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Beaumont Laboratory

Zika Virus

Microcephaly, Birth Defects

Instructions

  • Testing no longer includes Dengue and Chikungunya.
  • The patient’s healthcare provider must complete the Zika Virus Testing - Patient and Clinical Information form.
  • This form 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.a.  Patient has clinical illness consistent with Zika virus infection (two or more of the following):

  • Fever
  • Rash
  • Joint Pain
  • Red, Irritated Eyes

OR, patient has no symptoms with ongoing Zika virus exposure. 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.3.  Testing is not recommended for asymptomatic non-pregnant individuals.    Diagnostic Testing Options:1.  Nucleric Acid Amplification testing (i.e., PCR). a.  Available on any pregnant patient or non-pregnant patient with < 14 days post symptom onset.2.  Serology for detection of IgM. a.  Available on any pregnant symptomatic patient or non-pregnant symptomatic patient with >= 14 days post 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.

Testing Algorithm

Pregnant asymptomatic with ongoing exposure:  Zika PCR (serum & urine)Pregnant symptomatic:  Zika PCR (serum & urine) and Zika IgM (serum)Nonpregnant symptomatic < 14 days post-symptom onset:  Zika PCR (serum & urine)Nonpregnant symptomatic >= 14 days post-symptom onset:  Zika IgM (serum)

Specimen Collection Criteria

PCR
Collect:
Two plain Red-top tubes or two gold-top SST tubes AND urine in a sterile collection container.

SEROLOGY
Collect :
Two plain Red-top tubes or two Gold-top SST tubes.

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.

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)
  • 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:

PCR

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

Serology

Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): 2 weeks
Frozen (-20°C/-4°F or below): 1 year

Specimen Storage in Department Prior to Disposal:

No specimens will be stored in the Laboratory.

Laboratory

Sent to ARUP Laboratories, Salt Lake City, UT.

Performed

Monday, Wednesday, and 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
Semi-Quantitative Enzyme-Linked Immunosorbent Assay.

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

04/05/2018

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