SFDPH Health Update: Zika Virus September 21, 2016 SF Dept of Public Health San Francisco Department of Public Health, Zika 0 HEALTH UPDATE: ZIKA VIRUS SEPTEMBER 20, 2016 (UPDATED FROM JULY 28, 2016) WHAT HAS CHANGED Several commercial laboratories now offer the convenience of Zika RT-PCR testing and/or Zika IgM antibody testing, and so clinicians may opt to order Zika testing through a commercial lab. Due to the complexity of CDC Zika testing guidance, providers ordering testing through commercial labs should contact their lab to ensure the appropriate test is available and should order testing according to the recommended testing algorithm (read the full Health Update). ACTIONS REQUESTED OF ALL CLINICIANS Counsel pregnant women in any trimester to postpone travel to Zika transmission areas and counsel patients regarding prevention of sexual transmission of Zika virus, especially pregnant women, women planning pregnancy, or their partners. See SFDPH Zika Health Advisory dated July 28, 2016 for details. Counsel all travelers to Zika transmission areas to adhere strictly to recommended mosquito bite precautions. Test for Zika per CDC guidance. Zika testing is recommended for: (A) individuals who develop illness consistent with Zika disease within 2 weeks after potential exposure, and (B) asymptomatic pregnant women with potential Zika exposure.1 Testing is not recommended for asymptomatic, non-pregnant patients, even those with potential Zika exposure. Initially test with serum and urine RT-PCR if symptom onset or last potential exposure date (if pregnant) was less than 14 days before specimen collection. Initially test with serum IgM if symptom onset or last potential exposure date (if pregnant) was 2-12 weeks before specimen collection. Depending on results, additional testing may be required to confirm or rule out Zika infection. Providers ordering testing through commercial labs should contact their commercial laboratory to ensure the appropriate test is available, and the current testing algorithm (see next page) is being followed. Please note that when necessary, commercial labs can route specimens to a public health laboratory to perform the plaque reduction neutralization testing (PRNT) needed to confirm Zika reactive IgM results. Providers who plan to send testing directly through Public Health should follow SFDPH-specific instructions for test submission. See www.sfcdcp.org/zika_providers to download the updated instructions. Coordinate between prenatal care and labor/delivery settings: Prenatal providers should have a systematic way of communicating Zika testing so that Labor/Delivery personnel are aware of any pending Zika tests. Neonatal providers should consider holding a newborn serum specimen pending the maternal test result. Contact SFDPH Communicable Disease Control Unit (CDCU) for questions at (415) 554-2830. Check for updates regularly as knowledge and guidance are evolving rapidly. Read the full SFDPH Health Update. Recommended Resources: www.cdc.gov/zika www.cdph.ca.gov/HealthInfo/discond/Pages/Zika.aspx www.sfcdcp.org/zika_providers Comments are closed.
