Zika virus (ZIKV) is present in urine, saliva, tears, and breast milk, but the transmission risk associated with these body fluids is currently unknown. We evaluated the risk of ZIKV transmission through mucosal contact in rhesus macaques. Application of high-dose ZIKV directly to the tonsils of 3 rhesus macaques resulted in detectable plasma viremia in all animals by 2 days post-exposure; virus replication kinetics were similar to those observed in animals infected subcutaneously. Three additional macaques inoculated subcutaneously with ZIKV served as saliva donors to assess the transmission risk from contact with oral secretions from an infected individual. Seven naive animals repeatedly exposed to donor saliva via the conjunctivae, tonsils, or nostrils did not become infected. Our results suggest that there is a risk of ZIKV transmission via the mucosal route, but that the risk posed by oral secretions from individuals with a typical course of ZIKV infection is low.

Oropharyngeal mucosal transmission of Zika virus in rhesus macaques