Prolonged Detection of Japanese Encephalitis Virus in Urine and Whole Blood in a Returned Short-term Traveler

Huang, G Khai Lin; Tio, Shio Yen; Caly, Leon; Nicholson, Suellen; Thevarajan, Irani; Papadakis, Georgina; Catton, Mike; Tong, Steven Y C; Druce, Julian

Given the results of serological testing, serial samples of plasma, whole blood, and urine were tested using the conventional gel based pan-flavivirus PCR and JEV real-time PCR. Notably, both urine and whole blood specimens were found to be persistently positive for JEV (confirmed by sequencing of the NS5 region), while plasma was found to be persistently negative (Figure 1 ). Reproducibility of these findings was confirmed by re-extracting and retesting the 4 most recent urine and whole blood specimens directly from the primary samples, and repeat testing was performed on separate PCR runs. Whole-genome sequencing and subsequent phylogenetic analysis (Supplementary Figure 1) identified the isolated JEV strain (VIDRL_JEV aligned) as a member of Genotype I. Our patient's isolate localized within a subclade of viruses isolated from Thailand, geographically aligning with the travel history.