Materiały źródłowe

• #1 Zika Virus Diagnosis | NIAID: National Institute of Allergy and Infectious Diseases

  https://www.niaid.nih.gov/diseases-conditions/zika-diagnosis

  Accurate diagnostic tests for Zika virus infection are needed to distinguish it from other flavivirus infections and to identify women who have been infected with Zika virus during pregnancy and may be at risk for developing fetal complications. […] Currently, Zika virus often can be detected during the acute phase of infection and up to 14 days after the onset of symptoms using diagnostic tests for viral RNA. […] Prior Zika infection can be detected by antibody-based tests, however, these tests may also detect or cross-react with antibodies against other flaviviruses, particularly dengue virus. […] NIAID is working toward the development of improved Zika virus diagnostic tests by supporting its scientists and grantees to generate antibodies that can distinguish between Zika virus and dengue virus.

• #2 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Diagnostic testing for Zika virus infection and disease can be accomplished using both molecular and serologic methods. […] NAAT assays are the preferred method of diagnosis because they can provide confirmed evidence of infection. […] A negative NAAT does not exclude recent Zika infection. For this reason, Zika virus immunoglobulin (Ig) M antibody testing is recommended in certain situations. […] IgM testing is complicated by cross-reactive antibodies to other flaviviruses, which might make conclusive determination of which flavivirus is responsible for the person’s recent infection difficult. […] False-positive results are more common with IgM than NAAT and can occur due to non-specific reactivity or cross-reactivity with other flaviviruses. […] PRNTs may resolve false-positive IgM antibody results caused by non-specific reactivity and help identify the infecting virus.

• #3

  https://www.who.int/news-room/fact-sheets/detail/zika-virus

  Infection with Zika virus may be suspected based on symptoms of persons living in or visiting areas with Zika virus transmission and/or Aedes mosquito vectors. A diagnosis of Zika virus infection can only be confirmed by laboratory tests of blood or other body fluids, and it must be differentiated from cross-reactive related flaviviruses such as dengue virus, to which the patient may have been exposed or previously vaccinated. […] Most people infected with Zika virus do not develop symptoms. Among those who do, they typically start 3-14 days after infection, are generally mild including rash, fever, conjunctivitis, muscle and joint pain, malaise and headache, and usually last for 2-7 days. These symptoms are common to other arboviral and non-arboviral diseases; thus, the diagnosis of Zika virus infection requires laboratory confirmation.

• #4

  https://www.who.int/news-room/fact-sheets/detail/zika-virus

  Infection with Zika virus may be suspected based on symptoms of persons living in or visiting areas with Zika virus transmission and/or Aedes mosquito vectors. A diagnosis of Zika virus infection can only be confirmed by laboratory tests of blood or other body fluids, and it must be differentiated from cross-reactive related flaviviruses such as dengue virus, to which the patient may have been exposed or previously vaccinated. […] Most people infected with Zika virus do not develop symptoms. Among those who do, they typically start 3-14 days after infection, are generally mild including rash, fever, conjunctivitis, muscle and joint pain, malaise and headache, and usually last for 2-7 days. These symptoms are common to other arboviral and non-arboviral diseases; thus, the diagnosis of Zika virus infection requires laboratory confirmation.

• #5 Testing for Zika | Zika Virus | CDC

  https://www.cdc.gov/zika/testing/index.html

  To determine if you have Zika virus disease (Zika), your healthcare provider will ask about recent travel and symptoms you are experiencing. […] Your healthcare provider may order blood or urine tests to help determine if you have Zika. […] Testing should take place as soon as possible, while you still have symptoms. […] Testing for Zika is recommended if: […] Testing is no longer routinely recommended if you are pregnant and are not experiencing symptoms of Zika. However, after talking with your doctor, testing may be considered if you traveled to an area with an active CDC Zika Travel Health Notice or current or past Zika virus transmission. […] Testing for Zika to determine if it is safe to get pregnant is not recommended. […] To determine if you have Zika, a doctor or other healthcare provider will ask about recent travel and symptoms you are experiencing. […] Testing may include a molecular test, which looks for presence of the virus in the body or serological testing which looks for antibodies your body makes to fight infection. […] Testing should take place as soon as possible, while you still have symptoms.

• #6 Updating Zika Diagnostic Methods: The Point-of-Care Approach

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762020000600344

  Molecular methods are based on ZIKV genome detection and generally target highly conserved regions, such as UTR 5 and 3 regions, or partial sequences of E, C, NS1, NS3m or NS5. […] After RT-PCR, one of the most commonly used molecular methods is RT-LAMP. […] Several research groups have used this technique for ZIKV detection, evaluating the compatibility with different types of samples such as serum, urine, and saliva. […] Another technique that can be used in PoC is RT-RPA, where the capacity to detect different ZIKV strains has been tested, showing a 100% specificity and 83% sensitivity using clinical samples (serum, whole blood, urine, and semen). […] A detection strategy based on electrochemical immunosensors has been developed for the early stage of the disease. […] This type of method can be adapted to PoC devices, as it requires few components.

• #7 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Diagnostic testing for Zika virus infection and disease can be accomplished using both molecular and serologic methods. […] NAAT assays are the preferred method of diagnosis because they can provide confirmed evidence of infection. […] A negative NAAT does not exclude recent Zika infection. For this reason, Zika virus immunoglobulin (Ig) M antibody testing is recommended in certain situations. […] IgM testing is complicated by cross-reactive antibodies to other flaviviruses, which might make conclusive determination of which flavivirus is responsible for the person’s recent infection difficult. […] False-positive results are more common with IgM than NAAT and can occur due to non-specific reactivity or cross-reactivity with other flaviviruses. […] PRNTs may resolve false-positive IgM antibody results caused by non-specific reactivity and help identify the infecting virus.

• #8 Zika Virus Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/zika-virus-test/

  A Zika virus test looks for signs of a Zika virus infection in a sample of your blood or urine (pee). […] If general, Zika virus testing is mostly used to diagnose a Zika infection if you: […] There are two types of tests are used to check for Zika infections: […] A PCR test (polymerase chain reaction) is a common type of molecular test that checks for the Zika virus in a sample of your blood or urine. This test is recommended if you’re pregnant. […] A Zika virus test usually uses a sample of your blood or urine. […] You don’t any special preparations for a Zika virus test. […] If you have a negative Zika virus result: […] On a molecular test, such as a PCR test, it means that you probably don’t have a Zika infection. […] If you have a positive Zika virus test result: […] On a molecular test, such as a PCR test, it means that you most likely have a Zika infection. […] If you are pregnant or planning to become pregnant, you should avoid traveling in areas where Zika infection is a risk.

