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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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Summary and Recommendations (continued)

  • The CDC recommends that if a NAT such as rRT-PCR testing for Zika virus is negative on serum and urine, then serum IgM antibody testing for Zika virus infections should be performed. Typically, a positive rRT-PCR result on any specimen will confirm a Zika virus infection. Usually, no additional testing is required. However, a negative rRT-PCR result does not exclude the Zika virus infection, therefore, the serum should then be analyzed by a serological test for the Zika virus IgM antibody.
  • Serum must be submitted for all patients to be tested for Zika virus infection. Serum can be used if testing for both the IgM antibody methods and the molecular methods for Zika RNA. Urine can be tested, but is to be done alongside a patient-matched serum specimen by molecular methods for Zika virus RNA only if the method has been validated for this specimen type. Antibody testing of urine is not recommended.
  • 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, and for 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.
  • The FDA has issued EUA status for several Zika virus diagnostic tests for distribution to qualified laboratories. 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.
  • The CDC requires that samples with presumptive positive, equivocal, or inconclusive IgM test results for the Zika virus must be forwarded for confirmation by PRNT.
  • For the prevention of Zika virus infection, the CDC recommends that individuals prevent mosquito bites, plan for travel to other countries by checking where Zika virus outbreaks occur, and use protection during sex.
  • To minimize and prevent Zika virus transmission from blood transfusions, the US FDA recently issued a revised guidance recommending universal testing of donated whole blood and blood components for the Zika virus in the United States and its territories.
  • Currently, there is no specific medicine for the treatment of a Zika virus infection nor is there a vaccine to prevent the infection. Instead, treatment usually involves controlling and treating the symptoms of the infection. Many drugs are being studied for potential therapies for Zika infection and considerable efforts are underway to develop a Zika vaccine. A drug (niclosamide) already on the market as a treatment for tapeworm, has been found to have antiviral properties that inhibit the Zika virus from replicating.
  • For updates on the Zika virus transmission routes, travel advisories, testing details, symptomology/treatments, and other relevant items, one should consult both the CDC’s and FDA’s web portals for the Zika virus.