Zika Virus

David J Moffa, PhD, BCLD
Reviewers: Rodney E. Rohde, PhD, MS, SV, SM(ASCP)CMMBCM and Joshua J. Cannon, MS, MLS(ASCP)CMSHCM

This course is intended to provide a detailed description of the virology and pathogenesis of the Zika virus, including the modes of transmission, symptoms, and infection risks. The primary laboratory tests used for Zika virus identification are included. The CDC's Zika virus testing algorithms for symptomatic and asymptomatic individuals are reviewed, emphasizing the evaluation of women and newborns with peripartum Zika virus exposure. Finally, the prevention and treatment of Zika virus infections and the status of vaccine development is examined.

Continuing Education Credits

Objectives

  • Describe the virology and pathogenesis of the Zika virus.
  • Describe the modes of transmission, symptoms, and infection risks of Zika virus disease.
  • Determine the risk of Zika virus infection during pregnancy and the evaluation and consequences of congenital infections.
  • Discuss the diagnosis of Zika virus infection using a combination of clinical symptoms, history, and diagnostic testing.
  • Define the main laboratory tests used for Zika virus identification, including rRT-PCR, Zika IgM ELISA, and plaque reduction neutralization tests.
  • Review the latest Centers for Disease Control and Prevention (CDC) guidelines on Zika virus testing and diagnosis.
  • Examine the prevention and treatment of Zika virus infections and the status of vaccine development.

Course Outline

  • Introduction: Virology and Transmission
      • Virology and Transmission
      • Virology and Transmission (continued)
      • Which of the following statements relative to the Zika virus is false?
      • True or False: Mosquitoes carrying the Zika virus typically lay their eggs in moving water (such as streams and rivers) and live near people, where th...
  • History
      • Transmission History
      • Which of the following statements about the transmission history of the Zika virus is false?
  • Symptoms, Infection, and Risks
      • Symptoms of Zika Infection
      • Clinical Manifestation and Congenital Zika Virus Infection
      • Zika Virus Infection Risks
      • Which statement describing the symptoms and/or conditions associated with Zika infection is TRUE?
      • What is the rare neurological condition that can occur with a congenital Zika virus infection, in which an infant's head is significantly smaller than...
  • Patient Management: General population, Pregnancy, and Newborns
      • Zika Management for the General Population
      • Zika Virus Infection Management for Pregnant People
      • Zika Virus Infection Management for Pregnant People, continued
      • True or False: If an individual becomes infected with the Zika virus, they are unlikely to be protected from future infections.
      • True or False: Zika virus infection primarily spreads via infected mosquitoes but can also spread through sexual contact and blood transfusions.
      • Newborn Management, Evaluation, and Follow-up
      • Which of the following statements is not one of the CDC's recommendations for the assessment and testing for Zika virus infection in infants?
  • Diagnosis and Laboratory Testing
      • Overview: Diagnosis and Testing
      • Overview: Diagnosis and Testing, continued
      • Specimen Types and Collection
      • True or False: Since clinical symptoms of Zika virus infection may be absent or minimal, a definitive diagnosis is usually made by laboratory testing ...
    • Laboratory Tests Used for Zika Virus Identification
      • Zika Virus Testing Information Available for Laboratories
      • Zika Assays and Qualified Laboratories
      • True or False: Three tests commonly used to identify the Zika virus include Trioplex rRT-PCR, Zika MAC ELISA, and PRNT.
      • Information for Laboratories: Diagnostic Tests and Emergency Use Authorization (EUA)
      • All of the following statements correctly describe the FDA's EUA for the detection of the Zika virus except:
      • Real-Time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR)
      • True or False: Reverse transcription PCR (RT-PCR) is a PCR method that converts sample DNA into complementary RNA (cRNA) using the enzyme reverse tran...
      • Key Considerations: Interpreting and Reporting Zika Test Results
      • True or False: The CDC requires that samples with presumptive positive, equivocal, or inconclusive IgM test results for the Zika virus must be forward...
  • Prevention, Treatment, and Vaccine Development
      • Prevention
      • True or False: Prevention of mosquito bites, making plans before and after traveling to areas of Zika virus outbreaks, and protecting yourself during ...
      • Treatment
      • Vaccine Development
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author information: David J. Moffa, PhD, BCLD, has over 30 years of experience in the healthcare industry as an executive manager, clinical laboratory director, and medical laboratory scientist. He is currently a technical consultant for Kentmere Healthcare, Wilmington, DE, and until his retirement, was the Regional Director for LabCorp, Inc. He holds a PhD in medical biochemistry from the School of Medicine, West Virginia University.
The author has no conflict of interest to disclose. 
Reviewers:
Rodney E. Rohde, PhD, MS, SV, SM(ASCP)CMMBCM is the Professor and Chair of the Clinical Laboratory Science Program in the College of Health Professions at Texas State University in San Marcos, TX. Dr. Rohde brings his career experiences as a public and clinical microbiologist and infectious disease expert from CDC and the Texas Department of State Health Services Bureau of Laboratories and Zoonosis Control to the classroom. He is also the Associate Dean for Research and has been recognized with multiple research and teaching awards of excellence, including being named one of the Top 20 Professors of Clinical Laboratory Science You Should Know and the 2015 urEssential award from Cardinal Health.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab by Vastian. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Course Description: This course provides a summary of the virology and pathogenesis of the Zika virus, including the modes of transmission, symptoms, and infection risks. It also includes the primary laboratory tests used for Zika virus identification. Finally, it examines the prevention and treatment of Zika virus infections and the status of vaccine development.

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<i>Aedes aegypti</i>. Image courtesy of the CDC.
<em>Aedes aegypti</em> deposited eggs. Image courtesy CDC.