• #9 Zika Virus Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/zika-virus-test/

  A Zika virus test looks for signs of a Zika virus infection in a sample of your blood or urine (pee). […] If general, Zika virus testing is mostly used to diagnose a Zika infection if you: […] There are two types of tests are used to check for Zika infections: […] A PCR test (polymerase chain reaction) is a common type of molecular test that checks for the Zika virus in a sample of your blood or urine. This test is recommended if you’re pregnant. […] A Zika virus test usually uses a sample of your blood or urine. […] You don’t any special preparations for a Zika virus test. […] If you have a negative Zika virus result: […] On a molecular test, such as a PCR test, it means that you probably don’t have a Zika infection. […] If you have a positive Zika virus test result: […] On a molecular test, such as a PCR test, it means that you most likely have a Zika infection. […] If you are pregnant or planning to become pregnant, you should avoid traveling in areas where Zika infection is a risk.

• #10 SciELO Brazil – Clinical and laboratory diagnosis of Zika fever: an update Clinical and laboratory diagnosis of Zika fever: an update

  https://www.scielo.br/j/jbpml/a/7JQjQNpTWzYFqczTxgLHzmK/

  The molecular tests are direct; they determine the multiplication of viral particles (RNA) and amplify the genetic material to find the pathogen. The polymerase chain reaction (PCR) can detect the virus at the beginning of the disease, around four to seven days after the onset of symptoms. Acute infections by ZIKV can be detected by real-time (RT) PCR within the first seven days after the onset of symptoms, but it has also been detected in patients on the 11th day of illness. […] The search for circulating antibodies could be performed by different techniques such as ELISA, indirect immunofluorescence and by rapid immunochromatography test. […] Immunoglobulin class M (IgM) antibody detection characterizes acute infection. It must be performed around the third day of infection and may be detected between the 2nd and 12th weeks of the supposed exposure in endemic areas.

• #11 SciELO Brazil – Clinical and laboratory diagnosis of Zika fever: an update Clinical and laboratory diagnosis of Zika fever: an update

  https://www.scielo.br/j/jbpml/a/7JQjQNpTWzYFqczTxgLHzmK/

  Zika fever can be defined as an acute febrile viral illness, mainly transmitted by the mosquito of the genus Aedes. […] The laboratory investigation is more important in cases suspected of ZIKV infection that have evolved with neurological complications, in pregnant women, abortion or congenital malformations, and is a key part for diagnostic definition. Real-time polymerase chain reaction (RT-PCR) can detect the virus in blood samples about four to seven days after the onset of symptoms. In urine, it is possible to identify viral ribonucleic acid (RNA) up to 15 days after clinical onset, even if viremia has ceased, and it is an alternative for late diagnosis. […] Laboratory diagnosis is fundamental for the definitive diagnosis. ZIKV infection may be detected in blood and urine tests, based on indirect techniques such as enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence and immunochromatography, with determination of circulating antibodies. Also, it is possible to detect the ZIKV through a molecular methodology.

• #12 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluenc.com/dam/medpolicies/healthybluenc/active/guidelines/gl_pw_c194119.html

  For persons with suspected ZIKV disease, a positive RT-PCR result confirms ZIKV infection, but a negative result does not exclude infection. […] If IgM test results are positive, equivocal, or inconclusive, performing a plaque reduction neutralization test (PRNT) is needed to confirm the diagnosis. […] On the basis of the available data, the CDC recommended that ZIKV RT-PCR be performed on urine collected 14 days after onset of symptoms in individuals with suspected ZIKV disease. […] The most recent CDC key recommendations (December 9, 2019) are as follows: Pregnant women with recent possible ZIKV exposure and symptoms of ZIKV disease should be tested to diagnose the cause of their symptoms. […] Non-pregnant symptomatic individuals with possible exposure to ZIKV should receive testing of serum and urine by ZIKV RNA, NAT and ZIKV and/or dengue virus IgM testing of serum.

• #13 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluenc.com/dam/medpolicies/healthybluenc/active/guidelines/gl_pw_c194119.html

  Laboratory confirmation of ZIKV is considered the following: Presence of ZIKV RNA or antigen in serum or other samples (e.g. saliva, tissues, urine, whole blood); or IgM antibody against ZIKV positive and PRNT90 for ZIKV with titre 20 and ZIKV PRNT90 titre ratio 4 compared to other flaviviruses. […] For persons with suspected ZIKV disease, a positive RT-PCR result confirms ZIKV infection, and no antibody testing is indicated. However, because of the decline in the level of viremia over time and possible inaccuracy in reporting of dates of illness onset, a negative RT-PCR result does not exclude ZIKV infection. […] Without confirmatory PRNTs, it is not possible to determine whether a presumptive positive IgM antibody result against ZIKV reflects recent flavivirus infection or a false-positive result.

• #14 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Diagnostic testing for Zika virus infection and disease can be accomplished using both molecular and serologic methods. […] NAAT assays are the preferred method of diagnosis because they can provide confirmed evidence of infection. […] A negative NAAT does not exclude recent Zika infection. For this reason, Zika virus immunoglobulin (Ig) M antibody testing is recommended in certain situations. […] IgM testing is complicated by cross-reactive antibodies to other flaviviruses, which might make conclusive determination of which flavivirus is responsible for the person’s recent infection difficult. […] False-positive results are more common with IgM than NAAT and can occur due to non-specific reactivity or cross-reactivity with other flaviviruses. […] PRNTs may resolve false-positive IgM antibody results caused by non-specific reactivity and help identify the infecting virus.

• #15 SciELO Brazil – Clinical and laboratory diagnosis of Zika fever: an update Clinical and laboratory diagnosis of Zika fever: an update

  https://www.scielo.br/j/jbpml/a/7JQjQNpTWzYFqczTxgLHzmK/

  The molecular tests are direct; they determine the multiplication of viral particles (RNA) and amplify the genetic material to find the pathogen. The polymerase chain reaction (PCR) can detect the virus at the beginning of the disease, around four to seven days after the onset of symptoms. Acute infections by ZIKV can be detected by real-time (RT) PCR within the first seven days after the onset of symptoms, but it has also been detected in patients on the 11th day of illness. […] The search for circulating antibodies could be performed by different techniques such as ELISA, indirect immunofluorescence and by rapid immunochromatography test. […] Immunoglobulin class M (IgM) antibody detection characterizes acute infection. It must be performed around the third day of infection and may be detected between the 2nd and 12th weeks of the supposed exposure in endemic areas.

• #16 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Diagnostic testing for Zika virus infection and disease can be accomplished using both molecular and serologic methods. […] NAAT assays are the preferred method of diagnosis because they can provide confirmed evidence of infection. […] A negative NAAT does not exclude recent Zika infection. For this reason, Zika virus immunoglobulin (Ig) M antibody testing is recommended in certain situations. […] IgM testing is complicated by cross-reactive antibodies to other flaviviruses, which might make conclusive determination of which flavivirus is responsible for the person’s recent infection difficult. […] False-positive results are more common with IgM than NAAT and can occur due to non-specific reactivity or cross-reactivity with other flaviviruses. […] PRNTs may resolve false-positive IgM antibody results caused by non-specific reactivity and help identify the infecting virus.

