human Zika virus infection was possibly laboratory-acquired.[2] A researcher was working in a Uganda laboratory in 1963 with Zika virus strains isolated from mosquitoes. After he experienced fever and rash, laboratory testing indicated Zika virus infection. However, no apparent breakdown in biosafety procedures was identified, and mosquitoborne transmission could not be excluded. In 1972, Zika virus infection in another laboratory worker occurred, this time in the absence of a potential mosquitoborne route of transmission.[3] The person was symptomatic, and infection was confirmed by virus isolation. He worked in an arboviral laboratory but no exposure that might have led to infection was reported. A 1980 report by the American Committee on Arthropod-borne Viruses, which documented results of global laboratory surveys conducted in 1976 and 1978, noted an additional 3 Zika virus disease cases in laboratory workers. The suspected sources of these infections were through the aerosol route or unknown, and further details were not provided.[4] Finally, a laboratory-acquired Zika virus infection occurred in 2017 in Brazil after an infected mouse bit a researcher's finger.[5]

Zika virus diagnostic testing and laboratory research increased considerably beginning in 2015 when Zika virus began spreading through the Americas, increasing the risk for potential Zika virus exposure for laboratory workers and researchers. We report 4 cases of laboratory-associated Zika virus disease in the United States during 2016–2019.

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