Molecular diagnosis of Zika virus infections

Abstract

The association between Zika virus (ZIKV) infection and serious complications, such as microcephaly in infants and Guillain–Barre syndrome in adults, necessitates the availability of accurate diagnostic tests. Molecular testing for ZIKV RNA provides the most definitive diagnosis of infection. Since the onset of the ZIKV outbreak in the Americas, numerous commercially available assays and laboratory developed tests have been established for Zika RNA. Laboratories now have a wide variety of options available, and choices depend on their resources and patient needs. Molecular detection of Zika RNA however is complicated by issues such as low viral loads, short periods of positivity in some common specimen types, complex decisions on appropriate specimen selection, and timing of specimen collection. Further, the fact that most patients are asymptomatic during the primary infection makes the timing of specimen collection difficult to calculate, but testing still important for high-risk situations such as pregnant women.