• #17 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Diagnostic testing for Zika virus infection and disease can be accomplished using both molecular and serologic methods. […] NAAT assays are the preferred method of diagnosis because they can provide confirmed evidence of infection. […] A negative NAAT does not exclude recent Zika infection. For this reason, Zika virus immunoglobulin (Ig) M antibody testing is recommended in certain situations. […] IgM testing is complicated by cross-reactive antibodies to other flaviviruses, which might make conclusive determination of which flavivirus is responsible for the person’s recent infection difficult. […] False-positive results are more common with IgM than NAAT and can occur due to non-specific reactivity or cross-reactivity with other flaviviruses. […] PRNTs may resolve false-positive IgM antibody results caused by non-specific reactivity and help identify the infecting virus.

• #18 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Diagnostic testing for Zika virus infection and disease can be accomplished using both molecular and serologic methods. […] NAAT assays are the preferred method of diagnosis because they can provide confirmed evidence of infection. […] A negative NAAT does not exclude recent Zika infection. For this reason, Zika virus immunoglobulin (Ig) M antibody testing is recommended in certain situations. […] IgM testing is complicated by cross-reactive antibodies to other flaviviruses, which might make conclusive determination of which flavivirus is responsible for the person’s recent infection difficult. […] False-positive results are more common with IgM than NAAT and can occur due to non-specific reactivity or cross-reactivity with other flaviviruses. […] PRNTs may resolve false-positive IgM antibody results caused by non-specific reactivity and help identify the infecting virus.

• #19 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluenc.com/dam/medpolicies/healthybluenc/active/guidelines/gl_pw_c194119.html

  For persons with suspected ZIKV disease, a positive RT-PCR result confirms ZIKV infection, but a negative result does not exclude infection. […] If IgM test results are positive, equivocal, or inconclusive, performing a plaque reduction neutralization test (PRNT) is needed to confirm the diagnosis. […] On the basis of the available data, the CDC recommended that ZIKV RT-PCR be performed on urine collected 14 days after onset of symptoms in individuals with suspected ZIKV disease. […] The most recent CDC key recommendations (December 9, 2019) are as follows: Pregnant women with recent possible ZIKV exposure and symptoms of ZIKV disease should be tested to diagnose the cause of their symptoms. […] Non-pregnant symptomatic individuals with possible exposure to ZIKV should receive testing of serum and urine by ZIKV RNA, NAT and ZIKV and/or dengue virus IgM testing of serum.

• #20 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In presence of concern for cross-reactivity with other flaviviruses, plaque reduction neutralization tests (PRNTs) provide quantitative virus-specific antibody titers for dengue, Zika, and other flaviviruses. CDC uses a PRNT with a 90% cutoff value titer 10 in serum and 2 in cerebrospinal fluid (the typical starting dilutions) to define positive specimens. A neutralizing antibody titer 4-fold higher titers compared to other flavivirus titers is considered diagnostic. Differentiation from other flaviviruses and late diagnosis of Zika virus infection more than 3 months from illness is possible with PRNT. […] Prompt diagnosis and laboratory confirmation of Zika virus infection is challenging. […] Zika virus infection is diagnosed based on detection and isolation of Zika virus RNA from serum using nucleic acid amplification test (NAAT). The highest sensitivity of NAAT is during the initial week of illness, which is characterized by high viremia. After the initial week of illness, serologic testing for virus-specific immunoglobulin M (IgM) and neutralizing antibodies against Zika virus infection can be performed using enzyme-linked immunosorbent assay (ELISA). Serum IgM antibody testing should be performed if NAAT results are negative, regardless of when the specimen was collected.

• #21 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In presence of concern for cross-reactivity with other flaviviruses, plaque reduction neutralization tests (PRNTs) provide quantitative virus-specific antibody titers for dengue, Zika, and other flaviviruses. CDC uses a PRNT with a 90% cutoff value titer 10 in serum and 2 in cerebrospinal fluid (the typical starting dilutions) to define positive specimens. A neutralizing antibody titer 4-fold higher titers compared to other flavivirus titers is considered diagnostic. Differentiation from other flaviviruses and late diagnosis of Zika virus infection more than 3 months from illness is possible with PRNT. […] Prompt diagnosis and laboratory confirmation of Zika virus infection is challenging. […] Zika virus infection is diagnosed based on detection and isolation of Zika virus RNA from serum using nucleic acid amplification test (NAAT). The highest sensitivity of NAAT is during the initial week of illness, which is characterized by high viremia. After the initial week of illness, serologic testing for virus-specific immunoglobulin M (IgM) and neutralizing antibodies against Zika virus infection can be performed using enzyme-linked immunosorbent assay (ELISA). Serum IgM antibody testing should be performed if NAAT results are negative, regardless of when the specimen was collected.

• #22 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In presence of concern for cross-reactivity with other flaviviruses, plaque reduction neutralization tests (PRNTs) provide quantitative virus-specific antibody titers for dengue, Zika, and other flaviviruses. CDC uses a PRNT with a 90% cutoff value titer 10 in serum and 2 in cerebrospinal fluid (the typical starting dilutions) to define positive specimens. A neutralizing antibody titer 4-fold higher titers compared to other flavivirus titers is considered diagnostic. Differentiation from other flaviviruses and late diagnosis of Zika virus infection more than 3 months from illness is possible with PRNT. […] Prompt diagnosis and laboratory confirmation of Zika virus infection is challenging. […] Zika virus infection is diagnosed based on detection and isolation of Zika virus RNA from serum using nucleic acid amplification test (NAAT). The highest sensitivity of NAAT is during the initial week of illness, which is characterized by high viremia. After the initial week of illness, serologic testing for virus-specific immunoglobulin M (IgM) and neutralizing antibodies against Zika virus infection can be performed using enzyme-linked immunosorbent assay (ELISA). Serum IgM antibody testing should be performed if NAAT results are negative, regardless of when the specimen was collected.

• #23 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Zika virus NAAT and IgM testing should be performed on serum and NAAT on urine. […] If the Zika virus NAATs are negative and the IgM is positive, confirmatory PRNTs should be performed against Zika and dengue. […] Zika virus NAAT and IgM testing should be performed on infant serum and NAAT on infant urine. […] If the infant’s serum is IgM non-negative and NAAT negative, but PRNT was not performed on the mother’s serum, PRNT for Zika and dengue viruses should be performed on the infant serum.

• #24 Zika Virus Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/zika-virus-test/

  A Zika virus test looks for signs of a Zika virus infection in a sample of your blood or urine (pee). […] If general, Zika virus testing is mostly used to diagnose a Zika infection if you: […] There are two types of tests are used to check for Zika infections: […] A PCR test (polymerase chain reaction) is a common type of molecular test that checks for the Zika virus in a sample of your blood or urine. This test is recommended if you’re pregnant. […] A Zika virus test usually uses a sample of your blood or urine. […] You don’t any special preparations for a Zika virus test. […] If you have a negative Zika virus result: […] On a molecular test, such as a PCR test, it means that you probably don’t have a Zika infection. […] If you have a positive Zika virus test result: […] On a molecular test, such as a PCR test, it means that you most likely have a Zika infection. […] If you are pregnant or planning to become pregnant, you should avoid traveling in areas where Zika infection is a risk.

