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An unusual aspect of the Zika virus is that, in addition to being mosquito-borne, it can be transmitted sexually — a modality estimated to account for 23% of all infections in endemic regions. In a previous prospective study of 184 men with symptomatic illness, Zika virus RNA was found in the semen of 33% and continued to be detectable 90 days later in 21% (NEJM JW Infect Dis Jun 2018 and N Engl J Med 2018 Apr 12; 378:1377).
To examine why some individuals shed Zika virus RNA for prolonged periods and others do not, samples from the previous study were further characterized. Twenty-six long-term shedders (>78 days) were compared with 23 short-term shedders (<22 days). Long-term shedders had significantly higher semen leukocyte concentrations…