Imported Zika virus infections in Hungary between 2016 and 2018

Orsolya Nagy, Anna Nagy, Szilvia Tóth, Bernadett Pályi, Anita Vargáné Koroknai, Mária Takács

Research output: Contribution to journalArticle


Zika virus is a mosquito-borne flavivirus with significant public health concern due to its association with neurological symptoms and intrauterine malformations. Although it is endemic in tropical and subtropical areas, sexual transmission raises the possibility of autochthonous spreading elsewhere. We describe the first laboratory diagnosed imported Zika-infections of Hungary, to highlight the challenges of microbiological identification of the pathogen, caused by serological cross-reactivity and short viremia. Serological examination was carried out using indirect immunofluorescent assay and enzyme-linked immunosorbent assay. Plaque-reduction neutralization test was used for verification purposes. A wide range of clinical specimens: serum, whole-blood, urine, saliva, and semen were analyzed by molecular methods, and sequencing was applied in case of PCR positive results to identify the virus strain. Zika-infected patients with previous vaccination against flaviviruses or possible flavivirus infection in the past showed high serological cross-reactivity, and even cross-neutralizing antibodies were observed. Zika virus RNA could be detected in urine specimen in case of two patients, and in EDTA-anticoagulated whole-blood sample of one patient. The detected strains belong to the Asian lineage of the virus. We presume that serological investigation of imported Zika virus could be altered by infections, vaccination of endemic flaviviruses in Hungary and vice versa.

Original languageEnglish
Pages (from-to)423-442
Number of pages20
JournalActa microbiologica et immunologica Hungarica
Issue number4
Publication statusPublished - Jan 1 2019


  • Phylogenetic tree
  • Serological cross-reactivity
  • Zika cases

ASJC Scopus subject areas

  • Immunology and Microbiology(all)

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