• #25

  https://journals.lww.com/co-infectiousdiseases/fulltext/2016/10000/zika_virus_infection__epidemiology,_clinical.6.aspx

  ZIKV, a mosquito-transmitted virus in the family Flaviviridae and genus Flavivirus, was discovered in 1947 with little impact in public health systems worldwide for the following seven decades. […] The diagnosis of Zika infections can be performed on clinical-epidemiological and laboratorial bases. Currently, ZIKV can be detected in distinct clinical specimens such as blood (plasma, serum), CSF, urine, saliva, breast milk, semen, vaginal secretion, amniotic fluid and tissues. […] Overall, the laboratorial diagnosis of ZIKV infection relies on the same usual strategies used for other arboviruses, with viral genome detection by RT-PCR tests on acute-phase samples and serology (ELISA and immunofluorescence) for detection of specific antibody against the virus. […] The most commonly and widely used diagnostic technique for ZIKV diagnosis is based on the virus molecular detection by conventional or real-time RT-PCR, and some protocols have been described for detecting ZIKV within the group or specific to the virus.

• #26 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  Current diagnostic methods of ZIKV infection include viral nucleotide detection in blood, urine, amniotic fluid, and saliva samples, or the use of antibody-based bioassays that detect viral antigen-specific antibodies (IgG or IgM) in the patient’s serum. […] Herein, we discuss the current and emergent diagnostic techniques available for ZIKV detection. […] The best way to accurately diagnose a ZIKV infection would be to collect more than one fluid sample if possible and test them together. […] Among all other diagnostic methods, RT-qPCR is most popular due to its sensitivity and specificity for ZIKV. […] In this paper, we discuss the most traditionally used diagnostic methods in ZIKV detection, as well some new potential candidates for diagnosis. […] At the early onset of infection, the Centers for Disease Control and Prevention (CDC) recommends the use of reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) to detect and quantify ZIKV viral RNA.

• #27 Testing for Zika | Zika Virus | CDC

  https://www.cdc.gov/zika/testing/index.html

  To determine if you have Zika virus disease (Zika), your healthcare provider will ask about recent travel and symptoms you are experiencing. […] Your healthcare provider may order blood or urine tests to help determine if you have Zika. […] Testing should take place as soon as possible, while you still have symptoms. […] Testing for Zika is recommended if: […] Testing is no longer routinely recommended if you are pregnant and are not experiencing symptoms of Zika. However, after talking with your doctor, testing may be considered if you traveled to an area with an active CDC Zika Travel Health Notice or current or past Zika virus transmission. […] Testing for Zika to determine if it is safe to get pregnant is not recommended. […] To determine if you have Zika, a doctor or other healthcare provider will ask about recent travel and symptoms you are experiencing. […] Testing may include a molecular test, which looks for presence of the virus in the body or serological testing which looks for antibodies your body makes to fight infection. […] Testing should take place as soon as possible, while you still have symptoms.

• #28 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In presence of concern for cross-reactivity with other flaviviruses, plaque reduction neutralization tests (PRNTs) provide quantitative virus-specific antibody titers for dengue, Zika, and other flaviviruses. CDC uses a PRNT with a 90% cutoff value titer 10 in serum and 2 in cerebrospinal fluid (the typical starting dilutions) to define positive specimens. A neutralizing antibody titer 4-fold higher titers compared to other flavivirus titers is considered diagnostic. Differentiation from other flaviviruses and late diagnosis of Zika virus infection more than 3 months from illness is possible with PRNT. […] Prompt diagnosis and laboratory confirmation of Zika virus infection is challenging. […] Zika virus infection is diagnosed based on detection and isolation of Zika virus RNA from serum using nucleic acid amplification test (NAAT). The highest sensitivity of NAAT is during the initial week of illness, which is characterized by high viremia. After the initial week of illness, serologic testing for virus-specific immunoglobulin M (IgM) and neutralizing antibodies against Zika virus infection can be performed using enzyme-linked immunosorbent assay (ELISA). Serum IgM antibody testing should be performed if NAAT results are negative, regardless of when the specimen was collected.

• #29 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In patients within 7 days of symptom onset, a positive serum NAAT for Zika is suggestive of the presence of acute Zika virus infection. The NAAT should be repeated on newly extracted RNA from the same specimen to rule out false-positive test results. […] In patients within 7 days of symptom onset, a negative serum NAAT and IgM antibody testing is suggestive of absence of Zika virus infection. […] In patients with indeterminate IgM antibody testing, repeat IgM testing or confirmatory PRNTs test should be performed. […] Pregnant women with symptoms and possible exposure to Zika virus should undergo molecular and serologic diagnostic testing for confirmation of Zika virus infection. A NAAT on serum and urine specimen and IgM antibody test on serum should be performed and collected within 12 weeks of symptom onset.

• #30 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In patients within 7 days of symptom onset, a positive serum NAAT for Zika is suggestive of the presence of acute Zika virus infection. The NAAT should be repeated on newly extracted RNA from the same specimen to rule out false-positive test results. […] In patients within 7 days of symptom onset, a negative serum NAAT and IgM antibody testing is suggestive of absence of Zika virus infection. […] In patients with indeterminate IgM antibody testing, repeat IgM testing or confirmatory PRNTs test should be performed. […] Pregnant women with symptoms and possible exposure to Zika virus should undergo molecular and serologic diagnostic testing for confirmation of Zika virus infection. A NAAT on serum and urine specimen and IgM antibody test on serum should be performed and collected within 12 weeks of symptom onset.

• #31 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  The major benefit that this assay provides is high specificity and sensitivity. […] In the later stages of infection, typically during the first week of symptoms, the body of an infected person starts making neutralizing antibodies (IgM) against ZIKV, which then can be used to detect the presence of the disease. […] If the obtained results are inconclusive, the CDC recommends using the plaque reduction neutralization test (PRNT) to validate or discard previously made assumptions that arose as a result of an inconclusive MAC-ELISA. […] Recently, a new serological ZIKV-based assay similar to MAC ELISA and less labor intensive than PRNT has shown significant improvements in turnaround times. […] Current serological diagnostics of ZIKV rely on IgM capture, which can encounter problems with cross-reactivity among different flaviviruses.

• #32 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In patients within 7 days of symptom onset, a positive serum NAAT for Zika is suggestive of the presence of acute Zika virus infection. The NAAT should be repeated on newly extracted RNA from the same specimen to rule out false-positive test results. […] In patients within 7 days of symptom onset, a negative serum NAAT and IgM antibody testing is suggestive of absence of Zika virus infection. […] In patients with indeterminate IgM antibody testing, repeat IgM testing or confirmatory PRNTs test should be performed. […] Pregnant women with symptoms and possible exposure to Zika virus should undergo molecular and serologic diagnostic testing for confirmation of Zika virus infection. A NAAT on serum and urine specimen and IgM antibody test on serum should be performed and collected within 12 weeks of symptom onset.

