Which lab testing is recommended in the workup of Zika virus infection?

Updated: Dec 11, 2018
  • Author: Bhagyashri D Navalkele, MD, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Diagnosis of Zika virus (ZIKV) infection is typically based on serologic testing, although the CDC now recommends urine testing. The CDC has issued interim guidance on Zika virus antibody testing and result interpretation. See Serologic Testing (below).

Urine can be tested via real-time reverse transcription-polymerase chain reaction (rRT-PCR) using samples collected less than 2 weeks following symptom onset. Urine should be tested in conjunction with serum if specimens were obtained less than one week following symptom onset. A positive result on either test confirms Zika virus infection.

The viral level may be higher in urine and for a longer duration than in serum. In Florida, among 55 patients in whom travel-related Zika infection was suspected, urine and serum samples were collected within five days of symptom onset. Fifty-six percent of serum samples tested positive for Zika RNA, while 95% of urine samples tested positive. At day six and afterward, Zika RNA was no longer found in serum, while urine specimens continued to return positive results until day twenty. [20]

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