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Volume 22, Number 5—May 2016

Detection of Zika Virus in Semen

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To the Editor: As an increasing number of autochthonous Zika virus infections are reported from several South America countries (1), we read with interest the report from Musso et al. on the potential sexual transmission of Zika virus (2). We report additional evidence for this potential route of transmission after identification of an imported case of infection into the United Kingdom.

After an outbreak alert for Zika in French Polynesia, active screening was implemented at Public Health England (Porton Down, United Kingdom). In 2014, a 68-year-old man had onset of fever, marked lethargy, and an erythematous rash 1 week after returning from the Cook Islands. Serum samples taken 3 days into the febrile illness tested negative for dengue and chikungunya viruses by real-time reverse transcription PCR (rRT-PCR). Test results for dengue virus IgM and chikungunya virus IgM also were negative; a test result for dengue virus IgG was indeterminate.

An rRT-PCR test result for Zika virus (3) was positive and indicated a crossing threshold value of 35 cycles. This low viral load, commonly observed even in the acute phase of disease (3), meant that attempts to obtain sequence data were unsuccessful. Convalescent-phase serum, urine, and semen samples were requested; only semen was positive for Zika virus by rRT-PCR, at 27 and 62 days after onset of febrile illness. These results demonstrated stronger signals than those obtained in tests of the original serum sample, with crossing threshold values of 29 and 33 cycles, respectively. Zika virus–specific plaque reduction neutralization test results were positive on convalescent-phase serum samples.

Although we did not culture infectious virus from semen, our data may indicate prolonged presence of virus in semen, which in turn could indicate a prolonged potential for sexual transmission of this flavivirus. Moreover, these findings could inform decisions regarding what control methods are implemented and which specimen types are best suited for diagnostic detection.


Barry AtkinsonComments to Author , Pasco Hearn, Babak Afrough, Sarah Lumley, Daniel Carter, Emma J. Aarons, Andrew J. Simpson, Timothy J. Brooks, and Roger Hewson
Author affiliations: Public Health England, Porton Down, UK (B. Atkinson, P. Hearn, B. Afrough, S. Lumley, D. Carter, E.J. Aarons, A.J. Simpson, T.J. Brooks, R. Hewson); National Institute for Health Research, Liverpool, UK (T.J. Brooks, R. Hewson)



  1. Pan American Health Organization. Reported increase of congenital microcephaly and other central nervous system symptoms—epidemiological update [cited 2016 Feb 4].
  2. Musso  D, Roche  C, Robin  E, Nhan  T, Teissier  A, Cao-Lormeau  V-M. Potential sexual transmission of Zika virus. Emerg Infect Dis. 2015;21:35961. DOIPubMedGoogle Scholar
  3. Lanciotti  RS, Kosoy  OL, Laven  JJ, Velez  JO, Lambert  AJ, Johnson  AJ, Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008;14:12329.PubMedGoogle Scholar


Cite This Article

DOI: 10.3201/eid2205.160107

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Barry Atkinson, Public Health England, Porton Manor Farm Rd, Salisbury SP4 0JG, UK

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Page created: April 14, 2016
Page updated: April 14, 2016
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.