• #33 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  In patients within 7 days of symptom onset, a positive serum NAAT for Zika is suggestive of the presence of acute Zika virus infection. The NAAT should be repeated on newly extracted RNA from the same specimen to rule out false-positive test results. […] In patients within 7 days of symptom onset, a negative serum NAAT and IgM antibody testing is suggestive of absence of Zika virus infection. […] In patients with indeterminate IgM antibody testing, repeat IgM testing or confirmatory PRNTs test should be performed. […] Pregnant women with symptoms and possible exposure to Zika virus should undergo molecular and serologic diagnostic testing for confirmation of Zika virus infection. A NAAT on serum and urine specimen and IgM antibody test on serum should be performed and collected within 12 weeks of symptom onset.

• #34 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  The updated recommendations include concurrent ZIKV nucleic acid testing (NAT) of serum and urine and serologic IgM testing as soon as possible up to 12 weeks after symptom onset. […] Asymptomatic pregnant women with ongoing possible ZIKV exposure should be offered ZIKV NAT testing three times during pregnancy. […] For diagnosing postnatal ZIKV infection, RT-PCR is recommended during the first two weeks after symptom onset, serologic testing is recommended 2-12 weeks after symptom onset. […] For symptomatic non-pregnant persons, dengue and ZIKV NAATs should be performed on serum collected 7 days after symptom onset. […] For symptomatic pregnant women, serum and urine specimens should be collected as soon as possible within 12 weeks of symptom onset for concurrent dengue and ZIKV NAATs and IgM antibody testing.

• #35 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  The updated recommendations include concurrent ZIKV nucleic acid testing (NAT) of serum and urine and serologic IgM testing as soon as possible up to 12 weeks after symptom onset. […] Asymptomatic pregnant women with ongoing possible ZIKV exposure should be offered ZIKV NAT testing three times during pregnancy. […] For diagnosing postnatal ZIKV infection, RT-PCR is recommended during the first two weeks after symptom onset, serologic testing is recommended 2-12 weeks after symptom onset. […] For symptomatic non-pregnant persons, dengue and ZIKV NAATs should be performed on serum collected 7 days after symptom onset. […] For symptomatic pregnant women, serum and urine specimens should be collected as soon as possible within 12 weeks of symptom onset for concurrent dengue and ZIKV NAATs and IgM antibody testing.

• #36 Department of Public Health – Acute Communicable Disease Control

  http://publichealth.lacounty.gov/acd/Zika/Provider.htm

  Zika virus testing is recommended: […] Zika virus RNA PCR should be performed on both infant serum and urine, concurrently with Zika virus IgM on serum, ideally in the first two days of life. If non-negative IgM and negative Zika virus PCR, confirm with PRNT. […] Testing cerebral spinal fluid (CSF) for Zika virus RNA PCR and Zika virus IgM antibody testing should be considered, especially if serum and urine testing are negative and another etiology has not been identified. […] If Zika testing is indicated, healthcare providers should provide pretest counseling, providing the patient with information about Zika including the following points: More than one Zika test may be required before a final result is determined. […] There are different types of tests for Zika. […] Amniocentesis is not recommended until after 18 weeks of gestation, and the optimal time to perform amniocentesis to diagnose congenital Zika virus infection is not known.

• #37 Department of Public Health – Acute Communicable Disease Control

  http://publichealth.lacounty.gov/acd/Zika/Provider.htm

  A positive Zika virus RNA NAT result from amniotic fluid might indicate fetal infection. […] If amniocentesis is indicated for other reasons, NAT testing for Zika virus could be considered to assist with the diagnosis of fetal infection. […] Pregnant women with possible Zika exposure and who have not been tested since last exposure should be evaluated for Zika virus at antenatal and delivery hospitalizations. […] Birth hospitals may consider collecting infant specimens for concurrent Zika virus testing if maternal testing is being done. […] Further clinical evaluation for infants with laboratory evidence of congenital Zika virus infection should follow recommendations for infants with clinical findings even in the absence of clinically apparent abnormalities.

• #38 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Zika virus NAAT and IgM testing should be performed on serum and NAAT on urine. […] If the Zika virus NAATs are negative and the IgM is positive, confirmatory PRNTs should be performed against Zika and dengue. […] Zika virus NAAT and IgM testing should be performed on infant serum and NAAT on infant urine. […] If the infant’s serum is IgM non-negative and NAAT negative, but PRNT was not performed on the mother’s serum, PRNT for Zika and dengue viruses should be performed on the infant serum.

• #39 Clinical Testing and Diagnosis for Zika Virus Disease | Zika Virus | CDC

  https://www.cdc.gov/zika/hcp/diagnosis-testing/index.html

  Zika virus NAAT and IgM testing should be performed on serum and NAAT on urine. […] If the Zika virus NAATs are negative and the IgM is positive, confirmatory PRNTs should be performed against Zika and dengue. […] Zika virus NAAT and IgM testing should be performed on infant serum and NAAT on infant urine. […] If the infant’s serum is IgM non-negative and NAAT negative, but PRNT was not performed on the mother’s serum, PRNT for Zika and dengue viruses should be performed on the infant serum.

• #40 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  Molecular and serologic diagnostic testing for Zika virus is recommended for confirmation of diagnosis. Other than Zika virus RNA testing in infant’s serum and urine and IgM antibodies in serum, cerebrospinal fluid testing for NAAT and IgM antibody testing is recommended to increase diagnostic yield. […] Differentiation between dengue and Zika virus infection in infants can be performed by PRNT, if IgM test on infant’s initial sample is nonnegative and NAAT is negative. PRNT does not distinguish between infant or maternal passive antibodies collected from infant during or immediately after birth. […] CDC has provided guidance on interpretation of NAAT and IgM antibody testing for diagnosis of congenital Zika virus infection.

• #41 Zika Virus Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/2500035-workup

  Molecular and serologic diagnostic testing for Zika virus is recommended for confirmation of diagnosis. Other than Zika virus RNA testing in infant’s serum and urine and IgM antibodies in serum, cerebrospinal fluid testing for NAAT and IgM antibody testing is recommended to increase diagnostic yield. […] Differentiation between dengue and Zika virus infection in infants can be performed by PRNT, if IgM test on infant’s initial sample is nonnegative and NAAT is negative. PRNT does not distinguish between infant or maternal passive antibodies collected from infant during or immediately after birth. […] CDC has provided guidance on interpretation of NAAT and IgM antibody testing for diagnosis of congenital Zika virus infection.

