Abstract
ObjectiveTo review the state of knowledge about diagnostic testing for Zika virus infection and identify areas of research needed to address the current gaps in knowledge.MethodsWe made a non-systematic review of the published literature about Zika virus and supplemented this with information from commercial diagnostic test kits and personal communications with researchers in European preparedness networks. The review covered current knowledge about the geographical spread, pathogen characteristics, life cycle and infection kinetics of the virus. The available molecular and serological tests and biosafety issues are described and discussed in the context of the current outbreak strain.FindingsWe identified the following areas of research to address current knowledge gaps: (i) an urgent assessment of the laboratory capacity and capability of countries to detect Zika virus; (ii) rapid and extensive field validation of the available molecular and serological tests in areas with and without Zika virus transmission, with a focus on pregnant women; (iii) monitoring the genomic diversity of circulating Zika virus strains; (iv) prospective studies into the virus infection kinetics, focusing on diagnostic sampling (specimen types, combinations and timings); and (v) developing external quality assessments for molecular and serological testing, including differential diagnosis for similar viruses and symptom clusters. The availability of reagents for diagnostic development (virus strains and antigens, quantified viral ribonucleic acid) needs to be facilitated.ConclusionAn international laboratory response is needed, including preparation of protocols for prospective studies to address the most pressing information needs.
Highlights
On 1 February 2016, the World Health Organization (WHO) declared that the recent cluster of microcephaly cases and other neurological disorders reported in the Americas, where an outbreak of Zika virus infection is ongoing, constitutes a public health emergency of international concern.[1]
Zika virus is a mosquito-borne virus related to yellow fever, dengue, West Nile, Japanese encephalitis and tick-borne encephalitis viruses which all belong to the virus family Flaviviridae and genus Flavivirus
The question arises whether the increased incidences of Guillain–Barré syndrome and microcephaly in the current outbreak are due to certain specific virulent strains or to a common pattern of all Zika virus strains that have gone unnoticed because of the low number of cases in previous outbreaks.[8]
Summary
We made a non-systematic review to present the essential background information and current gaps in knowledge about diagnostic testing for Zika virus infection in humans. Perinatal transmission most probably occurs by transplacental transmission or during delivery by an infected mother.[34] Sexual transmission has been indicated in multiple cases.[35] Zika virus has been isolated from semen collected 14 days after the start of symptoms,[36] while detection of the Zika virus genome was described in semen at 28 and 62 days after the onset of symptoms.[37] The potential for Zika virus transmission via blood transfusion was identified in the French Polynesia outbreak in 2013–201438 and the Bra-. Data from the French Polynesia outbreak described viraemia that was of low intensity and short duration.[40,41,42] Zika virus has been detected in serum, saliva, urine and nasopharyngeal swabs by molecular methods. Pan-genus and syndromic serum panel tests and antigens need to be available and confirmatory techniques such as enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay and virus neutralizing testing are required
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