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Zika Virus

Test Codes

Blood PCR: EPIC LAB7137, Beaker: XBLD, Mayo: VZIKS
Urine PCR: EPIC: LAB7138, Beaker: XZURN, Mayo: VZIKU
Serum IgM: EPIC: LAB7906, Beaker: XPKZM, Mayo: VZIKM

Department

Send Outs

Instructions

Questions and answers concerning pregnancy, exposure, and display of symptoms are required. Requests received without this information will not sent for testing.

Testing Algorithm:

• Nonpregnant asymptomatic: Testing not recommended
• Nonpregnant symptomatic < 14 days post-symptom onset: Blood PCR and Urine PCR
• Nonpregnant symptomatic ≥ 14 days post-symptom onset: Serum IgM
• Pregnant asymptomatic without exposure: Testing not recommended
• Pregnant asymptomatic with ongoing exposure: Blood PCR and Urine PCR
• Pregnant symptomatic: Blood PCR, Urine PCR, and Serum IgM

Specimen Collection Criteria

PCR
Collect: Gold-top SST tubes or (acceptable) red top tube AND urine in a sterile collection container.

SEROLOGY
Collect: Red-top tubes or Gold-top SST tubes.

Physician Office/Draw Specimen Preparation

Transport: Serum or Urine for PCR testing, refrigerated (2-8°C or 36-46°F).

Transport: Serum for IgM serology, frozen (-20°C/-4°F or below).

Preparation for Courier Transport

Blood PCR: Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer 0.5 mL serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F). (Minimum: 0.25 mL)

Urine PCR: Transfer 1.0 mL to a plastic transport tube and refrigerate (2-8°C or 36-46°F). (Minimum: 0.3 mL)

Serum IgM: Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer 1.0 mL serum to a plastic transport tube and freeze (-20°C/-4°F or below) immediately. (Minimum: 0.8 mL)

Rejection Criteria

• Specimens in bacterial or viral transport systems.
• Grossly hemolyzed specimen
• Grossly icteric specimen
• Grossly lipemic specimen
• Heat activated specimen
• Specimens not collected and processed as indicated.

In-Lab Processing

Blood PCR: Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer 0.5 mL serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F) immediately. (Minimum: 0.25 mL)

Urine PCR: Transfer 1.0 mL to a plastic transport tube and refrigerate (2-8°C or 36-46°F). (Minimum: 0.3 mL)

Serum IgM: Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer 1.0 mL serum to a plastic transport tube and freeze (-20°C/-4°F or below) immediately. (Minimum: 0.8 mL)

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): 7 days
Frozen (-20°C/-4°F or below): 7 days

Serology
Room Temperature (20-26°C or 68-78.8°F): unacceptable
Refrigerated (2-8°C or 36-46°F): unacceptable
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

Sent to Mayo Clinic Laboratories in Rochester, MN.

Performed

Varies.
Results available in 1-14 days.

Reference Range

Negative.

Test Methodology

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

SEROLOGY
Semi-Quantitative Enzyme-Linked Immunosorbent Assay.

Interpretation

These assays determine 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

CPT Codes

PCR, Blood: 87662
PCR, Urine: 87662
Serology (IgM): 86794

Contacts

Last Updated

5/22/2023