• #42 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  Testing of infants with possible congenital ZIKV infection should be guided by: Whether the infant has abnormalities consistent with congenital ZIKV syndrome (e.g., microcephaly, intracranial calcifications, or other brain or eye abnormalities); the mother’s ZIKV testing results. […] Congenital ZIKV infection can be diagnosed by RT-PCR and through serologic testing. […] A positive infant serum or urine rRT-PCR test result confirms congenital ZIKV infection. […] Positive ZIKV IgM testing, with a negative rRT-PCR result, indicates probable congenital ZIKV infection. […] For persons with possible ZIKV exposure who have symptoms of ZIKV disease should receive testing in accordance with CDC interim guidance: Algorithm for U.S. Testing of Symptomatic Individuals. […] ZIKV testing for this purpose remains of uncertain value, because current understanding of the duration and pattern of shedding of ZIKV in reproductive tissues is limited.

• #43 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  Testing of infants with possible congenital ZIKV infection should be guided by: Whether the infant has abnormalities consistent with congenital ZIKV syndrome (e.g., microcephaly, intracranial calcifications, or other brain or eye abnormalities); the mother’s ZIKV testing results. […] Congenital ZIKV infection can be diagnosed by RT-PCR and through serologic testing. […] A positive infant serum or urine rRT-PCR test result confirms congenital ZIKV infection. […] Positive ZIKV IgM testing, with a negative rRT-PCR result, indicates probable congenital ZIKV infection. […] For persons with possible ZIKV exposure who have symptoms of ZIKV disease should receive testing in accordance with CDC interim guidance: Algorithm for U.S. Testing of Symptomatic Individuals. […] ZIKV testing for this purpose remains of uncertain value, because current understanding of the duration and pattern of shedding of ZIKV in reproductive tissues is limited.

• #44 Zika Virus Diagnosis | NIAID: National Institute of Allergy and Infectious Diseases

  https://www.niaid.nih.gov/diseases-conditions/zika-diagnosis

  Accurate diagnostic tests for Zika virus infection are needed to distinguish it from other flavivirus infections and to identify women who have been infected with Zika virus during pregnancy and may be at risk for developing fetal complications. […] Currently, Zika virus often can be detected during the acute phase of infection and up to 14 days after the onset of symptoms using diagnostic tests for viral RNA. […] Prior Zika infection can be detected by antibody-based tests, however, these tests may also detect or cross-react with antibodies against other flaviviruses, particularly dengue virus. […] NIAID is working toward the development of improved Zika virus diagnostic tests by supporting its scientists and grantees to generate antibodies that can distinguish between Zika virus and dengue virus.

• #45 Zika Virus Diagnosis | NIAID: National Institute of Allergy and Infectious Diseases

  https://www.niaid.nih.gov/diseases-conditions/zika-diagnosis

  Additionally, research is underway to create novel recombinant Zika virus proteins that are less cross-reactive to other flaviviruses that could be the basis for new antibody tests. […] Further, NIAID-supported scientists are working to identify biosignatures unique to Zika infection that could form the basis of additional rapid diagnostic tests.

• #46 Zika Virus Diagnosis | NIAID: National Institute of Allergy and Infectious Diseases

  https://www.niaid.nih.gov/diseases-conditions/zika-diagnosis

  Additionally, research is underway to create novel recombinant Zika virus proteins that are less cross-reactive to other flaviviruses that could be the basis for new antibody tests. […] Further, NIAID-supported scientists are working to identify biosignatures unique to Zika infection that could form the basis of additional rapid diagnostic tests.

• #47 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  Microfluidic Paper-based Analytical Devices (PAD) are being developed to detect various infectious diseases at the POC settings. […] The surface plasmon resonance based biosensor is a label-free technology that is being applied to both analytical chemistry and bioassay development. […] A newly developed cell-free based biosensor has been proven to be effective at detecting the presence of ZIKV RNA, and it is specific enough to differentiate between closely related flaviviruses and even different ZIKV lineages within a single base resolution, when coupled to a CRISPR/Cas9-based module. […] Reverse transcription-loop mediated isothermal amplification (RT-LAMP) is an isothermal amplification technology that does not require thermocycling for nucleic acid amplification. […] Alternatively, recombinase polymerase amplification (RPA), another isothermal amplification technology, can also be used for nucleic acid amplification, without the need for active temperature control in between runs.

• #48 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  Microfluidic Paper-based Analytical Devices (PAD) are being developed to detect various infectious diseases at the POC settings. […] The surface plasmon resonance based biosensor is a label-free technology that is being applied to both analytical chemistry and bioassay development. […] A newly developed cell-free based biosensor has been proven to be effective at detecting the presence of ZIKV RNA, and it is specific enough to differentiate between closely related flaviviruses and even different ZIKV lineages within a single base resolution, when coupled to a CRISPR/Cas9-based module. […] Reverse transcription-loop mediated isothermal amplification (RT-LAMP) is an isothermal amplification technology that does not require thermocycling for nucleic acid amplification. […] Alternatively, recombinase polymerase amplification (RPA), another isothermal amplification technology, can also be used for nucleic acid amplification, without the need for active temperature control in between runs.

• #49 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  Microfluidic Paper-based Analytical Devices (PAD) are being developed to detect various infectious diseases at the POC settings. […] The surface plasmon resonance based biosensor is a label-free technology that is being applied to both analytical chemistry and bioassay development. […] A newly developed cell-free based biosensor has been proven to be effective at detecting the presence of ZIKV RNA, and it is specific enough to differentiate between closely related flaviviruses and even different ZIKV lineages within a single base resolution, when coupled to a CRISPR/Cas9-based module. […] Reverse transcription-loop mediated isothermal amplification (RT-LAMP) is an isothermal amplification technology that does not require thermocycling for nucleic acid amplification. […] Alternatively, recombinase polymerase amplification (RPA), another isothermal amplification technology, can also be used for nucleic acid amplification, without the need for active temperature control in between runs.

• #50 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  Microfluidic Paper-based Analytical Devices (PAD) are being developed to detect various infectious diseases at the POC settings. […] The surface plasmon resonance based biosensor is a label-free technology that is being applied to both analytical chemistry and bioassay development. […] A newly developed cell-free based biosensor has been proven to be effective at detecting the presence of ZIKV RNA, and it is specific enough to differentiate between closely related flaviviruses and even different ZIKV lineages within a single base resolution, when coupled to a CRISPR/Cas9-based module. […] Reverse transcription-loop mediated isothermal amplification (RT-LAMP) is an isothermal amplification technology that does not require thermocycling for nucleic acid amplification. […] Alternatively, recombinase polymerase amplification (RPA), another isothermal amplification technology, can also be used for nucleic acid amplification, without the need for active temperature control in between runs.

• #51 Advances in Diagnostic Methods for Zika Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6298530/

  Microfluidic Paper-based Analytical Devices (PAD) are being developed to detect various infectious diseases at the POC settings. […] The surface plasmon resonance based biosensor is a label-free technology that is being applied to both analytical chemistry and bioassay development. […] A newly developed cell-free based biosensor has been proven to be effective at detecting the presence of ZIKV RNA, and it is specific enough to differentiate between closely related flaviviruses and even different ZIKV lineages within a single base resolution, when coupled to a CRISPR/Cas9-based module. […] Reverse transcription-loop mediated isothermal amplification (RT-LAMP) is an isothermal amplification technology that does not require thermocycling for nucleic acid amplification. […] Alternatively, recombinase polymerase amplification (RPA), another isothermal amplification technology, can also be used for nucleic acid amplification, without the need for active temperature control in between runs.

