Zika Virus Information for Health Care Providers
The following information has been summarized from guidance provided by the Centers for Disease Control and Prevention (CDC).
- Ask all pregnant patients about possible Zika virus exposure during each prenatal visit. Potential Zika virus exposures include travel to areas with active Zika virus transmission and sexual contact with persons who have traveled to areas with active Zika transmission.
- For any patient presenting with symptoms consistent with Zika virus, ask about travel history and possible Zika virus exposure and assess for pregnancy status.
- Symptomatic travelers, including pregnant women, who have visited areas with active Zika virus transmission and had illness onset during travel or within 2 weeks from returning are recommended for testing.
- Asymptomatic pregnant women who have traveled to areas with active Zika virus transmission within the past 2 to 12 weeks or who had sexual contact with a male who traveled to an area of active Zika transmission and had clinical illness consistent with Zika virus can be offered testing.
- Note - Clinical illness consistent with Zika virus disease includes 1 or more of the following symptoms: acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis.
- The testing criteria listed here are for general purposes and may not include all situations that would necessitate testing of Zika virus. Health care providers should contact the regional health department in their area to discuss any patients suspected of having Zika virus. See information below in 'How to Report and Test'.
How to Report and Test
- Zika is a nationally notifiable condition and reportable in South Carolina.
- Report all suspected and confirmed cases of Zika virus disease by calling the regional health department in your area. View Contact information for DHEC regional health departments (pdf).
- DHEC regional staff will collect patient data using a standardized data collection tool and can assist with consultation regarding testing and specimen collection.
- The collected information will be reviewed to verify that testing criteria are met. If testing criteria are met, patient specimens can be submitted for testing. If the patient is not available to provide specimens at a later time, and there may be a delay in determining if testing criteria are met, consider collecting and holding the specimens. After collection, specimens should be kept cold.
- The DHEC Guidance for Zika Testing and Response to Zika: When to Test for Zika Virus offer more information on reporting and testing.
- The DHEC Bureau of Labs performs the Zika Trioplex rRT-PCR assay and CDC Zika MAC-ELISA serology test for Zika IgM.
- Serum and urine are the recommended specimens for testing.
- Serum: At least 0.5 mL of serum is needed for testing. Blood specimens should be collected in a red top tube or in a serum separator tube (SST). If using a red top tube, remove the serum from the red cell layer. The blood should be spun down as soon after collection as possible.
- Urine: At least 0.5-1.0 mL is needed for testing. Collect in a sterile container with a tight-fitting screw cap secured with self-sealing lab film, if possible. Other specimen testing can be submitted, if indicated. If you have questions about what testing specimens other than serum and urine, call the regional DHEC staff in your area.
- If assistance is needed with specimen collection, please talk with staff from the regional health department.
- Regional staff will coordinate transport of specimens to DHEC's Bureau of Laboratories for Zika virus testing.
- Turnaround time for test results may vary. In most instances, it is anticipated that results will be available in less than one week.
- Guidance regarding Zika virus disease from CDC and other public health agencies continues to evolve.
- Visit the CDC Zika website for health care providers to view up - to - date information regarding clinical evaluation, testing and other patient guidance.
- Global information on the geographic distribution of Zika virus can be found at www.cdc.gov/zika/geo/index.html
- Information regarding the number of Zika virus disease cases in the United States can be found here at www.cdc.gov/zika/geo/united - states.html
- A Zika Toolkit for healthcare providers who care for non-pregnant women and men of reproductive age has been created by Office of Population Affairs. The toolkit suggests ways to put CDC guidance into practice.
Health Alerts, Notifications
DHEC has issued the following Zika - related advisories through its Health Alert Network.
- August 1, 2016 - CDC Health Advisory - CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito - borne Zika Virus Transmission in Miami - Dade and Broward Counties, Florida
- July 27, 2016 - DHEC Health Advisory - Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016
- June 21, 2016 - CDC Health Update - CDC Recommendations for Subsequent Zika IgM Antibody Testing
- May 18, 2016 - CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Miami-Dade and Broward Counties, Florida
- May 5, 2016 – DHEC Health Advisory – ZIKA Test Approved for Commercial Labs
- May 25, 2016 - CDC Health Update - Diagnostic Testing of Urine Specimens for Suspected Zika Virus Infection
- March 25, 2016 – DHEC Health Advisory – Update: Interim Guidance for Health Care Providers Caring for Women with Possible Zika Virus Exposure – U.S., 2016
- March 11, 2016 – CDC Health Update – Revision to CDC's Zika Travel Notices: Minimal Likelihood for Mosquito-Borne Zika Virus Transmission at Elevations Above 2,000 Meters
- Feb. 23, 2016 - CDC Health Advisory - Update: Interim Guidelines for Prevention of Sexual Transmission of Zika
Virus-United States, 2016
- Feb. 19, 2016 - DHEC Health Advisory - Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection - United States, 2016
- Feb. 6, 2016 - DHEC Health Advisory - New and Updated CDC Guidance Regarding Zika Virus
- Jan. 28, 2016 - DHEC Health Advisory - Interim Guidelines for the Evaluation and Testing of Infants with
Possible Congenital Zika Virus Infection – United States, 2016