{"id":1059,"date":"2016-05-26T18:20:33","date_gmt":"2016-05-26T18:20:33","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=1059"},"modified":"2017-08-21T10:56:01","modified_gmt":"2017-08-21T10:56:01","slug":"primary-care-corner-with-geoffrey-modest-md-zika-virus-testing","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/05\/26\/primary-care-corner-with-geoffrey-modest-md-zika-virus-testing\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Zika Virus Testing"},"content":{"rendered":"<p><strong>By Dr. Geoffrey Modest<\/strong><\/p>\n<p>Zika virus testing: the CDC just published new guidance for testing for the Zika virus (see\u00a0<a href=\"http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6518e1.htm?s_cid=mm6518e1_w\">http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6518e1.htm?s_cid=mm6518e1_w<\/a> ):<\/p>\n<ul>\n<li>Use real-time reverse transcription-polymerase chain reaction (rRT-PCR) on urine if &lt;14 days after the onset of symptoms in patients with suspected Zika virus disease<\/li>\n<li>Use rRT-PCR test on urine and on serum if &lt;7\u00a0days after symptom onset<\/li>\n<li>Any positive test result provides evidence of Zika infection<\/li>\n<\/ul>\n<p>Basis of recommendations (details in\u00a0<a href=\"http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6518e2.htm?s_cid=mm6518e2_w\">http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6518e2.htm?s_cid=mm6518e2_w<\/a> )<\/p>\n<ul>\n<li>rRT-PCR is a rapid test and is highly specific<\/li>\n<li>In most patients, the Zika virus RNA is not detected in the serum after the first week of illness<\/li>\n<li>Recent report found the\u00a0rRT-PCR to be positive in the urine for at least 2 weeks after onset of symptoms (in Florida study, from as early as 1st day of symptoms till as late as 20 days later)<\/li>\n<li>The Florida study also found that of 66 cases, 61 (92%)\u00a0had positive urine and 31 (47%) positive blood testing.<\/li>\n<li>Within the first 5 days of symptoms, of 55 patients, 52(95%) had a positive urine test and 31 (56%) had a positive blood test<\/li>\n<li>&gt;5 days after symptoms, 9 (82%) had positive urine\u00a0and none\u00a0had positive serum<\/li>\n<li>Of the 53 who had testing at multiple sites: 92% had positive urine, 81% positive saliva, and 51% positive serum<\/li>\n<\/ul>\n<p>So, urine testing is by far the most sensitive overall, but there are occasional cases of Zika positive only on blood testing.<\/p>\n<p>No change in recommendations on who to test (see\u00a0<a href=\"http:\/\/www.cdc.gov\/zika\/pdfs\/denvchikvzikv-testing-algorithm.pdf\">http:\/\/www.cdc.gov\/zika\/pdfs\/denvchikvzikv-testing-algorithm.pdf<\/a> ):<\/p>\n<ul>\n<li>Persons with 2 or more of: rash, fever, arthalgias or conjunctivitis during or within 2 weeks of return from an area with Zika virus activity, or with a link to a Zika virus infected traveler (sexual partner, household contact, etc.)<\/li>\n<li>For CDC guidance for women of reproductive age with possible Zika virus exposure, see\u00a0<a href=\"http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6512e2.htm\">http:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm6512e2.htm<\/a><\/li>\n<\/ul>\n<p>For recent review on Zika: see\u00a0<a href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/04\/27\/primary-care-corner-with-geoffrey-modest-md-zika-virus-review\/\">https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/04\/27\/primary-care-corner-with-geoffrey-modest-md-zika-virus-review\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Primary Care Corner with Geoffrey Modest MD: Zika Virus Testing  [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/05\/26\/primary-care-corner-with-geoffrey-modest-md-zika-virus-testing\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-1059","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/1059","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=1059"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/1059\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=1059"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=1059"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=1059"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}