Zika Virus: Diagnostics for an Emerging Pandemic Threat

Waggoner, Jesse J.; Pinsky, Benjamin A.

doi:10.1128/jcm.00279-16

Cited by 235 publications

(273 citation statements)

References 86 publications

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“…Some investigators and CDC guidance have recommended the use of assays for two targets when testing for the virus is performed, requiring both target assays to return a positive result (two-target-positive result) before considering a sample to be positive. Most laboratories have found assays targeting the envelope gene to be more sensitive than those for other genomic targets (20). With the low viral loads seen in ZKV specimens, especially in serum samples, a requirement for both targets to be positive may result in numerous equivocal results, causing ongoing clinical dilemmas particularly for pregnant patients.…”

Section: Discussionmentioning

confidence: 99%

Zika Virus Testing Considerations: Lessons Learned from the First 80 Real-Time Reverse Transcription-PCR-Positive Cases Diagnosed in New York State

et al. 2017

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The performance and interpretation of laboratory tests for Zika virus (ZKV) continue to be evaluated. Serology is cross-reactive, laborious, and frequently difficult to interpret, and serum was initially solely recommended for molecular diagnosis. ZKV testing was initiated in January 2016 in New York State for symptomatic patients, pregnant women, their infants, and patients with Guillain-Barré syndrome who had traveled to areas with ZKV transmission. Subsequently, eligibility was expanded to pregnant women with sexual partners with similar travel histories. Serum and urine collected within 4 weeks of symptom onset or within 6 weeks of travel were tested with real-time reverse transcription-PCR (RT-PCR) assays targeting the ZKV envelope and NS2B genes. In this review of lessons learned from the first 80 positive cases in NYS, ZKV RNA was detected in urine only in 50 patients, in serum only in 19 patients, and in both samples concurrently in 11 patients, with average viral loads in urine a log higher than those in serum. Among 93 positive samples from the 80 patients, 41 were positive on both gene assays, 52 were positive on the envelope only, and none were positive on the NS2B only. Of the 80 infected patients, test results for 74 (93%) would have defined their infection status as not detected or equivocal if the requirement for positive results from two assay targets (two-target-positive requirement) in the initial federal guidance to public health laboratories was enforced, if urine was not tested, or if the extended eligibility time for molecular testing was not implemented. These changes facilitated more extensive molecular diagnosis of ZKV, reducing reliance on time-consuming and potentially inconclusive serology.

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Section: Discussionmentioning

confidence: 99%

Zika Virus Testing Considerations: Lessons Learned from the First 80 Real-Time Reverse Transcription-PCR-Positive Cases Diagnosed in New York State

et al. 2017

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“…One newborn had no clinical signs or symptoms, whereas the other presented with diffuse rash and thrombocytopenia [52,69]. To date, microcephaly has not been reported in any child who was infected with ZIKV at the time of birth [70]. The signs and symptoms of the disease in children are similar to those of infected adults [11,69]; however, arthralgia is sometimes difficult to detect in children and can manifest as irritability, pain on palpation, walking with a limp, refusal to move or movement with great difficulty, or feeling pain while moving the affected joint [69].…”

Section: Childrenmentioning

confidence: 96%

Zika virus disease: a current review of the literature

et al. 2016

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“…The symptoms last for one week on average, and arthralgia may last two weeks [45]. Conjunctivitis and periorbital edema are more frequent symptoms than in other Flaviviridea infections such as dengue [46,47]. The hospitalization rate is low and fatality is extremely rare [3].…”

Section: Clinical Features and Differential Diagnosismentioning

confidence: 99%

Global Alert: Zika Virus-an Emerging Arbovirus

Özkurt¹,

Tanrıverdi²

2017

Eurasian J Med

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Zika virus (ZIKV) is an arbovirus of the Flavivirus genus, and it has an envelope and a single RNA molecule. In early 2016, the World Health Organization declared ZIKV infection to be an emerging global health threat. The major transmission route of the virus to humans is Aedes mosquitoes. ZIKV can be transmitted between humans by transplacental, perinatal, and sexual routes and via blood and body fluids. ZIKV infection usually results in a mild and self-limiting disease with low-grade fever, conjunctivitis, and periorbital edema. Neurological complications such as Guillain-Barré syndrome, meningoencephalitis, acute disseminated encephalomyelitis, acute myelitis, and transverse myelitis have been reported during ZIKV infection. Intrauterine and congenital ZIKV infections have strong teratogenic effects on the fetus. Intrauterine or congenital ZIKV infection can lead to microcephaly, ocular anomalies (such as macular atrophy, pigment mottling, and optic nerve anomalies), and cardiac anomalies (such as atrial or ventricular septal defect). Calcification in the brain between the cortical and subcortical areas, ventriculomegaly, cerebellar hypoplasia, corpus callosum hypoplasia, cortical/subcortical atrophy, delayed myelination, enlarged cisterna magna, and craniofacial disproportion have been reported as brain development defects. ZIKV infection usually results in a mild disease, and it does not require specific therapy. However, complications of infection during the early period of life are serious. Thus, many drugs have been investigated, and vaccine development studies have been conducted to prevent ZIKV infection. Vector control and personal protection from mosquito-borne transmission are important for decreasing the prevalence of ZIKV infection. In particular, pregnant residents or travelers to endemic areas should be carefully protected against mosquito-borne transmission.Keywords: Zika virus, Flavivirus, microcephaly, Guillain-Barré Syndrome, aedes, arbovirus ÖZ Zika virus (ZIKV), Flavivirus ailesinden sivrisineklerle bulaşan zarflı ve tek sarmallı RNA'ya sahip bir arbovirusdur. 2016 yılı başında Dünya Sağlık Örgütü (DSÖ) ZIKV enfeksiyonunun giderek önemi artan bir küresel tehdit olduğunu açıklamıştır. Virusun insanlara esas geçiş yolu Aedes tipi sivrisineklerin ısırmasıdır. İnsanlar arasında transplasental, perinatal, cinsel yolla, ayrıca kan ve vücut sıvıları aracılığı ile bulaşır. ZIKV enfeksiyonu genellikle hafif ve kendini sınırlandıran hastalık olup, düşük derecede ateş, konjuktivit ve periorbital ödem ile seyreder. ZIKV enfeksiyonu esnasında Guillain-Barre sendromu, meningoensefalit, akut dissemine ensefalomyelit (ADEM), akut myelit, transvers myelit gibi nörolojik komplikasyonlar rapor edilmiştir. Intrauterin ve konjenital ZIKV enfeksiyonu fetus üzerinde ağır teratojenik etkiye sahiptir. İntrauterin enfeksiyon mikrosefali, oküler anomaliler (maküler atrofi, pigment beneklenmesi ve optik sinir anomalileri gibi) ve kardiyak anomalilere (atrial veya ventriküler septal defekt gibi) yol açabilir. ...

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Zika Virus: Diagnostics for an Emerging Pandemic Threat

Cited by 235 publications

References 86 publications

Zika Virus Testing Considerations: Lessons Learned from the First 80 Real-Time Reverse Transcription-PCR-Positive Cases Diagnosed in New York State

Zika Virus Testing Considerations: Lessons Learned from the First 80 Real-Time Reverse Transcription-PCR-Positive Cases Diagnosed in New York State

Zika virus disease: a current review of the literature

Global Alert: Zika Virus-an Emerging Arbovirus

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