Download PDF
Semin Reprod Med 2016; 34(05): 285-292
DOI: 10.1055/s-0036-1592312
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Zika Virus in Semen: What We Know and What We Need to Know

Megan E. Gornet
1   The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Nabal J. Bracero
2   Department of Obstetrics and Gynecology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
,
James H. Segars
3   Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

Publication Date:
14 September 2016 (online)

    Permissions and Reprints

Abstract

The emergence of the Zika virus (ZIKV) epidemic in South and Central America has ascended to the forefront of international attention. While research regarding the effects and details surrounding ZIKV in pregnancy is well underway, especially related to blood-borne transmission, less attention has been devoted to ZIKV infection in semen and questions concerning implications of ZIKV infection in men. In this review, we present what is known and unknown, and the implications for localization of ZIKV to the male urogenital system. We examine the duration and viral load of ZIKV in semen, male and female transmission of ZIKV, the asymptomatic male carrier, and the consequences for assisted reproductive technology and sperm banking facilities. Furthermore, we discuss the potential for active ZIKV transmission in the United States as world travel continues to rise and the evolution and case history of ZIKV sexual transmission. We also review the current government-sponsored and reproductive society recommendations for managing sexual transmission of ZIKV and elucidate future research needs.

Keywords

Zika - semen - sexual transmission - male
 

  • References

  • 1 Center for Disease Control. Chikungunya virus in the United States. 2014 data. Available at: http://www.cdc.gov/chikungunya/geo/united-states-2014.html . Accessed July 16, 2016
    PubMedGoogle Scholar
  • 2 Pan American Health Organization. World Health Organization. Zika–Epidemiological Update. Available at: http://www.paho.org/hq/index.php . Accessed April 21, 2016
    PubMedGoogle Scholar
  • 3 Gao D, Lou Y, He D , et al. Prevention and control of Zika as a mosquito-borne and sexually transmitted disease: a mathematical modeling analysis. Sci Rep 2016; 6: 28070
    CrossrefPubMedGoogle Scholar
  • 4 Coelho FC, Durovni B, Saraceni V , et al. Sexual transmission causes a marked increase in the incidence of Zika in women in Rio de Janeiro, Brazil. Available at: http://biorxiv.org/content/early/2016/05/26/055459 . Accessed July 16, 2016
    PubMedGoogle Scholar
  • 5 Davidson A, Slavinski S, Komoto K, Rakeman J, Weiss D. Suspected female-to-male sexual transmission of Zika virus – New York City, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (28) 716-717
    CrossrefPubMedGoogle Scholar
  • 6 Center for Disease Control. Surveillance and control of Aedes aegypti and Aedes albopictus in the United States: estimated range of Aedes aegypti and Aedes albopictus in the United States. Available at: http://www.cdc.gov/chikungunya/resources/vector-control.html . Accessed July 16, 2016
    PubMedGoogle Scholar
  • 7 Center for Disease Control. Zika virus disease in the United States, 2015–2016. Available at: http://www.cdc.gov/zika . Accessed August 1, 2016
    PubMedGoogle Scholar
  • 8 Weaver SC, Costa F, Garcia-Blanco MA , et al. Zika virus: history, emergence, biology, and prospects for control. Antiviral Res 2016; 130: 69-80
    CrossrefPubMedGoogle Scholar
  • 9 Faye O, Freire CC, Iamarino A , et al. Molecular evolution of Zika virus during its emergence in the 20(th) century. PLoS Negl Trop Dis 2014; 8 (1) e2636
    CrossrefPubMedGoogle Scholar
  • 10 Foy BD, Kobylinski KC, Chilson Foy JL , et al. Probable non-vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis 2011; 17 (5) 880-882
    CrossrefPubMedGoogle Scholar
  • 11 Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis 2015; 21 (2) 359-361
    CrossrefPubMedGoogle Scholar
  • 12 Atkinson B, Hearn P, Afrough B , et al. Detection of Zika virus in semen. [letter] Emerg Infect Dis 2016; 22 (5) 940
    CrossrefPubMedGoogle Scholar
  • 13 Mansuy JM, Dutertre M, Mengelle C , et al. Zika virus: high infectious viral load in semen, a new sexually transmitted pathogen?. Lancet Infect Dis 2016; 16 (4) 405
    PubMedGoogle Scholar
  • 14 Venturi G, Zammarchi L, Fortuna C , et al. An autochthonous case of Zika due to possible sexual transmission, Florence, Italy, 2014. Euro Surveill 2016; 21 (8) 10.2807/1560-7917.ES.2016.21.8.30148
    PubMedGoogle Scholar
