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Updated Guidance for Lab Testing for Zika Virus

MMWR; 2016 Nov 25; Centers for Disease Control & Prevention

The Centers for Disease Control and Prevention (CDC) has issued updated guidance for US laboratory testing for Zika virus infection. The guidance updates recommendations for testing of specimens by US laboratories for possible Zika virus infection. Major updates to the guidance with clinical implications for health care providers caring for pregnant women with possible Zika virus exposure, infants with possible congenital Zika virus infections, and nonpregnant persons with suspected Zika virus disease, include:

  • In addition to specimens listed in CDC’s clinical guidance, whole blood can now be tested for Zika virus RNA in accordance with the Emergency Use Authorization (EUA) for Zika virus nucleic acid testing (NAT)* for a) symptomatic persons tested up to 14 days after onset of symptoms, b) asymptomatic pregnant women tested within 14 days of last possible Zika virus exposure, and c) infants tested for congenital Zika virus infection.
  • The use of plaque reduction neutralization testing (PRNT) for confirmation of Zika virus infection, including in pregnant women and infants, is currently not routinely recommended in Puerto Rico.
  • PRNT can be used to test for congenital Zika virus infection in children aged ≥18 months; maternally derived antibodies in the infant are expected to have waned, and therefore PRNT results will reflect infant-derived antibodies. Local health departments should determine when to implement testing of infants aged ≥18 months based on local context, including the regional circulation of similar flaviviruses, laboratory capacity, and other epidemiologic circumstances.


Centers for Disease Control and Prevention. Guidance for U.S. laboratory testing for Zika virus infection: Implications for health care providers. MMWR Morb Mortal Wkly Rep. 2016;65:1304. doi:10.15585/mmwr.mm6546a7.