Whole-Blood Testing for Diagnosis of Acute Zika Virus Infections in Routine Diagnostic Setting

Voermans, Jolanda J.C.; Pas, Suzan D.; Linden, A. van der; GeurtsvanKessel, Corine; Eijk, Annemiek van der; Reusken, Chantal

doi:10.3201/eid2507.182000

Cited by 16 publications

(17 citation statements)

References 13 publications

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“…In pregnant women, viremia has been reported for up to 126 days 25 . Recently, several studies have demonstrated the prolonged detection of ZIKV RNA in whole blood by comparison to plasma samples 105 . Whole blood samples should therefore be considered in asymptomatic patients requiring a confirmed diagnosis, such as pregnant women with fetal anomalies 11 …”

Section: Travel Medicine Implicationsmentioning

confidence: 99%

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Vouga

Chiu

Pomar

et al. 2019

Journal of Travel Medicine

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Rationale for review Young adults of childbearing age and pregnant women are travelling more frequently to tropical areas, exposing them to specific arboviral infections such as dengue, zika and chikungunya viruses, which may impact ongoing and future pregnancies. In this narrative review, we analyse their potential consequences on pregnancy outcomes and discuss current travel recommendations. Main findings Dengue virus may be associated with severe maternal complications, particularly post-partum haemorrhage. Its association with adverse fetal outcomes remains unclear, but prematurity, growth retardation and stillbirths may occur, particularly in cases of severe maternal infection. Zika virus is a teratogenic infectious agent associated with severe brain lesions, with similar risks to other well-known TORCH pathogens. Implications of chikungunya virus in pregnancy are mostly related to intrapartum transmission that may be associated with severe neonatal infections and long-term morbidity. Travel recommendations Few agencies provide specific travel recommendations for travelling pregnant patients or couples trying to conceive and discrepancies exist, particularly regarding Zika virus prevention. The risks significantly depend on epidemiological factors that may be difficult to predict. Prevention relies principally on mosquito control measures. Couples trying to conceive and pregnant women should receive adequate information about the potential risks. It seems reasonable to advise pregnant women to avoid unnecessary travel to Aedes spp. endemic regions. The current rationale to avoid travel and delay conception is debatable in the absence of any epidemic. Post-travel laboratory testing should be reserved for symptomatic patients.

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Section: Travel Medicine Implicationsmentioning

confidence: 99%

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Vouga

Chiu

Pomar

et al. 2019

Journal of Travel Medicine

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“…Historically, Colombia is one of the countries most affected by dengue, chikungunya, and Zika in the Americas region with dengue cases being diagnosed and reported to the national surveillance system since 1950 [ 4 , 27 – 30 ]. Although confirmation of these arboviruses should be based upon a positive result from antigen, antibody, or virus detection and/or isolation, the majority of diagnosis in endemic and resource constraint settings is mostly based on clinical symptoms [ 1 , 12 , 13 , 31 ]. In Colombia, confirmation of probable cases is largely based on clinical diagnosis plus at least one serological positive test or an epidemiological link to a confirmed case 14 days prior to symptoms onset [ 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the reporting of Dengue, Chikungunya and Zika to the National Surveillance System in Colombia from 2014–2017: A Capture-recapture analysis accounting for misclassification of arboviral diagnostics

et al. 2021

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Background Chikungunya, dengue, and Zika are three different arboviruses which have similar symptoms and are a major public health issue in Colombia. Despite the mandatory reporting of these arboviruses to the National Surveillance System in Colombia (SIVIGILA), it has been reported that the system captures less than 10% of diagnosed cases in some cities. Methodology/Principal findings To assess the scope and degree of arboviruses reporting in Colombia between 2014–2017, we conducted an observational study of surveillance data using the capture-recapture approach in three Colombian cities. Using healthcare facility registries (capture data) and surveillance-notified cases (recapture data), we estimated the degree of reporting by clinical diagnosis. We fit robust Poisson regressions to identify predictors of reporting and estimated the predicted probability of reporting by disease and year. To account for the potential misclassification of the clinical diagnosis, we used the simulation extrapolation for misclassification (MC-SIMEX) method. A total of 266,549 registries were examined. Overall arboviruses’ reporting ranged from 5.3% to 14.7% and varied in magnitude according to age and year of diagnosis. Dengue was the most notified disease (21–70%) followed by Zika (6–45%). The highest reporting rate was seen in 2016, an epidemic year. The MC-SIMEX corrected rates indicated underestimation of the reporting due to the potential misclassification bias. Conclusions These findings reflect challenges on arboviruses’ reporting, and therefore, potential challenges on the estimation of arboviral burden in Colombia and other endemic settings with similar surveillance systems.

