800-551-0488

Lab results are too important to go anywhere else

Beaumont Laboratory

Zika Virus

Emerging Arbovirus Panel, Chikungunya, Dengue, Microcephaly, Birth Defects

Instructions

  • Testing includes Zika, Dengue and Chikungunya.
  • The patient’s healthcare provider must complete the Zika Virus Testing - Patient and Clinical Information form.

    At the bottom of the form:

    Under "Indicate Specimen Source" Check the appropriate source box
         
    Under "Tests that require MDHHS Approval Emerging Arbovirus Panel" check the box for PCR and/or Serology as advised during the approval process.

  • These forms must be included with the specimen when it is sent to the Send Out Laboratory.
  • Specimens received without the appropriate forms and information will not be shipped.
  • Order as a Miscellaneous Sendout (XMISC).

Criteria for Diagnostic Testing of Potentially Exposed Individuals:

  1. Pregnant women with a history of travel to an area with ongoing Zika virus transmission.
    1. Patient has clinical illness consistent with Zika virus infection (two or more of the following) within 2 weeks of travel:
      • Fever
      • Rash
      • Joint Pain
      • Red, Irritated Eyes
    2. OR, patient has no symptoms but are within 2-12 weeks after their return from travel.
  2. Others who have a history of travel to an area with ongoing Zika virus transmission and have a clinical illness consistent with Zika virus within 2 weeks of travel.

Diagnostic Testing Options:

  1. Nucleric Acid Amplification testing (i.e., PCR).
    1. Available on samples collected less than or equal to 14 days of symptom onset.
    2. Available on other specimens (tissue, urine, amniotic fluid).
  2. Serology for detection of IgM.
    1. Available on samples collected 4 days to 12 weeks of symptom onset.
      NOTE: If IgM is detected, a plaque-reduction neutralization test (PRNT) will be performed to rule out cross-reaction with other associated mosquito-borne diseases or if the IgM results are inconclusive.

Specimen Collection Criteria

PCR
Collect (preferred):
Two plain Red-top tubes.
Also acceptable: Cerebrospinal Fluid (CSF), amniotic fluid, urine, or tissue in a sterile collection container. (NOTE: These samples must be accompanied by serum.)
PCR testing not available on SST tubes.

SEROLOGY
Collect (preferred):
Two plain Red-top tubes.
Also acceptable: Two Gold-top SST tubes or Cerebrospinal Fluid (CSF). (NOTE: CSF must be accompanied by serum.)

Physician Office/Drawsite Specimen Preparation

Transport: Refrigerated (2-8°C or 36-46°F), with the completed Zika Virus Testing - Patient and Clinical Information form and the MDHHS Test request form.

Preparation for Courier Transport

  • Blood: Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer 2.5 mL serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F) immediately. (Minimum Serum: 1.0 mL)
  • CSF and Amnio: Transfer 1.0 mL to a plastic transport tube and refrigerate (2-8°C or 36-46°F).
  • Urine: Transfer 2.0 mL to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Rejection Criteria

  • Specimens in bacterial or viral transport systems.
  • Specimens not collected and processed as indicated.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 72 hours
Frozen (-20°C/-4°F or below): 30 days

Specimen Storage in Department Prior to Disposal:

No specimens will be stored in the Laboratory.

Laboratory

All testing is performed by the Michigan Department of Health and Human Services (MDHHS).

Performed

Monday – Friday.
Negative results may be available sooner (within 2 weeks). Other results may take longer due to the need to perform additional studies (4-6 weeks).

Reference Range

Negative.

Test Methodology

PCR
Real-time Polymerase Chain Reaction (RT-PCR).

SEROLOGY
CDC MAC-ELISA, IgM ELISA.

Interpretation

This assay determines the presence of viral nucleic acid (RNA) or IgM antibodies from Zika virus in clinical specimens from patients who have been exposed to this virus.

Clinical Disease

About 1 in 5 people infected with Zika virus become symptomatic. Characteristic clinical findings are acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis. Other commonly reported symptoms include myalgia and headache. Clinical illness is usually mild with symptoms lasting for several days to a week. Severe disease requiring hospitalization is uncommon and case fatality is low. However, there have been cases of Guillain-Barre syndrome reported in patients following suspected Zika virus infection. The Brazil Ministry of Health is also investigating the possible association between Zika virus and a reported increase in the number of babies born with microcephaly. Due to concerns of microcephaly associated with maternal Zika virus infection, fetuses and infants of women infected with Zika virus during pregnancy should be evaluated for possible congenital infection and neurologic abnormalities.

Epidemiology

  • Zika virus can be transmitted from the bite of an infected Aedes mosquito.
  • A mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth, but this is rare.
  • It is possible that Zika virus could be passed from a mother to her baby during pregnancy.
  • Spread of the virus through blood transfusion and sexual contact have been reported.

Incubation Period

The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.

Transmission

  • The virus is transmitted by the bite of an infected Aedes species mosquito (A. aegypti and A. albopictus). These mosquitoes typically lay eggs in and near standing water in things like buckets, bowls, animal dishes, flower pots and vases. They prefer to bite people, and live indoors and outdoors near people.
  • Mosquitoes that spread Zika are aggressive daytime biters. They can also bite at night.
  • Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.
  • NOTE: These mosquitos are not found in Michigan at this time.

Reference

http://www.cdc.gov/zika/index.html

Last Updated

01/16/2018

Microtainer® and Vacutainer® are registered trademarks of Becton, Dickinson and Company.
UroVysion® is a registered trademark of Abbott Laboratories. ThinPrep® is a registered trademark of Hologic, Incorporated.

This directory currently reflects information only for specimens collected and/or processed at the Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.