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Test Catalog

Test ID: RZIKS    
Zika Virus, PCR, Molecular Detection, Serum

Useful For Suggests clinical disorders or settings where the test may be helpful

Qualitative detection of Zika virus RNA in serum from individuals meeting CDC Zika virus clinical or epidemiologic criteria

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Zika virus is an RNA virus in the genus Flavivirus and is primarily transmitted through the bite of an infected Aedes species mosquito. Other means of transmission include through transfusion of blood and blood products, sexually through genital secretions, perinatally, vertically from mother to fetus, and potentially through contact with other body secretions such as tears and sweat.

 

Historically, most cases of Zika virus infection have occurred in parts of Africa and South-East Asia. However, Zika virus emerged in South America in early 2015 and is now endemic in over 50 countries in South, Central, and North America, including in several US territories and focal regions of the southern United States.

 

The majority (approximately 80%) of individuals infected with Zika virus are asymptomatic. Among symptomatic patients, fever, headache, retro-orbital pain, conjunctivitis, maculopapular rash, myalgias and arthralgias are commonly reported. Notably, these symptoms are not distinct and can be seen with other emerging arboviruses, including dengue and chikungunya. Therefore, diagnostic testing for each of these viruses is recommended in patients returning for areas where these viruses cocirculate. Intrauterine or prenatal infection with Zika virus has been causally linked to development of microcephaly, with the greatest risk for fetal abnormality occurring if the infection is acquired during the first trimester. Finally, Zika virus has also been associated with development of Guillain-Barre syndrome.

 

A number of Zika virus serologic and nucleic acid amplification tests (NAAT) have received emergency use authorization (EUA) through the Food and Drug Administration (FDA). The recommended tests vary by the patient's symptoms, course of illness, and whether or not the patient is pregnant.

 

For the most up-to-date information regarding CDC testing guidelines visit www.cdc.gov/zika/.

 

These guidelines are reflected in the following MCL testing algorithms in Special Instructions:

-Assessment for Zika Virus Infection in Nonpregnant Individuals

-Assessment for Zika Virus Infection in Pregnant Women

 

Zika virus testing is not recommended for asymptomatic couples attempting conception, given the potential for false-positive and false-negative results. Additionally, it is well established the Zika virus may remain in reproductive fluids, despite negative serologic and molecular test results in blood and urine.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

Interpretation Provides information to assist in interpretation of the test results

A positive test result indicates the presence of Zika virus RNA in the specimen.

 

A negative test result with a positive internal control indicates that Zika virus RNA is not detectable in the specimen.

 

A negative test result with a negative internal control is considered evidence of PCR inhibition or reagent failure. A new specimen should be collected for testing if clinically indicated.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This assay is for in vitro diagnostic use under the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) only.

 

Negative Zika virus RT-PCR results do not preclude infection with Zika virus and should not be used as the sole basis for patient treatment or management decisions. All results should be interpreted by a trained professional in conjunction with review of the patient's exposure history and clinical signs and symptoms.

 

False-negative results may arise from degradation of Zika virus RNA during incorrect shipping or storage, and specimen collection after the period that Zika virus RNA is typically found in the patient (7 days after onset of symptoms.)

Supportive Data

The RealStar Zika virus RT-PCR Kit US by Altona Diagnostics received Emergency Use Authorization from the FDA on May 13, 2016. The letter can be accessed at www.fda.gov/downloads/MedicalDevices/Safety/EmergencySituations/UCM501023.pdf.

 

Details regarding the performance characteristics for the RealStar Zika virus RT-PCR kit, as established by the Altona Diagnostics, can be viewed at www.fda.gov/downloads/MedicalDevices/Safety/EmergencySituations/UCM501027.pdf

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Oduyebo T, Igbinosa I, Petersen EE, et al: US Update: Interim Guidance for Health Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure-United States. Morb Mortal Wkly Rep MMWR 2016 Jul 25;65:739-744

2. United States Food and Drug Administration. Emergency Use Authorizations (Medical Devices). Available at www.fda.gov/MedicalDevices/Safety/EmergencySituations/ucm161496.htm

3. Waggoner JJ, Pinsky BA: Zika Virus: Diagnostics for an Emerging Pandemic Threat. J Clin Microbiol 2016;54(4):860-867

Special Instructions Library of PDFs including pertinent information and forms related to the test