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September 12, 2016: Zika May Spread from Infected Eyes

Zika virus is capable of infecting the eye, according to a new study. The study, in mice, helps explain why some people with Zika virus develop eye disease, and suggests that contact with infected eyes may play a role in spreading the disease.

“Researchers have found that Zika virus can live in eyes and have identified genetic material from the virus in tears, according to a study from Washington University School of Medicine in St. Louis. The study, in mice, helps explain why some Zika patients develop eye disease including a condition known as uveitis which can lead to permanent vision loss.

“The study, published Sept. 6 in Cell Reports, describes the effect of Zika virus infection in the eyes of mouse fetuses, newborns and adults. The researchers now are planning complementary studies in human patients infected with the virus.

“’Our study suggests that the eye could be a reservoir for Zika virus,” said Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine and one of the study’s senior authors. "We need to consider whether people with Zika have infectious virus in their eyes and how long it actually persists.’

“Zika virus causes mild disease in most adults but can cause brain damage and death in fetuses. About a third of all babies infected in utero with Zika show eye disease such as inflammation of the optic nerve, retinal damage or blindness after birth. In adults, Zika can cause conjunctivitis — redness and itchiness of the eyes — and, in rare cases, uveitis.

“To determine what effect Zika infection has on the eye, the researchers infected adult mice under the skin — similar to the way humans are infected by mosquitoes — and found live virus in the eyes seven days later. These observations confirm that Zika is able to travel to the eye. It is not yet known whether the virus typically makes that trip by crossing the blood-retina barrier that separates the eye from the bloodstream, traveling along the optic nerve that connects the brain and the eye, or some other route.

“Eye infection raises the possibility that people could acquire Zika infection through contact with tears from infected people. The researchers found that the tears of infected mice contained Zika’s RNA — the genetic material from the virus — but not infectious virus when tested 28 days after infection.

“‘Even though we didn’t find live virus in mouse tears, that doesn’t mean that it couldn’t be infectious in humans,” said Jonathan J. Miner, MD, PhD, an instructor in medicine and the study’s lead author. "There could be a window of time when tears are highly infectious and people are coming in contact with it and able to spread it.’

“The eye is an immune privileged site, meaning the immune system is less active there, to avoid accidentally damaging sensitive tissues responsible for vision in the process of fighting infection. Consequently, infections sometimes persist in the eye after they have been cleared from the rest of the body.”

Source: Washington University School of Medicine

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