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Table 1
Testing algorithms for pregnant women with a history of travel to ZIkV areas with or without clinical illness consistent with ZIkV infections.
PREGNANT WOMEN WITH
HISTORY OF TRAVEL TO ZIKV AREA
→
→
Pregnant women reports clinical illness consistent Pregnant women does not report clinical illness consiswith ZIkV disease or within 2 weeks of travel
tent with ZIkV disease during or with 2 weeks of travel
→
→
Test for ZIkV Infection
Fetal ultrasound to detect microcephaly or intracranial
calcification
→
→
Either finding present
No findings present
→
→
Test pregnant women
for ZIkV infection. Consider amniocentesis or
ZIkV testing
Consider several ultrasounds
to detect development of
microcephaly or intracranial
calcification
→ → →
Either finding develops
→
→
Fetal ultrasound to detect microcephaly or intracranial calcification. Offer amniocentesis for ZIkV
testing.
→ → →
→
Positive or inconclusive test for ZIKV infection
←
MMWR 2016; 65; 30-33
Table 2
Testing for Zika virus following symptoms onset * (6)
SYMPTOMS ONSET
< 4 days
•
•
•
•
•
4-7 days
•
•
•
•
≥ 7 days
•
•
RT-PCR of serum for detection of ZIkV RNA
Acute serum should be obtained and compared to convalescent serum 2-3
weeks later
Concomitant RT-PCR for dengue and Chikungunya viruses
RT-PCR of serum for detection of ZIkV RNA
ZIkV serologic testing (IgM and confirming neutralizing antibody titers that are
> 4fold higher than dengue virus neutralizing antibody liters.
Acute and convalescent sera obtained to detect an increased antibody liter in 2
weeks period.
Concomitant serology testing for dengue virus infection and Chikungunya virus
infection.
ZIkV serologic testing (IgM and confirmatory neutralizing antibody titers that
are ≥ 4 fold higher than dengue virus neutralizing antibody titers in serum.
Test is considered inconclusive if ZIkV neutralizing antibody titers are < 4 fold
higher than dengue neutralizing antibody titers.
Acute and convalescent sera should be obtained to detect and increased antibody, titer within 2 week interval.
Concomitant serologic testing for dengue virus infection and Chikungunya
virus infection.
*Laboratory specimens may be sent to CDC arborvirus diagnostic laboratory
(1-970-221-6400) or contact local Health Department.
RT-PCR: Reverse-transcriptase polymerase chain reaction
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