• #51 Updating Zika Diagnostic Methods: The Point-of-Care Approach

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762020000600344

  Molecular methods are based on ZIKV genome detection and generally target highly conserved regions, such as UTR 5 and 3 regions, or partial sequences of E, C, NS1, NS3m or NS5. […] After RT-PCR, one of the most commonly used molecular methods is RT-LAMP. […] Several research groups have used this technique for ZIKV detection, evaluating the compatibility with different types of samples such as serum, urine, and saliva. […] Another technique that can be used in PoC is RT-RPA, where the capacity to detect different ZIKV strains has been tested, showing a 100% specificity and 83% sensitivity using clinical samples (serum, whole blood, urine, and semen). […] A detection strategy based on electrochemical immunosensors has been developed for the early stage of the disease. […] This type of method can be adapted to PoC devices, as it requires few components.

• #52 Zika Virus Diagnosis | NIAID: National Institute of Allergy and Infectious Diseases

  https://www.niaid.nih.gov/diseases-conditions/zika-diagnosis

  Accurate diagnostic tests for Zika virus infection are needed to distinguish it from other flavivirus infections and to identify women who have been infected with Zika virus during pregnancy and may be at risk for developing fetal complications. […] Currently, Zika virus often can be detected during the acute phase of infection and up to 14 days after the onset of symptoms using diagnostic tests for viral RNA. […] Prior Zika infection can be detected by antibody-based tests, however, these tests may also detect or cross-react with antibodies against other flaviviruses, particularly dengue virus. […] NIAID is working toward the development of improved Zika virus diagnostic tests by supporting its scientists and grantees to generate antibodies that can distinguish between Zika virus and dengue virus.

• #53 Kephera | Rapid Diagnosis of Infectious Disease | Zika Virus

  https://kephera.com/our-focus/zika-virus/

  Zika has emerged in recent years as a major public health threat. This has led to an urgent need for diagnostic tools for both clinical and epidemiological use. […] This highlights the need for tests that are highly specific for Zika. […] Zika infection can be detected by molecular assays, but this approach is only useful during the relatively brief viremic phase—typically several weeks or less. After this period, individuals at risk for complications caused by prior infection can only be identified by serologic assays. […] The close genetic relationship between Zika and other flaviviruses makes serological diagnosis difficult due to cross-reactivities between viral antigens. […] With support from the National Institutes of Health, Kephera is developing a test for Zika infection based on the development of engineered antigens that allow differentiation of the immune response to Zika from that to other related viruses, such as Dengue. The assay will be developed in convenient and cost-effective ELISA format to aid in diagnosis and surveillance.

• #54 Why We Need New Diagnostics for the Zika Virus – The Native Antigen Company

  https://thenativeantigencompany.com/why-we-need-new-diagnostics-for-the-zika-virus/

  While Zika is no longer in the public eye, it hasnt vanished. […] A major gap in our protective arsenal is a lack of sensitive and accurate diagnostics. […] There is a pressing need for better means of diagnosis. […] Combined, insufficient laboratory infrastructure, lack of symptoms, and overlapping sequelae makes routine testing with accurate diagnostics a necessity for case identification and epidemiological surveillance of ZIKV. […] This lack of diagnostic specificity poses a serious health risk to pregnant women, as mis-diagnosing ZIKV infection can result in incorrect evaluations of congenital disease risks, abortions, and unwarranted delays in pregnancy. […] Developing accurate diagnostics for ZIKV has been challenged by the prevalence of cross-reacting antibodies in Zika and dengue-endemic populations.

• #55 Why We Need New Diagnostics for the Zika Virus – The Native Antigen Company

  https://thenativeantigencompany.com/why-we-need-new-diagnostics-for-the-zika-virus/

  This has prompted screening of ZIKV antigen arrays alongside mutation studies aimed at removing cross-reactive epitopes, while retaining ZIKV-specific regions. […] Nonetheless, few have been extensively evaluated, and while there have been general improvements in assays that are commercially available, specificity claims are not always borne out of independent studies. As such, more rigorous diagnostic studies are needed to evaluate these designs and find practical solutions.

• #56 Zika Virus Testing – Testing.com

  https://www.testing.com/tests/zika-virus-test/

  Zika virus tests are authorized by the FDA to diagnose or rule out a Zika virus infection. […] False negative test results, in which a person has a negative test result despite having a Zika virus infection, can occur due to being tested too soon after infection. […] False positive results occur when a test result is positive for a Zika virus infection when a patient does not actually have this infection. […] Testing for Zika virus infection in fetuses during pregnancy may be considered if ultrasound findings suggest abnormalities that could be caused by a Zika virus infection. […] Testing of a fetus may also be recommended if the pregnant parent has a positive or inconclusive Zika virus test result.

• #57 Zika Virus Testing – Testing.com

  https://www.testing.com/tests/zika-virus-test/

  Zika virus tests are authorized by the FDA to diagnose or rule out a Zika virus infection. […] False negative test results, in which a person has a negative test result despite having a Zika virus infection, can occur due to being tested too soon after infection. […] False positive results occur when a test result is positive for a Zika virus infection when a patient does not actually have this infection. […] Testing for Zika virus infection in fetuses during pregnancy may be considered if ultrasound findings suggest abnormalities that could be caused by a Zika virus infection. […] Testing of a fetus may also be recommended if the pregnant parent has a positive or inconclusive Zika virus test result.

• #58 Zika virus: Optimized tests for reliable diagnosis | ScienceDaily

  https://www.sciencedaily.com/releases/2016/05/160512102626.htm

  The researchers assume that depending on the testing system, 20 to 80 percent of the patients may get an incorrect diagnosis, if serological testing methods are not used for further diagnosis. […] The researchers from Bonn consequently developed two new optimized PCR tests. […] „With our study, we especially wanted to call attention to the fact that a negative PCR test is not necessarily reliable,” Drexler explains.

• #59 Zika virus: For health professionals – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/zika-virus/health-professionals.html

  A positive PCR test for Zika virus signifies an acute infection. […] A negative PCR test for Zika virus may mean: there was no infection, the individual was infected but the virus was no longer present when the sample was collected. […] The major limitations of serology are that it: may take several days or weeks to perform and report back results, is prone to cross-react with antibodies that target other similar flaviviruses related to Zika virus, including the dengue virus. […] Due to cross-reactivity with dengue virus and the potential for persistence of IgM antibodies, serological testing is not recommended for Zika virus. […] Identifying and confirming Zika virus-specific antibodies in serum samples requires further testing and, in some cases, collecting additional samples. […] A negative serological test for Zika could mean: antibodies have yet to develop, there was no infection, which may warrant the collection of additional samples.

