Recommendations for Zika virus testing should be adapted to specific patient circumstances. This provides the current, best available guidance for the most common scenarios. Specific information on INFANT DIAGNOSTIC TESTING GUIDANCE TABLE - consultation with MDPH is required and available 24/7 by calling 617-983-6800 Category Sample Type Timing Additional Notes About Testing Infants born to mothers with confirmed Specimens from infant Infant testing is recommended even if infant appears clinically Infant serum (≥1 mL) laboratory evidence of Zika virus infection1 2 days delivery well Infant urine ≤ Infants born to mothers with evidence of Specimens from infant Infant testing is recommended even if infant appears clinically Infant serum (≥1 mL) infection with a non-specified flavivirus2 2 days after delivery well Infant urine ≤ Specimens from infant Infant (≥1 mL) Infants born with identified abnormalities 2 days after delivery ≤ Infant urine OR Formalin-fixed placenta tissues Fetus with identified abnormalities detected Maternal serum and urine if not on ultrasound previously tested AND Amniocentesis has inherent and a decision to perform it Amniotic fluid can be considered Maternal risk factor for Zika virus infection3 should be made in context and with informed discussion. The AND mother did NOT have laboratory- ability of a negative amniotic fluid RT-PCR to exclude confirmed Zika virus infection infection is not known. Fetal losses, miscarriages, or still births Products of conception contact – AND MDPH to discuss whether testing is Contact MDPH to Specific specimens will depend on gestational age of fetus Maternal risk factor for Zika virus infection3 indicated and specific specimens to discuss and will require consultation with an epidemiologist AND mother did NOT have laboratory- submit confirmed Zika virus infection 1Confirmatory laboratory evidence of Zika virus infection includes detection of viral RNA in maternal serum or urine (PCR positive), or an anti-Zika IgM antibody positive result with positive Zika neutralizing antibody titers and negative titers against dengue (<10) 2Evidence of infection with an unspecified flavivirus includes a positive or equivocal IgM antibody for Zika virus with positive neutralizing antibody titers for both Zika and Dengue 3Risk factors for maternal Zika virus infection include travel to or residence in an area with Zika virus (See ) or unprotected sexual contact with a partner with travel to or residence in such area. .
Recommendations for Zika virus testing should be adapted to specific patient circumstances. This provides the current, best available guidance for the most common scenarios. Specific information on INFANT DIAGNOSTIC TESTING GUIDANCE TABLE - consultation with MDPH is required and available 24/7 by calling 617-983-6800 Category Sample Type Timing Additional Notes About Testing Infants born to mothers with confirmed laboratory evidence of Zika virus infection1 Infant serum (≥1 mL) Infant urine Specimens from infant ≤ 2 days delivery Infant testing is recommended even if infant appears clinically well Infants born to mothers with evidence of infection with a non-specified flavivirus2 Infant serum (≥1 mL) Infant urine Specimens from infant ≤ 2 days after delivery Infant testing is recommended even if infant appears clinically well Infants born with identified abnormalities OR Fetus with identified abnormalities detected on ultrasound AND Maternal risk factor for Zika virus infection3 AND mother did NOT have laboratory- confirmed Zika virus infection Infant (≥1 mL) Infant urine Formalin-fixed placenta tissues Maternal serum and urine if not previously tested Amniotic fluid can be considered Specimens from infant ≤ 2 days after delivery Amniocentesis has inherent and a decision to perform it should be made in context and with informed discussion. The ability of a negative amniotic fluid RT-PCR to exclude infection is not known. Fetal losses, miscarriages, or still births AND Maternal risk factor for Zika virus infection3 AND mother did NOT have laboratory- confirmed Zika virus infection Products of conception – contact MDPH to discuss whether testing is indicated and specific specimens to submit Contact MDPH to discuss Specific specimens will depend on gestational age of fetus and will require consultation with an epidemiologist 1Confirmatory laboratory evidence of Zika virus infection includes detection of viral RNA in maternal serum or urine (PCR positive), or an anti-Zika IgM antibody positive result with positive Zika neutralizing antibody titers and negative titers against dengue (<10) 2Evidence of infection with an unspecified flavivirus includes a positive or equivocal IgM antibody for Zika virus with positive neutralizing antibody titers for both Zika and Dengue 3Risk factors for maternal Zika virus infection include travel to or residence in an area with Zika virus (See ) or unprotected sexual contact with a partner with travel to or residence in such area. .
dph-infant-zika-advisory.docx