Detection of Zika Virus and Human Papilloma Virus in Cervical Cytology Samples using Two Real Time PCR Based Techniques in Ecuadorian Women diagnosed with ASCUS.

OBJECTIVE: Atypical Squamous Cells of Undetermined Significance(ASCUS) is the most reported result on pap smears. It is most commonly related to Human Papillomavirus (HPV) infections. However, other pathogens (EBV, Chlamydia) have been reported on cervical samples with abnormal results. Zika virus(ZIKV) has been found to induce cellular abnormalities on different tissues and its presence has been identified on genital secretions. METHODS: Two real-time PCR has been made on cervical samples from the gynecological service of a third level hospital on Guayaquil-Ecuador. This work was part of a bigger study of ZIKV presence on different body fluids. RESULTS: From 89 samples obtained, 19 received an ASCUS result. From these 5 were positive for ZIKV and 5 were positive for HPV, there were no co infections. CONCLUSION: Given the presence of ZIKV RNA and the absence of HPV DNA on cervical samples diagnosed as ASCUS, it might be plausible that ZIKV could be a triggering factor for the induction of cellular changes observed on these cells.

High incidence of Zika virus infection detected in plasma and cervical cytology specimens from pregnant women in Guayaquil, Ecuador.

Zika virus (ZIKV) infection during pregnancy has been linked to severe birth defects, and the epidemiologic situation of the ZIKV epidemic in Ecuador is poorly understood. Guayaquil, Ecuador, has a tropical climate and experiences frequent outbreaks of dengue and chikungunya virus, and in December 2015, ZIKV was identified. Given the well-documented effects of ZIKV in pregnancy, including microcephaly, we tested for the presence of ZIKV in both plasma and cervical cytology of pregnant women. We report the identification of a population of pregnant women with a high incidence of ZIKV infection detected in the plasma and lower reproductive tract. A case-control study was performed to determine the incidence of ZIKV infection among low-income, pregnant women at risk for preterm delivery compared to matched controls. Plasma and cervical cytology specimens were tested for ZIKV by rRT-PCR. Fifty-nine pregnant women were enrolled. The incidence of ZIKV was 54% (32/59) overall: 18/31 (58.1%) in cases and 14/28 (50.0%) in controls. ZIKV detection in plasma and cervical cytology specimens demonstrated good agreement. Overall, outcomes for neonates born to ZIKV-positive and ZIKV-negative mothers were similar. However, two neonates were born with microcephaly to case mothers who were ZIKV positive. We report a high incidence of ZIKV infection (54%) in a distinctive population in Guayaquil, Ecuador. We identify ZIKV in cervical samples that correlates with ZIKV in the plasma. These data raise concerns regarding the breadth of the ZIKV epidemic in Ecuador and demonstrate the utility of cervical cytology specimens for ZIKV testing.

Zika Virus and Chikungunya Virus CoInfections: A Series of Three Cases from a Single Center in Ecuador.

Zika virus (ZIKV) and chikungunya virus (CHIKV) cocirculate throughout much of the tropical Western Hemisphere; however, few cases of coinfection with these two pathogens have been reported. Herein, we describe three cases of ZIKV-CHIKV coinfection detected at a single center in Ecuador: a patient who developed symptoms on postoperative day 5 from an orthopedic procedure, a woman who had traveled to Ecuador for fertility treatment, and a woman who was admitted for Guillain-Barré syndrome and had ZIKV and CHIKV detected in serum and cerebrospinal fluid. All cases were diagnosed using a multiplex real-time reverse transcription polymerase chain reaction, and ZIKV viremia was detected as late as 16 days after symptom onset. These cases demonstrate the varied clinical presentation of ZIKV-CHIKV coinfections as well as the importance of multiplexed arboviral testing for these pathogens.