Zika Virus: Overview and Laboratory Testing

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David J Moffa, PhD, BCLD
Reviewer: Rodney E. Rohde, PhD, MS, SV, SM(ASCP)CMMBCM

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Continuing Education Credits

  • P.A.C.E.® Contact Hours: 2 hour(s)
  • Florida Board of Clinical Laboratory Science CE - General (Serology/Immunology): 2 hour(s)


  • Understand the virology and pathogenesis of the Zika virus.
  • Describe the modes of transmission, symptoms, and infection risks.
  • Determine the risk of Zika virus infection during pregnancy and the evaluation and consequences of congenital infections.
  • Discuss the diagnosis of Zika virus infection using a combination of clinical symptoms, history, and diagnostic testing.
  • Define the main laboratory tests used for Zika virus identification, including RT-PCR, Zika IgM ELISA and plaque reduction neutralization tests (PRNT).
  • Review the latest Centers for Disease Control and Prevention (CDC) guidelines on Zika virus testing and diagnosis, with emphasis on the evaluation of women and newborns with peripartum Zika virus exposure.
  • Examine the prevention and treatment of Zika virus infections and the status of vaccine development.
  • Review the CDC's Zika virus testing algorithms for symptomatic and asymptomatic individuals.

Course Outline

  • Introduction: Virology and Transmission
      • Virology and Transmission
      • Virology and Transmission (continued)
      • Which of the following choices are true relative to the Zika virus? (Select all that apply.)
      • Mosquitoes carrying the Zika virus typically lay their eggs in moving water (such as streams and rivers) and live near people, where they usually bite...
  • History
      • Transmission History
      • Which of the following statements about the transmission history of the Zika virus is false?
  • Symptoms, Infection, and Risks
      • Symptoms of Zika Infection
      • Clinical Manifestation and Congenital Zika Virus Infection
      • Zika Virus Infection Risks
      • Which statement describing the symptoms and/or conditions associated with Zika infection is TRUE?
      • What is the rare neurological condition that can occur with a congenital Zika virus infection in which an infant's head is significantly smaller than ...
  • Patient Management: General population, Pregnancy, and Newborns
      • Zika Management for the General Population
      • Zika Virus Infection Management for Pregnant Women
      • Zika Virus Infection Management for Women Wanting to Become Pregnant
      • Zika Virus Infection Management for Women Wanting to Prevent Pregnancy
      • If an individual becomes infected with Zika virus, it is not likely that he or she will be protected from future infections.
      • Zika virus infection primarily spreads via infected mosquitoes, but can also spread through sexual contact and blood transfusions.
      • Which of these statements accurately corresponds with the CDC's most recent guidelines on pregnancy management for Zika virus infections?
      • Newborn Management, Evaluation, and Follow-up
      • Which of the following statements is NOT one of the CDC's recommendations for the assessment and testing for Zika virus infection in infants?
  • Diagnosis and Laboratory Testing
      • Overview: Diagnosis and Testing
      • Overview: Diagnosis and Testing (continued)
      • Specimen Types and Collection
      • Since clinical symptoms of Zika virus infection may be absent or minimal, a definitive diagnosis is usually made by laboratory testing of serum or uri...
      • The __________ test measures the Zika virus RNA and is often employed early in the course of the infection. Typically, a positive result using this ty...
    • Laboratory Tests Used for Zika Virus Identification
      • Zika Virus Testing Information Available for Laboratories
      • CDC-Approved Zika Assays and Qualified Laboratories
      • For qualified laboratories within the United States, the CDC has made available two tests for use in identifying the Zika virus; the Trioplex rRT-PCR ...
      • Information for Laboratories: Diagnostic Tests and Emergency Use Authorization (EUA)
      • Which statement(s) correctly describes the FDA's EUA for the detection of the Zika virus?
      • Real-Time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR)
      • Reverse transcription PCR (RT-PCR) is a PCR method that converts sample DNA into complimentary-RNA (cRNA) using the enzyme reverse transcriptase.
      • Trioplex Real-Time RT-PCR Assay
      • Zika IgM ELISA (Zika MAC-ELISA)
      • Zika MAC-ELISA: Key Facts
      • Plaque Reduction Neutralization Test (PRNT)
      • Which choices accurately describe the Trioplex Real-Time RT-PCR Assay? (Select all that apply.)
      • Key Considerations: Interpreting and Reporting Zika Test Results
      • The CDC requires that samples with presumptive positive, equivocal, or inconclusive IgM test results for the Zika virus must be forwarded for confirma...
    • CDC Guidelines on Zika Virus Testing and Diagnosis
      • Overview and Testing Algorithms
      • Overview and Testing Algorithms: Pregnant or Non-Pregnant Symptomatic Individuals
      • Overview and Testing Algorithm: Asymptomatic Pregnant Women
      • If an asymptomatic pregnant woman is considered to have a possible Zika virus exposure, testing of serum and urine using Zika virus NAT should occur t...
  • Prevention, Treatment and Vaccine Development
      • Prevention
      • Prevention of mosquito bites, making plans prior to and after traveling to areas of Zika virus outbreaks, and protecting yourself during sex are all w...
      • Treatment
      • Vaccine Development
  • Summary and Recommendations
      • Summary and Recommendations:
      • Summary and Recommendations (continued)
      • Links to CDC and FDA Zika Information Updates
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended Audience: Clinical laboratory professionals including medical laboratory scientists, medical technologists, and technicians. This course is also appropriate for clinical laboratory science and MLT students, pathologists, and clinicians. 
Author information: David J. Moffa, PhD, BCLD, has over 30 years of experience in the healthcare industry as an executive manager, clinical laboratory director, and medical laboratory scientist. He is currently a technical consultant for Kentmere Healthcare, Wilmington, DE, and until his retirement, was the Regional Director for LabCorp, Inc. He holds a PhD in medical biochemistry from the School of Medicine, West Virginia University.
Reviewer information: Rodney E. Rohde, PhD, MS, SV, SM(ASCP)CMMBCM is the Professor and Chair of the Clinical Laboratory Science Program in the College of Health Professions at Texas State Universit in San Marcos, TX. Dr. Rohde brings his career experiences as a public and clinical microbiologist and infectious disease expert from CDC and the Texas Department of State Health Services Bureau of Laboratories and Zoonosis Control to the classroom. He is also the Associate Dean for Research and has been recognized with multiple research and teaching awards of excellence, including being named one of the Top 20 Professors of Clinical Laboratory Science You Should Know and the 2015 urEssential award from Cardinal Health.  
Course Description: This course is intended to provide a detailed description of the virology and pathogenesis of the Zika virus, including the modes of transmission, symptoms, and infection risks. The primary laboratory tests used for Zika virus identification are included. The CDC's Zika virus testing algorithms for symptomatic and asymptomatic individuals are reviewed, emphasizing the evaluation of women and newborns with peripartum Zika virus exposure. Finally, the prevention and treatment of Zika virus infections and the status of vaccine development is examined. 

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This course is part of:
Overview of the PCR
(Taken from Government public domain use from the National Library of Medicine (NLM). Source: PCR Introduction, NCBI, NIH, available at 
Overview of RT-PCR

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<i>Aedes aegypti</i>. Image courtesy of the CDC.
<em>Aedes aegypti</em> deposited eggs. Image courtesy CDC.