Many people infected with Zika virus won’t have symptoms or will only have mild symptoms that can last for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. Once a person has been infected with Zika, they are likely to be protected from future infections. 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.
Testing of specimens within the United States to determine possible Zika virus infection should be limited to specimens collected from patients meeting CDC’s clinical and epidemiological criteria for testing.
Current information and guidance for the U.S. Zika response is available at.
- Guidance for U.S. Laboratories Testing for Zika Virus Infection.
- CDC’s Zika website.
- State and public health laboratory response.
Zika PCR Fact Sheets
- For Patients: Understanding Results from the Zika Virus Detection by RT-PCR Test
- For Healthcare Provider: Interpreting Zika Virus Detections by RT-PCR Test Results
A Rare NEJM Case Study Raises Questions about Zika Transmission
For additional information refer to our Laboratory Test Directory regarding Zika Virus IgM Antibody Capture (MAC), by ELISA.
ARUP Laboratories now offers IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) detection for Zika virus infections. This test is performed using a commercial assay and is available to patients meeting Centers for Disease Control and Prevention (CDC) clinical and/or epidemiological criteria.
Zika virus-specific IgM and neutralizing antibodies typically develop toward the end of the first week of illness. IgM levels are variable, but generally are positive starting near day 4 after onset of symptoms and continuing for up to 12 weeks post symptom onset or exposure, but may persist longer.
- For symptomatic pregnant women, IgM serology is performed concurrently with NAT.
- For asymptomatic pregnant women, if testing is conducted, IgM serology should follow the testing algorithm for symptomatic pregnant women.
- For pregnant women with possible exposure to Zika virus and who have a fetus with prenatal ultrasound findings consistent with congenital Zika virus infection, IgM serology should be performed on maternal serum concurrently with NAT following the testing algorithm for symptomatic pregnant women.
- For symptomatic non-pregnant individuals, testing should be performed on NAT negative samples collected <14 days after onset of symptoms or on samples collected ≥14 days after onset of symptoms.
- IgM testing is not recommended for asymptomatic non-pregnant individuals.
Cross-reactive antibodies due to other flavivirus infections may be detected and are reported as “presumptive other flavivirus.” Testing for dengue and West Nile virus should be performed in conjunction with Zika virus testing.
ARUP will report all “presumptive Zika” and “presumptive other flavivirus” results to the appropriate public health authorities for epidemiological case tracking.
Testing will not be performed on patients who do not meet the following CDC criteria for testing.
For more information, visit https://arupconsult.com/content/mosquito-borne-arboviruses.
For additional information refer to our Laboratory Test Directory regarding Zika Virus by PCR, Blood.
ARUP Laboratories now offers EUA approved Zika Virus by PCR on blood (serum) and urine and is available to patients meeting Centers for Disease Control and Prevention (CDC) Zika virus clinical criteria (e.g., clinical signs and symptoms associated with Zika virus infection) and/or Zika virus epidemiological criteria (e.g., history of residence in or travel to a geographic region with active Zika transmission at the time of travel, or other epidemiologic criteria for which Zika virus testing may be indicated). View the criteria www.cdc.gov/zika/.
Zika virus RNA is generally detectable in serum and or urine during the acute phase of infection and up to 14 days following onset of symptoms, if present. Positive results are indicative of current infection.
For the identification of Zika virus RNA from individuals meeting CDC Zika virus clinical criteria and/or CDC Zika virus epidemiological criteria (www.cdc.gov/zika/). Intended use:
Primary testing approach if testing is performed during the acute phase of infection, which is less than 14 days after symptom onset.
- Health care providers are strongly encouraged to collect serum specimens alongside other specimen types to provide additional opportunities for diagnosing Zika virus infection in cases when PCR tests are negative.
- A negative PCR result does not exclude Zika virus infection and serum should be analyzed for IgM antibodies to Zika Virus.
- If serologic testing is needed on a patient-matched serum specimen, contact ARUP client services to order Zika Virus. IgM Antibody Capture (MAC), by ELISA (test code 2013942).
- This test has not been FDA cleared or approved. This test has been authorized by the FDA under an EUA for use by authorized laboratories only.
- This test has been authorized only for the detection of RNA from Zika virus and diagnosis of Zika virus infection, not for any other viruses or pathogens; and is only authorized for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of in vitro diagnostic tests for detection of Zika virus and/or diagnosis of Zika virus infection under section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner.
Fact Sheet for Patients: Understanding Results from the Zika Virus Detection by RT-PCR Test
Fact Sheet for Healthcare Provider: Interpreting Zika Virus Detections by RT-PCR Test Results
For more information, visit ARUP Consult mosquito borne arboviruses