When is Zika virus infection testing indicated in pregnant women?

Updated: Jun 30, 2021
  • Author: Bhagyashri D Navalkele, MD, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Pregnant women and their partner with history of travel to an area with risk for Zika or Zika outbreak, should monitor for symptoms (acute onset of fever, rash, arthralgia, conjuctivitis) and avoid sexual transmission through abstinence or use of condoms. 

Zika testing is recommended in pregnant women under following conditions:

  • Pregnant women with travel to an area with risk for Zika or sex with partner with travel or residence in area with Zika should undergo testing if symptomatic or ultrasound suggest fetus abnormalities related to ZIKV infection.
  • Pregnant women who reside or frequently (daily or weekly) travel to an area with risk for Zika should undergo testing if symptomatic at any time during pregnancy or if asymptomatic during first prenatal care visit and two additional testing at regular prenatal care visits during pregnancy. 

Routine Zika testing is NOT recommended in asymptomatic pregnant women with infrequent travel-associated exposure to an area with Zika.

Guidelines on Zika testing in pregnancy by the Centers for Disease Control and Prevention are as follows [48] :​

Asymptomatic pregnant women:

  • For asymptomatic pregnant persons living in or with recent travel to the United States and its territories, routine Zika virus testing is NOT currently recommended.
  • For asymptomatic pregnant women with recent travel to  an area with risk for Zika outside the United States and its territories, Zika virus testing is NOT routinely recommended, but NAAT testing may still be considered up to 12 weeks after travel.
  • Zika virus serologic testing is NOT recommended for asymptomatic pregnant women.

Symptomatic pregnant women:

  • For symptomatic pregnant women who had recent travel to areas with  a risk of Zika, specimens should be collected for Zika virus NAAT testing on a serum specimen, and Zika virus NAAT on a urine specimenas soon as possible after the onset of symptoms up to 12 weeks after symptom onset. 
  • Zika virus IgM testing is NOT recommended for symptomatic pregnant women.
  • For symptomatic pregnant women who have had sex with someone who lives in or recently traveled to areas with  a risk for Zika, specimen for Zika NAAT should be collected as soon as possible after the onset of symptoms up to 12 weeks after sympt

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