  • 15 D'Ortenzio E, Matheron S, Yazdanpanah Y , et al. Evidence of sexual transmission of Zika virus. N Engl J Med 2016; 374 (22) 2195-2198
    CrossrefPubMedGoogle Scholar
  • 16 Frank C, Cadar D, Schlaphof A , et al. Sexual transmission of Zika virus in Germany, April 2016. Euro Surveill 2016; 21 (23)
    PubMedGoogle Scholar
  • 17 Deckard DT, Chung WM, Brooks JT , et al. Male-to-male sexual transmission of Zika virus – Texas, January 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (14) 372-374
    CrossrefPubMedGoogle Scholar
  • 18 Fréour T, Mirallié S, Hubert B , et al. Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016. Euro Surveill 2016; 21 (23)
    PubMedGoogle Scholar
  • 19 Oster AM, Russell K, Stryker JE , et al. Update: interim guidance for prevention of sexual transmission of Zika virus—United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (12) 323-325
    CrossrefPubMedGoogle Scholar
  • 20 Lazear HM, Diamond MS. Zika virus: new clinical syndromes and its emergence in the western hemisphere. J Virol 2016; 90 (10) 4864-4875
    CrossrefPubMedGoogle Scholar
  • 21 Gourinat AC, O'Connor O, Calvez E, Goarant C, Dupont-Rouzeyrol M. Detection of Zika virus in urine. Emerg Infect Dis 2015; 21 (1) 84-86
    CrossrefPubMedGoogle Scholar
  • 22 Bingham AM, Cone M, Mock V , et al. Comparison of test results for Zika virus RNA in urine, serum, and saliva specimens from persons with travel-associated Zika virus disease - Florida, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (18) 475-478
    CrossrefPubMedGoogle Scholar
  • 23 Mansuy JM, Pasquier C, Daudin M , et al. Zika virus in semen of a patient returning from a non-epidemic area. Lancet Infect Dis 2016; 16 (8) 894-895
    PubMedGoogle Scholar
  • 24 Turmel JM, Abgueguen P, Hubert B , et al. Late sexual transmission of Zika virus related to persistence in the semen. Lancet 2016; 387 (10037) 2501
    CrossrefPubMedGoogle Scholar
  • 25 Deen GF, Knust B, Broutet N , et al. Ebola RNA persistence in semen of Ebola virus disease survivors - preliminary report. N Engl J Med 2015; DOI: 10.1056/NEJMoa1511410
    PubMedGoogle Scholar
  • 26 Habu A, Murakami Y, Ogasa A, Fujisaki Y. [Disorder of spermatogenesis and viral discharge into semen in boars infected with Japanese encephalitis virus (author's transl)]. Uirusu 1977; 27 (1) 21-26
    CrossrefPubMedGoogle Scholar
  • 27 Edwards MS, Popek EJ, Wise B, Hatzenbuehler L, Arunachalam AR, Hair AB. Ascending in utero herpes simplex virus infection in an initially healthy-appearing premature infant. Pediatr Dev Pathol 2015; 18 (2) 155-158
    CrossrefPubMedGoogle Scholar
  • 28 Driggers RW, Ho CY, Korhonen EM , et al. Zika virus infection with prolonged maternal viremia and fetal brain abnormalities. N Engl J Med 2016; 374 (22) 2142-2151
    CrossrefPubMedGoogle Scholar
  • 29 Tang H, Hammack C, Ogden SC , et al. Zika virus infects human cortical neural progenitors and attenuates their growth. Cell Stem Cell 2016; 18 (5) 587-590
    CrossrefPubMedGoogle Scholar
  • 30 International Trade Administration. National Travel and Tourism Office. 2014 U.S. Travel and Tourism Statistics (US. Resident Outbound Analysis)
    PubMedGoogle Scholar
  • 31 TSA prepared for millions of spring break travelers. Transportation Security Administration. 2016. Available at: https://www.tsa.gov/news/releases/2016/03/07/tsa-prepared-millions-spring-break-travelers . Accessed September 1, 2016
    PubMedGoogle Scholar
  • 32 Sifferlin A. CDC director talks challenges of fighting Zika [interview with Tom Frieden]. TIME. Available at: http://time.com/4230985/zika-virus-cdc-microcephaly/ . Accessed July 16, 2016
    PubMedGoogle Scholar
  • 33 Central Intelligence Agency. The World Factbook 2013–2014. Central America and Caribbean: Puerto Rico. Available at: https://www.cia.gov/library/publications/the-world-factbook/geos/rq.html . Accessed July 16, 2016
    PubMedGoogle Scholar
  • 34 Petersen EE, Polen KN, Meaney-Delman D , et al. Update: interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure – United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (12) 315-322
    CrossrefPubMedGoogle Scholar
  • 35 Brasil P, Pereira Jr JP, Raja Gabaglia C , et al. Zika virus infection in pregnant women in Rio de Janeiro - preliminary report. N Engl J Med 2016; DOI: 10.1056/NEJMoa1602412. [Epub ahead of print]
    PubMedGoogle Scholar
  • 36 World Health Organization, Pan American Health Organization. Presentation at the Bloomberg School of Public Health, John Hopkins University, Baltimore, MD. 2016
    PubMedGoogle Scholar
  • 37 Musso D, Cao-Lormeau VM, Gubler DJ. Zika virus: following the path of dengue and chikungunya?. Lancet 2015; 386 (9990) 243-244