• #60 Zika virus: For health professionals – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/zika-virus/health-professionals.html

  A positive PCR test for Zika virus signifies an acute infection. […] A negative PCR test for Zika virus may mean: there was no infection, the individual was infected but the virus was no longer present when the sample was collected. […] The major limitations of serology are that it: may take several days or weeks to perform and report back results, is prone to cross-react with antibodies that target other similar flaviviruses related to Zika virus, including the dengue virus. […] Due to cross-reactivity with dengue virus and the potential for persistence of IgM antibodies, serological testing is not recommended for Zika virus. […] Identifying and confirming Zika virus-specific antibodies in serum samples requires further testing and, in some cases, collecting additional samples. […] A negative serological test for Zika could mean: antibodies have yet to develop, there was no infection, which may warrant the collection of additional samples.

• #61 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluenc.com/dam/medpolicies/healthybluenc/active/guidelines/gl_pw_c194119.html

  For persons with suspected ZIKV disease, a positive RT-PCR result confirms ZIKV infection, but a negative result does not exclude infection. […] If IgM test results are positive, equivocal, or inconclusive, performing a plaque reduction neutralization test (PRNT) is needed to confirm the diagnosis. […] On the basis of the available data, the CDC recommended that ZIKV RT-PCR be performed on urine collected 14 days after onset of symptoms in individuals with suspected ZIKV disease. […] The most recent CDC key recommendations (December 9, 2019) are as follows: Pregnant women with recent possible ZIKV exposure and symptoms of ZIKV disease should be tested to diagnose the cause of their symptoms. […] Non-pregnant symptomatic individuals with possible exposure to ZIKV should receive testing of serum and urine by ZIKV RNA, NAT and ZIKV and/or dengue virus IgM testing of serum.

• #62 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  The updated recommendations include concurrent ZIKV nucleic acid testing (NAT) of serum and urine and serologic IgM testing as soon as possible up to 12 weeks after symptom onset. […] Asymptomatic pregnant women with ongoing possible ZIKV exposure should be offered ZIKV NAT testing three times during pregnancy. […] For diagnosing postnatal ZIKV infection, RT-PCR is recommended during the first two weeks after symptom onset, serologic testing is recommended 2-12 weeks after symptom onset. […] For symptomatic non-pregnant persons, dengue and ZIKV NAATs should be performed on serum collected 7 days after symptom onset. […] For symptomatic pregnant women, serum and urine specimens should be collected as soon as possible within 12 weeks of symptom onset for concurrent dengue and ZIKV NAATs and IgM antibody testing.

• #63 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  The updated recommendations include concurrent ZIKV nucleic acid testing (NAT) of serum and urine and serologic IgM testing as soon as possible up to 12 weeks after symptom onset. […] Asymptomatic pregnant women with ongoing possible ZIKV exposure should be offered ZIKV NAT testing three times during pregnancy. […] For diagnosing postnatal ZIKV infection, RT-PCR is recommended during the first two weeks after symptom onset, serologic testing is recommended 2-12 weeks after symptom onset. […] For symptomatic non-pregnant persons, dengue and ZIKV NAATs should be performed on serum collected 7 days after symptom onset. […] For symptomatic pregnant women, serum and urine specimens should be collected as soon as possible within 12 weeks of symptom onset for concurrent dengue and ZIKV NAATs and IgM antibody testing.

• #64 CG-LAB-10 Zika Virus Testing

  https://provider.healthybluela.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_c194119.html

  The updated recommendations include concurrent ZIKV nucleic acid testing (NAT) of serum and urine and serologic IgM testing as soon as possible up to 12 weeks after symptom onset. […] Asymptomatic pregnant women with ongoing possible ZIKV exposure should be offered ZIKV NAT testing three times during pregnancy. […] For diagnosing postnatal ZIKV infection, RT-PCR is recommended during the first two weeks after symptom onset, serologic testing is recommended 2-12 weeks after symptom onset. […] For symptomatic non-pregnant persons, dengue and ZIKV NAATs should be performed on serum collected 7 days after symptom onset. […] For symptomatic pregnant women, serum and urine specimens should be collected as soon as possible within 12 weeks of symptom onset for concurrent dengue and ZIKV NAATs and IgM antibody testing.

• #65 Testing for Zika | Zika Virus | CDC

  https://www.cdc.gov/zika/testing/index.html

  To determine if you have Zika virus disease (Zika), your healthcare provider will ask about recent travel and symptoms you are experiencing. […] Your healthcare provider may order blood or urine tests to help determine if you have Zika. […] Testing should take place as soon as possible, while you still have symptoms. […] Testing for Zika is recommended if: […] Testing is no longer routinely recommended if you are pregnant and are not experiencing symptoms of Zika. However, after talking with your doctor, testing may be considered if you traveled to an area with an active CDC Zika Travel Health Notice or current or past Zika virus transmission. […] Testing for Zika to determine if it is safe to get pregnant is not recommended. […] To determine if you have Zika, a doctor or other healthcare provider will ask about recent travel and symptoms you are experiencing. […] Testing may include a molecular test, which looks for presence of the virus in the body or serological testing which looks for antibodies your body makes to fight infection. […] Testing should take place as soon as possible, while you still have symptoms.

• #66 Testing for Zika | Zika Virus | CDC

  https://www.cdc.gov/zika/testing/index.html

  To determine if you have Zika virus disease (Zika), your healthcare provider will ask about recent travel and symptoms you are experiencing. […] Your healthcare provider may order blood or urine tests to help determine if you have Zika. […] Testing should take place as soon as possible, while you still have symptoms. […] Testing for Zika is recommended if: […] Testing is no longer routinely recommended if you are pregnant and are not experiencing symptoms of Zika. However, after talking with your doctor, testing may be considered if you traveled to an area with an active CDC Zika Travel Health Notice or current or past Zika virus transmission. […] Testing for Zika to determine if it is safe to get pregnant is not recommended. […] To determine if you have Zika, a doctor or other healthcare provider will ask about recent travel and symptoms you are experiencing. […] Testing may include a molecular test, which looks for presence of the virus in the body or serological testing which looks for antibodies your body makes to fight infection. […] Testing should take place as soon as possible, while you still have symptoms.

• #67 Zika Virus – Serology and PCR | Public Health Ontario

  https://www.publichealthontario.ca/en/Laboratory-Services/Test-Information-Index/Zika-Virus

  This page provides information on the testing available for Zika virus (also known as Zika or Zika Fever) or ZIKV at Public Health Ontarios (PHO) laboratory. Testing for ZIKV at PHOs laboratory involves PCR and/or serology depending on the specific clinical scenario. […] Zika virus testing is limited to symptomatic individuals, pregnant women, and neonates/infants born to confirmed or suspected mothers or those with symptoms of congenital Zika syndrome (CZS). […] Molecular testing to detect ZIKV nucleic acids is the preferred testing modality when performed within 14 days of symptom onset. […] Serology is not routinely recommended due to its lack of specificity for diagnosing recent infection. […] ZIKV PCR should be requested on serum and urine collected within 14 days of symptom onset or most recent exposure.

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