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Epic Test Code LAB1217 Zika Virus, PCR, Molecular Detection, Serum

Additional Codes

MML:VZIKS


Ordering Guidance


Due to similar clinical presentations, testing for RNA or IgM-class antibodies to dengue and chikungunya viruses, concurrently with Zika virus testing, is strongly recommended.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container: Sterile container

Specimen Volume: 0.5 mL

Collection Instructions:

1. Within 2 hours of collection, centrifuge and aliquot the serum into a sterile container.

2. Serum specimens not aliquoted from the serum gel collection tube into a sterile container will be rejected.


Useful For

Qualitative detection of Zika virus RNA in serum from individuals meeting the Centers of Disease Control and Prevention Zika virus clinical or epidemiologic criteria

Testing Algorithm

The following algorithms are available:

-Assessment for Zika Virus Infection

-Mosquito-borne Disease Laboratory Testing

Method Name

Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR)/DNA Probe Hybridization

Reporting Name

Zika Virus PCR, Serum

Specimen Type

Serum

Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

Gross hemolysis Reject
Heat-inactivated specimen Reject

Clinical Information

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 Southeast 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. Fever, headache, retro-orbital pain, conjunctivitis, maculopapular rash, myalgias, and arthralgias are commonly reported among symptomatic patients. 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 form 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 have received emergency use authorization through the US Food and Drug Administration. 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 the Centers of Disease Control and Prevention testing guidelines, visit www.cdc.gov/zika/.

 

These guidelines are reflected in Assessment for Zika Virus Infection.

 

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

Negative

 

Reference values apply to all ages.

Interpretation

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 polymerase chain reaction inhibition or reagent failure. A new specimen should be collected for testing if clinically indicated.

Cautions

This assay is for in vitro diagnostic use under the US Food and Drug Administration emergency use authorization only.

 

Negative Zika virus reverse transcription polymerase chain reaction 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 US Food and Drug Administration on May 13, 2016.

 

Details regarding the performance characteristics for the RealStar Zika virus RT-PCR kit, as established by Altona Diagnostics, can be viewed at www.fda.gov/media/97712/download

Day(s) Performed

Tuesday, Thursday

Report Available

Same day/1 to 5 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

87662

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.