Zika Virus RNA Detection by Real Time PCR - Serum

Bacterial/ Viral

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No Fasting Required

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Detects Zika viral RNA.

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Zika Virus RNA Detection by Real Time PCR - Serum

Why is it done?
- Detects and identifies Zika virus RNA in serum samples using real-time polymerase chain reaction (PCR) technology for acute viral infection diagnosis
- Diagnosis of acute Zika virus infection in patients presenting with clinical symptoms such as fever, rash, joint pain, and myalgia
- Identification of Zika virus in symptomatic patients during the acute phase of infection (typically within the first 5-12 days of symptom onset)
- Screening of pregnant women or those with suspected intrauterine exposure to rule out congenital Zika virus infection
- Investigation of severe complications such as Guillain-Barré syndrome and neurological manifestations potentially associated with Zika infection
- Blood donor screening to prevent transmission of Zika virus through transfusions
- Epidemiological surveillance and monitoring of Zika virus outbreaks in endemic and non-endemic regions
Normal Range
- Negative Result: No Zika virus RNA detected in the serum sample; indicates absence of active Zika virus infection at the time of testing
- Positive Result: Zika virus RNA detected; indicates active Zika virus infection; specific cycle threshold (Ct) or quantification cycle (Cq) values may be reported (typically <40 indicates positive)
- Units of Measurement: Reported as Detected/Not Detected or as Cycle Threshold (Ct) value; some laboratories may report viral load in copies/mL
- Clinical Interpretation: Negative results indicate no current Zika viremia; positive results confirm active infection requiring clinical follow-up and potential public health notification
- Timing Considerations: RNA detection window is limited to acute phase (approximately 3-14 days after symptom onset); negative results in symptomatic patients with suspected infection may require serological testing (IgM antibodies)
Interpretation
- Positive Test Result: Confirms active Zika virus infection with viral replication occurring in the bloodstream; indicates patient is contagious and can transmit virus through mosquito vectors; in pregnant women raises concern for congenital infection and potential adverse fetal outcomes
- Negative Test Result: No current Zika viremia detected; may indicate absence of infection, past infection with clearance of virus, or testing performed outside acute viremia window; if clinical suspicion remains high, serological testing or repeat testing after 2-3 days may be warranted
- High Ct Values (closer to 40): Suggests lower viral load; may indicate early infection, late-stage infection with declining viremia, or sample quality issues; remains positive but may require careful clinical correlation
- Low Ct Values (closer to 20): Indicates high viral load consistent with acute active infection; patient likely in early phase of illness with maximum viremia and infectious potential
- Factors Affecting Results: Timing of specimen collection relative to symptom onset, sample handling and storage conditions, presence of inhibitors in sample, primer efficiency, and laboratory-specific PCR conditions may influence test sensitivity and Ct values
- Clinical Significance: Real-time PCR is highly specific and sensitive for acute Zika detection; positive results combined with compatible clinical symptoms and epidemiological exposure provide definitive diagnosis; particularly valuable in early symptomatic phase when antibody responses are not yet developed
Associated Organs
- Primary Organ Systems Involved:
  - Circulatory/Hematologic system - virus circulates in blood during acute viremia
  - Nervous system - associated with neurological complications including encephalitis and Guillain-Barré syndrome
  - Reproductive system - placental transmission causing congenital infection and fetal abnormalities
  - Integumentary system - characteristic rash and skin manifestations
  - Musculoskeletal system - arthralgia and joint pain
- Associated Medical Conditions:
  - Acute febrile illness with fever, headache, myalgia, and malaise
  - Maculopapular rash typically appearing on trunk and extremities
  - Polyarthralgia and arthritis, particularly affecting small joints of hands and feet
  - Guillain-Barré syndrome - post-infection autoimmune neurological complication
  - Congenital Zika syndrome - associated with microcephaly, developmental delays, and eye abnormalities
  - Meningitis and encephalitis with neurological manifestations
  - Thrombocytopenia and bleeding complications
- Potential Complications and Risks:
  - Severe neurological complications with potential for long-term disability
  - Adverse pregnancy outcomes including miscarriage and preterm delivery
  - Fetal developmental abnormalities and congenital birth defects
  - Hematologic complications including thrombocytopenia and coagulopathy
  - Secondary infection risk during acute viremia phase
Follow-up Tests
- If Positive Results Obtained:
  - Zika IgM and IgG serology - to assess immune response and differentiate acute from prior infection
  - Complete blood count - to evaluate for thrombocytopenia and other hematologic abnormalities
  - Liver function tests - to assess for hepatic involvement
  - Cerebrospinal fluid (CSF) analysis and Zika RNA testing - if neurological symptoms present
  - Obstetric ultrasound - for pregnant women to assess fetal development and screen for abnormalities
  - Amniocentesis with Zika RNA testing - may be considered in pregnant women to assess fetal infection status
- If Negative Results with Continued Suspicion:
  - Repeat serum Zika RNA PCR testing - if initial testing done too early or too late in illness course
  - Zika IgM serology - to assess for antibody response indicating infection
  - Testing for other arboviruses - dengue and chikungunya RNA/serology to rule out alternative diagnoses
- For Monitoring and Follow-up:
  - Serial Zika RNA testing - not routinely recommended as viremia typically clears within 1-2 weeks
  - Clinical follow-up visits - to monitor symptom resolution and screen for complications
  - Neurology consultation - if Guillain-Barré syndrome or other neurological complications develop
  - Obstetric and pediatric surveillance - for pregnant patients and exposed infants
- Additional Complementary Tests:
  - Dengue and Chikungunya serology/RNA - for differential diagnosis in endemic regions
  - Neuroimaging studies (MRI/CT) - if neurological symptoms present
  - Electromyography and nerve conduction studies - to confirm Guillain-Barré syndrome
Fasting Required?
- Fasting Status: No - Fasting is NOT required for Zika virus RNA detection by real-time PCR serum test
- Specimen Collection: Patient may eat and drink normally; test can be performed at any time of day
- Medications: No specific medications need to be discontinued; patient may take regular medications as prescribed
- Patient Preparation Requirements:
  - No special preparation needed prior to blood draw
  - Wear loose-fitting clothing on arms to facilitate venipuncture
  - Remain hydrated to make blood collection easier
  - Inform phlebotomist of any difficulty with venipuncture or syncope history
- Specimen Handling Considerations:
  - Blood is collected in appropriate serum separator tube (SST) or EDTA tube per laboratory protocol
  - Specimens should be processed promptly and kept at appropriate temperature to preserve RNA integrity
  - Refrigeration at 2-8°C is typically recommended if testing delayed; some specimens may require freezing at -20°C or lower for longer-term storage
  - Contact laboratory for specific collection and storage requirements

How our test process works!