Laboratory diagnosis of Zika virus

The recommendations for laboratory diagnosis of ZIKV infection are the detection of viral-RNA by molecular methods, detection of ZIKV-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies by serologic tests and the plaque reduction neutralization test (PRNT) for confirmation of positive IgM results, in pregnant women. In the acute phase of disease ZIKV may be detected in blood (whole blood, serum, plasma), urine, saliva, cerebrospinal fluid (CSF), and other fluids; in urine, the virus may be detected over a longer period, viz., 15-20 days from the onset of symptoms. An accurate laboratory diagnosis requires combining serologic data to molecular testing, as well as clinical and epidemiological criteria, especially for pregnant women and children born with Zika congenital syndromes.