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The page below is a sample from the LabCE course Zika Virus: Overview and Laboratory Testing. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Overview: Diagnosis and Testing

The diagnosis of a Zika virus infection is based on a patient’s clinical features, places and dates of travel, and activities. Clinical symptoms, if present, typically begin two to seven days after being bitten by an infected mosquito or after contacting the Zika virus from other transmission sources. Since clinical symptoms and features may be absent, minimal, or mimic other types of viral infections, a definitive diagnosis is usually made by laboratory testing of serum or urine for viral nucleic acid or virus-specific immunoglobulin M (IgM) and neutralizing antibodies.
The CDC and the WHO have issued certain guidelines and criteria for diagnosing Zika virus infections in symptomatic and non-symptomatic individuals, as well as other individuals at higher risk, such as pregnant women and those individuals traveling to high exposure geographical areas.
Laboratory testing for congenital Zika virus infection is recommended for:
  • Infants born to mothers with laboratory evidence of Zika virus infection during pregnancy
  • Infants who have abnormal clinical findings suggestive of congenital Zika virus syndrome and a maternal epidemiologic link suggesting possible transmission (regardless of maternal Zika virus test results)
It is important to note that the CDC and several state and local health departments are presently testing for Zika virus. Different diagnostic tests are available to help determine if a person is infected with Zika virus disease. Healthcare providers are asked to contact their state or local health department to facilitate testing. In addition, the FDA has issued Emergency Use Authorization (EUA) status for several Zika virus diagnostic tests for distribution to qualified laboratories. More details on EUA testing will be provided in the next section of this course.
Currently, the CDC sends all test results to the appropriate state or local health department and in turn the state or local health department forwards test results to the referring physician. Test reports are then given to the patient by the referring physician.
Testing of specimens within the United States to determine possible Zika virus infection should be limited to specimens collected from patients meeting the CDC’s clinical and epidemiological criteria for testing. Information on clinical signs and symptoms (https://www.cdc.gov/zika/symptoms/index.html) associated with Zika virus infection is available. It is important to note that Zika virus infection can cause signs and symptoms similar to those seen in patients with dengue and chikungunya virus infections.
Additional information on the CDC guidelines on Zika virus testing will be presented in another section of this course.