Zika Virus

Zika is a mosquito-borne virus transmitted by Aedes mosquitoes across tropical and subtropical regions. Outbreaks of Zika virus disease have recently been identified in Central America, South America, the Caribbean, the US territories of Puerto Rico and the Virgin Islands, and the continental United States. These recent outbreaks are a matter of international concern. The virus has a connection to severe congenital health consequences, especially in babies born to infected women. Zika is linked to and has led to an increase in cases of microcephaly, a rare neurological condition, as well as other birth defects in babies born to infected mothers. The World Health Organization (WHO) has also determined a link between Zika and Guillain-Barré syndrome, a rare and life-threatening condition in adults.

Transmission and Symptoms

Zika virus is transmitted by mosquitoes, through unprotected sexual contact (including oral, vaginal, and anal), blood transfusion and from an infected mother to her fetus. Symptoms are generally mild and include fever, rash, conjunctivitis, muscle pain and headache. Importantly, several other mosquito-borne viral infections, including Dengue and Chickungunya, circulate in the same geographic areas and present with similar clinical features. Many patients experience no symptoms at all, making early, accurate diagnosis imperative to limit spread of disease and incidence of birth defects.

Zika Virus Testing

The US Food and Drug Administration (FDA) has issued Emergency Use Authorization (EUA) for several diagnostic tools for Zika virus. BioReference® is pleased to offer these tests to ensure a more accurate diagnosis, offering moms-to-be, women who plan to become pregnant and healthcare providers greater certainty in test results and to help reduce subsequent spread of infection. Please find fact sheets for each of these tests below.

Test Benefits

Zika virus assay results will typically be available in two days (unless IgM testing is reflexed), giving healthcare providers and patients peace of mind to proceed with family planning without the need to wait for government issued results from public health laboratories.

Patient Considerations and CDC Guidance for Testing

The Centers for Disease Control and Prevention (CDC) has released interim clinical guidance for the diagnosis and testing of Zika virus. 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. As Zika continues to be an area of evolving care and practice, please check for revisions and updates through the CDC’s Zika website.

Please refer to the most current CDC guidelines for further information on which serologic tests are appropriate for patients, based on exposure history and the presence or absence of symptoms. Current indications and guidelines are summarized below.

• Exposed symptomatic individuals <14 days from symptom onset: Recommend paired serum and urine molecular testing. If negative, suggest reflex to serology testing; follow up as per current CDC guidance.
• Exposed symptomatic individuals >14 days from symptom onset or exposed asymptomatic pregnant women 2-12 weeks after exposure: Recommend serology testing. If positive, suggest paired serum and urine molecular testing; follow up as per current CDC guidance.
• Exposed asymptomatic pregnant women <14 days from exposure: Recommend paired serum and urine molecular testing. If negative, suggest serology testing; follow up as per current CDC guidance.