title: Interim Guidance for Interpretation of Zika Virus Antibody Test Results.
abstract: Zika virus is a single-stranded RNA virus in the genus Flavivirus and is closely related to dengue, West Nile, Japanese encephalitis, and yellow fever viruses (1,2). Among flaviviruses, Zika and dengue virus share similar symptoms of infection, transmission cycles, and geographic distribution. Diagnostic testing for Zika virus infection can be accomplished using both molecular and serologic methods. For persons with suspected Zika virus disease, a positive real-time reverse transcription-polymerase chain reaction (rRT-PCR) result confirms Zika virus infection, but a negative rRT-PCR result does not exclude infection (3-7). In these cases, immunoglobulin (Ig) M and neutralizing antibody testing can identify additional recent Zika virus infections (6,7). However, Zika virus antibody test results can be difficult to interpret because of cross-reactivity with other flaviviruses, which can preclude identification of the specific infecting virus, especially when the person previously was infected with or vaccinated against a related flavivirus (8). This is important because the results of Zika and dengue virus testing will guide clinical management. Pregnant women with laboratory evidence of Zika virus infection should be evaluated and managed for possible adverse pregnancy outcomes and be reported to the U.S. Zika Pregnancy Registry or the Puerto Rico Zika Active Pregnancy Surveillance System for clinical follow-up (9,10). All patients with clinically suspected dengue should have proper management to reduce the risk for hemorrhage and shock (11). If serologic testing indicates recent flavivirus infection that could be caused by either Zika or dengue virus, patients should be clinically managed for both infections because they might have been infected with either virus.
authors.affiliation: Zika virus response epidemiology and laboratory teams, CDC.
authors.forename: Ingrid B
authors.initials: IB
authors.lastname: Rabe
authors.forename: J Erin
authors.initials: JE
authors.lastname: Staples
authors.forename: Julie
authors.initials: J
authors.lastname: Villanueva
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Hummel
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
authors.forename: Laura
authors.initials: L
authors.lastname: Rose
authors.forename: Susan
authors.initials: S
authors.lastname: Hills
authors.forename: Annemarie
authors.initials: A
authors.lastname: Wasley
authors.forename: Marc
authors.initials: M
authors.lastname: Fischer
authors.forename: Ann M
authors.initials: AM
authors.lastname: Powers
mesh_terms: D000914:Antibodies, Viral / Q000302:isolation & purification*; D002487:Centers for Disease Control and Prevention, U.S.; D003715:Dengue / Q000175:diagnosis / Q000628:therapy; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D014481:United States; D000071244:Zika Virus / Q000276:immunology*; D000071243:Zika Virus Infection / Q000175:diagnosis* / Q000628:therapy
chemical_list: D000914:Antibodies, Viral