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Revised diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories

  • Published Date:

    February 7, 2016

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    Revision of: Updated diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories. January 13, 2016. Memorandum Many countries in the Americas now have local transmission of multiple arboviruses that can cause febrile illness with rash, myalgia, or arthralgia. Therefore, laboratory testing has become even more important to confirm the etiology of these diseases. Zika, chikungunya, and dengue virus infections should all be considered for patients with acute fever, rash, myalgia, or arthralgia who have traveled within the previous 2 weeks to an area with ongoing transmission or are living in an area with ongoing transmission. In accordance with the Updated Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age During Ongoing Zika Virus Transmission — United States, 2016 (, this test algorithm now includes a recommendation to offer serologic testing to asymptomatic pregnant women with a history of travel to areas with local transmission of Zika virus or are living in an area with ongoing transmission. Laboratory evidence of recent chikungunya, dengue, or Zika virus infection is generally accomplished by testing serum to detect viral nucleic acid or virus- specific immunoglobulin (Ig) M and neutralizing antibodies. However, serological cross- reactivity may occur between Zika and other flaviviruses (e.g., dengue, yellow fever, St. Louis encephalitis, Japanese encephalitis, West Nile), so emphasis should be placed on molecular testing (RT-PCR) in acute specimens received from individuals with clinically compatible illness. Laboratory testing for Zika, chikungunya, and dengue viruses is currently available at CDC and several state and territory health departments.denvchikvzikv-testing-algorithm.pdf
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