    CrossrefPubMedGoogle Scholar
  • 38 Oster AM, Brooks JT, Stryker JE , et al. Interim guidelines for prevention of sexual transmission of Zika virus. United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (5) 120-121
    CrossrefPubMedGoogle Scholar
  • 39 Food and Drug Administration. Recommendations for donor screening, deferral, and product management to reduce the risk of transfusion-transmission of Zika virus. Available at: http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM486360.pdf . Accessed February 23, 2016
    PubMedGoogle Scholar
  • 40 Center for Disease Control. Update: Interim guidelines for prevention of sexual transmission of Zika virus – United States, 2016. CDC Health Alert Network; 2016
    Google Scholar
  • 41 Food and Drug Administration. Donor screening recommendations to reduce the risk of transmission of Zika virus by human cells, tissues, and cellular and tissue-based products. 2016 . Available at: http://www.fda.gov/downloads/biologicsbloodvaccines/guidancecomplianceregulatoryinformation/guidances/tissue/ucm488582.pdf . Accessed March 1, 2016
    PubMedGoogle Scholar
  • 42 Ball GD, Bracero N, Davis O , et al. Guidance for Providers Caring for Women and Men of Reproductive Age with Possible Zika Virus Exposure. American Society of Reproductive Medicine. Zika Guidance Task Force. April 7, 2016. Available at: https://www.asrm.org . Accessed August 1, 2016
    PubMedGoogle Scholar
  • 43 Brooks JT, Friedman A, Kachur RE, LaFlam M, Peters PJ, Jamieson DJ. Update: Interim guidance for prevention of sexual transmission of Zika virus - United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (29) 745-747
    CrossrefPubMedGoogle Scholar
  • 44 Rossi SL, Tesh RB, Azar SR , et al. Characterization of a novel murine model to study Zika virus. Am J Trop Med Hyg 2016; 94 (6) 1362-1369
    CrossrefPubMedGoogle Scholar
  • 45 Vestergaard BF, Scherer WF. An RNA viral infection of hamster testes and uteri resulting in orchitis and effects on fertility and reproduction. Am J Pathol 1971; 64 (3) 541-556
    PubMedGoogle Scholar
  • 46 Prisant N, Bujan L, Benichou H , et al. Zika virus in the female genital tract. [Letter] Lancet Infect Dis ;S1473-3099(16)30193-1. doi: 10.1016/S1473-3099(16)30193-1
    PubMedGoogle Scholar
  • 47 Dudley DM, Aliota MT, Mohr EL , et al. A rhesus macaque model of Asian-lineage Zika virus infection. Nat Commun 2016; 7: 12204
    CrossrefPubMedGoogle Scholar
  • 48 Thorson A, Formenty P, Lofthouse C, Broutet N. Systematic review of the literature on viral persistence and sexual transmission from recovered Ebola survivors: evidence and recommendations. BMJ Open 2016; 6 (1) e008859
    CrossrefPubMedGoogle Scholar
  • 49 Gardella B, Roccio M, Maccabruni A , et al. HIV shedding in cervico-vaginal secretions in pregnant women. Curr HIV Res 2011; 9 (5) 313-320
    CrossrefPubMedGoogle Scholar
  • 50 Duffy MR, Chen TH, Hancock WT , et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009; 360 (24) 2536-2543
    CrossrefPubMedGoogle Scholar
  • 51 Center for Disease Control. Zika virus. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. Available at: http://www.cdc.gov/zika/index.html . Accessed September 1, 2016
    PubMedGoogle Scholar
  • 52 World Health Organization. Zika virus, microcephaly, Guillain-Barré Syndrome. Situation report. 2016. Available at: http://apps.who.int/iris/bitstream/10665/249534/1/zikasitrep18Aug16-eng.pdf?ua=1 . Accessed September 1, 2016
    PubMedGoogle Scholar
  • 53 Merino O, Aguagüiña WE, Esponda P , et al. Protective effect of butylated hydroxytoluene on sperm function in human spermatozoa cryopreserved by vitrification technique. Andrologia 2015; 47 (2) 186-193
    CrossrefPubMedGoogle Scholar
  • 54 Elder K, Baker DJ, Ribes JA. Infections, infertility and assisted reproduction. Part II: Infections in reproductive medicine & Part III: Infections and the assisted reproductive laboratory. Cambridge UK: Cambridge University Press; 2005
    Google Scholar
  • 55 Fourie JM, Loskutoff N, Huyser C. Semen decontamination for the elimination of seminal HIV-1. Reprod Biomed Online 2015; 30 (3) 296-302
    CrossrefPubMedGoogle Scholar
  • 56 Halfon P, Giorgetti C, Khiri H , et al. Semen may harbor HIV despite effective HAART: another piece in the puzzle. PLoS ONE 2010; 5 (5) e10569
    CrossrefPubMedGoogle Scholar
  • 57 Magli MC, Van den Abbeel E, Lundin K, Royere D, Van der Elst J, Gianaroli L ; Committee of the Special Interest Group on Embryology. Revised guidelines for good practice in IVF laboratories. Hum Reprod 2008; 23 (6) 1253-1262
    CrossrefPubMedGoogle Scholar