Novel Testing to Elucidate Reproductive Outcomes of ZIKV Infection - Olympics 2016

寨卡病毒（ZIKV）是一种蚊子传播的黄病毒，在美洲出现，截至2016年4月，在包括巴西在内的30个国家和地区发现了当地传播。大多数感染寨卡病毒的人（80%）无症状，寨卡病毒可能通过性传播，使可能没有旅行过的人处于危险之中。寨卡病毒的母胎传播也有记录。2016年4月，美国疾病控制和预防中心证实，胎儿感染寨卡病毒是导致小头畸形和其他严重脑部异常的原因，这些畸形会导致存活婴儿永久发病。关于寨卡病毒感染仍存在许多问题，包括寨卡病毒通过体液性传播或围产期传播的持续时间和可能性；寨卡病毒感染者的短期和长期生殖结果；以及有症状或无症状寨卡病毒感染的男女所生婴儿的结局。犹他大学与美国奥林匹克委员会（USOC）合作，为计划在巴西举行的2016年夏季奥运会和残奥会做准备，巴西是美洲寨卡病毒爆发的中心。该伙伴关系的重点是了解寨卡病毒感染的动态，以便更好地保护参加2016年奥运会的运动员和工作人员的健康。这种伙伴关系也为研究提供了一个特殊的机会，有可能回答FOA PAR-16-106“寨卡病毒并发症的快速评估（R21）”确定的许多重要研究问题。美国奥委会提议的队列是独一无二的，因为它包括有兴趣在奥运会后怀孕的育龄男性和女性。他们与美国奥委会的持续关系为纵向研究提供了一个机会，这将对包括美国在内的美洲以及其他面临寨卡病毒出现的地理区域产生巨大的好处。目的1)通过抗体检测确定2016年奥运会和残奥会期间随美国奥委会（USOC）前往巴西的运动员、教练员、工作人员和其他人员及其性伴侣中寨卡病毒感染的发生率和危险因素；目标2a)利用新型PCR技术，确定在可能与寨卡病毒性传播或围产期传播相关的特定体液（包括血液、唾液、精液和阴道分泌物）中检测寨卡病毒核酸的持续时间；目标2b)评估寨卡病毒感染者一年的生殖结果，包括避孕和怀孕。

Zika virus (ZIKV) is a mosquito-borne flavivirus that has emerged in the Americas with local transmission identified in 30 countries and territories as of April 2016, including Brazil. Most persons (80%) with ZIKV infection are asymptomatic and ZIKV may be sexually transmitted, placing individuals who may not have travelled at risk. Maternal-fetal transmission of ZIKV has also been documented. In April 2016, the US Centers for Disease Control and Prevention confirmed that fetal infection with ZIKV was the cause of microcephaly and other severe brain anomalies that result in permanent morbidity in surviving infants. Many questions remain regarding ZIKV infection, including the duration and potential for sexual or perinatal transmission of ZIKV from body fluids; the short and long-term reproductive outcomes of individuals infected with ZIKV; and the outcomes for infants born to men and women with either symptomatic or asymptomatic ZIKV infection. The University of Utah partnered with the United States Olympic Committee (USOC) to prepare for the 2016 Summer Olympic and Paralympic Games scheduled to occur in Brazil, the epicenter of the ZIKV outbreak in the Americas. The partnership focuses on understanding the dynamics of ZIKV infection in order to better protect the health of athletes and staff who will participate in the 2016 Games. This partnership also offers an exceptional opportunity for research that has the potential to answer many of the important research questions identified by the FOA PAR-16-106 “Rapid Assessment of ZIKV Complications (R21).” The proposed USOC cohort is unique in that it includes men and women in their reproductive years who are interested in conceiving after the Games. Their ongoing relationship with the USOC offers an opportunity for longitudinal study that will be of enormous benefit to the Americas, including the US, and to other geographic areas facing the emergence of ZIKV. We propose the following Specific Aims: Aim 1) Determine incidence of and risk factors for ZIKV infection in a cohort of athletes coaches, staff, other personnel traveling to Brazil with the US Olympic Committee (USOC) as part of the 2016 Olympic and Paralympic games and their sexual partners through antibody testing; Aim 2a) Determine in ZIKV infected individuals, the duration of ZIKV nucleic acid detection in specific body fluids that may be associated with sexual or perinatal transmission of the virus including blood, saliva, semen, and vaginal secretions using novel PCR technology; and Aim 2b) Evaluate the reproductive outcomes of ZIKV infected individuals for one year including contraceptive use and pregnancy.