The Complex Interpretation and Management of Zika Virus Test Results

Kenneth W. Lin, MD, MPH; John D. Kraemer, JD, MPH; Rachael Piltch-Loeb, MSPH; Michael A. Stoto, PhD


J Am Board Fam Med. 2018;31(6):924-930. 

In This Article

Implications for Clinicians

What follows from these scenarios? First, women who have a low pretest probability of infection should be counseled against testing. Conversely, since a negative test cannot "rule out" Zika virus infection in women with a high pretest probability of infection, enhanced prenatal monitoring and newborn evaluation should still occur, regardless of the test result. Second, an interpretation of the results depends on what tests are used; patient characteristics, such as where the individual lives or has traveled; and why was the test performed (eg, in response to symptoms, known exposure, concerns about pregnancy complications, or for active surveillance purposes). Third, many of these ambiguities leading to potential false positives can be resolved through an adherence to CDC's sequential testing algorithms,[10] but this will sometimes require plaque reduction neutralization tests, which are of limited availability. Now that the CDC only recommends universal testing for pregnant women who present with Zika virus-compatible symptoms or ongoing Zika virus exposure throughout pregnancy, clinicians should take all these factors into account in shared decision-making discussions with pregnant women about whether to test or not.