Zika Testing

There are two types of testing used to find out if someone has the Zika virus:

1) Molecular Test for Zika Virus

Real-time reverse transcription-polymerase chain reaction (rRT-PCR)

rRT-PCR testing should be done on blood and urine when a pregnant woman has symptoms, and for pregnant women who do not have symptoms but who have traveled to places with active Zika transmission. A positive rRT-PCR result confirms Zika virus infection and there is no need for other testing. When results are negative it doesn’t mean a person doesn’t have Zika virus. IgM antibody testing should be done to try and rule out the Zika virus.

Trioplex Real-time RT-PCR Assay

The Trioplex rRT-PCR is a laboratory test designed to detect Zika virus, dengue virus, and chikungunya virus RNA. The Food and Drug Administration (FDA) has not cleared or approved this test. However, FDA has authorized the use of this test under an Emergency Use Authorization (EUA).

Who can have this testing?

  • Pregnant women who have symptoms of Zika
    • This testing should be done during the first two weeks after symptoms start
  • Pregnant women without symptoms that have traveled to places with active Zika transmission
    • This testing should be done within 2 weeks of the date of last possible exposure
  • Pregnant women who present for care at and after 2 weeks after exposure and have been found to be IgM positive

2) Serologic Test for Zika Virus

Zika MAC-ELISA/ Plaque Reduction Neutralization Test

The Zika IgM Antibody Capture Enzyme-Linked Immunosorbent Assay (Zika MAC-ELISA) is used to find Zika virus IgM antibodies in blood or fluid taken from the spinal column in the back (cerebrospinal fluid). These results may be difficult to understand so confirmation of these results is done though a Plaque Reduction Neutralization Test (PRNT).

Who can have this testing?

  • Pregnant women who do not have symptoms but who have traveled to an area with Zika
    • This testing should be done within 2-12 weeks after travel or having sexual contact with someone who has the Zika virus infection.
  • When pregnant women with no symptoms live in a place with active Zika virus transmission, they should have this testing as part of routine obstetric care in the 1st and 2nd trimester.

Not everyone needs to have Zika virus testing

If you are not pregnant and have not had symptoms of Zika virus:

  • testing is not recommended for you
  • testing is not the best way to know if you are at risk for passing the virus to someone else

If you are not pregnant and have not had symptoms of Zika virus, but you are at risk for having Zika (from travel or sex), you should follow precautions to prevent passing it to someone else (see How to Prevent Getting or Spreading the Zika Virus).

Testing Information:

  • The Centers for Disease Control and Prevention (CDC), along with state and local health departments are testing for Zika virus. There are different diagnostic tests that can find out if a person is infected with Zika virus disease. Patients can contact their healthcare providers who will contact their state or local health department for testing information
  • Testing can also be done thorough private labs
  • Information on the specific testing, time to results, forms and who qualifies for testing can be found on the companies’ websites

The chart below can help healthcare providers decide who qualifies for testing and what testing is best:

testing-guidance