Zika virus infection laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.
Overview
The diagnosis of Zika virus infection is usually made by detection of elevated IgM and IgG Zika virus antibodies on ELISA or viral RNA on RT-PCR. Non-specific lab findings include elevated markers of inflammation, mild neutropenia, normal leukocyte count or mild leukocytosis with normal platelet count and liver function tests.
Laboratory Findings
- The diagnosis of Zika virus infection is usually made by detection of elevated IgM and IgG Zika virus antibodies on ELISA or viral RNA on RT-PCR.
- Patients with Zika virus may also have the following non-specific lab findings
Non-Specific Laboratory Findings
- Elevated markers of inflammation and acute phase reactants (e.g. ESR, C-reactive protein, ferritin)
- Elevated lactate dehydrogenase (LDH)
- Mild neutropenia
- Normal leukocyte count / mild leukocytosis
- Platelet count and liver function tests (LFTs) are usually normal (vs. thrombocytopenia and elevated LFTs in Dengue fever)
ELISA
- ELISA can be used to detect virus-specific IgM (anti-ZIKV-IgM) and neutralizing antibodies toward the end of the first week of illness.
- Cross-reaction with related flaviviruses (e.g., dengue and West Nile viruses) is common and may be difficult to discern.
- Plaque-reduction neutralization testing can be performed to measure virus-specific neutralizing antibodies and discriminate between cross-reacting antibodies in primary flavivirus infections.[1]
PCR
- During the first week after onset of symptoms, Zika virus may be diagnosed by performing reverse transcriptase-polymerase chain reaction (RT-PCR) on serum.
References
- ↑ For HealthCare Providers: Diagnostic Testing. Center for Disease Control and Prevention (June 1, 2015). http://www.cdc.gov/zika/hc-providers/diagnostic.html Accessed December 21, 2015.