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“…A better option may lie in performing nucleic acid testing on other types of specimens. The CDC does allow for testing of a variety of biological fluids and even recommends using whole blood in lieu of serum [47,[52][53][54].…”

Section: Discussionmentioning

confidence: 99%

Strain-Dependent Activity of Zika Virus and Exposure History in Serological Diagnostics

et al. 2020

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Zika virus (ZIKV) circulates as two separate lineages, with significant genetic variability between strains. Strain-dependent activity has been reported for dengue virus, herpes simplex virus and influenza. Strain-dependent activity of subject specimens to a virus could be an impediment to serological diagnosis and vaccine development. In order to determine whether ZIKV exhibits strain-dependent activity when exposed to antibodies, we measured the neutralizing properties of polyclonal serum and three monoclonal antibodies (ZKA185, 753(3)C10, and 4G2) against three strains of ZIKV (MR−766, PRVABC59, and R103454). Here, MR−766 was inhibited almost 60% less by ZKA185 than PRVABC59 and R103454 (p = 0.008). ZKA185 enhanced dengue 4 infection up to 50% (p = 0.0058). PRVABC59 was not inhibited by mAb 753(3)C10 while MR−766 and R103453 were inhibited up to 90% (p = 0.04 and 0.036, respectively). Patient serum, regardless of exposure history, neutralized MR−766~30%−40% better than PRVABC56 or R103454 (p = 0.005−0.00007). The most troubling finding was the significant neutralization of MR−766 by patients with no ZIKV exposure. We also evaluated ZIKV antibody cross reactivity with various flaviviruses and found that more patients developed cross-reactive antibodies to Japanese encephalitis virus than the dengue viruses. The data here show that serological diagnosis of ZIKV is complicated and that qualitative neutralization assays cannot discriminate between flaviviruses.Trop. Med. Infect. Dis. 2020, 5, 38 2 of 14 with ZIKV, dengue virus (DENV) and other endemic flaviviruses is recommended by the Centers for Disease Control and Prevention ( CDC) to confirm diagnosis when RT-PCR is negative, and IgM ELISA is "not negative" [7]. Unfortunately, even PRNT can be problematic for diagnosis with over half of patients exhibiting significant neutralization of ZIKV, DENV, and other flaviviruses when positive for ZIKV IgM [9].ZIKV co-circulates with other flaviviruses, including DENV, West Nile virus (WNV), Japanese Encephalitis virus (JEV) and Yellow Fever virus (YFV). Antibody-based assays can be problematic as serological cross-reactivity can confound results [10][11][12]. Furthermore, previous exposures and co-infections can further complicate diagnostic tests [13][14][15]. Additional difficulties arise when diagnosing clinical samples in different locations as reference virus and antigen sources can produce divergent results in response to locally circulating viral isolates [16].Prior to the 2016 outbreak, there were very few ZIKV isolates available for use, which included the prototype MR−766 isolate as well as IbH 30656 a Nigerian isolate and DAK AR 41524 from Senegal (BEIResources.org). MR−766 had been extensively characterized prior to the outbreak and was the reference strain used by many researchers in the early days following emergence [6,[17][18][19][20]. Within a year of emergence, the CDC prototype PRVABC59 was released for use through BEI resources and many labs began using this modern isolate for their research and dia...

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Whole-Blood Testing for Diagnosis of Acute Zika Virus Infections in Routine Diagnostic Setting

Cited by 16 publications

References 13 publications

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Assessing the reporting of Dengue, Chikungunya and Zika to the National Surveillance System in Colombia from 2014–2017: A Capture-recapture analysis accounting for misclassification of arboviral diagnostics

Strain-Dependent Activity of Zika Virus and Exposure History in Serological Diagnostics

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