Kelly Young from NEJM Journal Watch reports that “The CDC offers new guidance for clinicians trying to interpret antibody test results for possible Zika infection.
“When a patient with suspected Zika has a negative result on real-time reverse transcription-polymerase chain reaction testing, antibody testing for both Zika and dengue should be performed (a negative RT-PCR can’t rule out Zika). The new guidance, published in MMWR, includes a helpful table laying out various test result scenarios and how to interpret them.
“In general, clinicians should try to reduce the risk for hemorrhagic complications in patients with suspected dengue. Pregnant women with serologic or molecular evidence of a recent Zika infection should be evaluated and managed for adverse pregnancy outcomes, including early pregnancy loss and microcephaly. In instances where the antibody tests cannot conclusively identify which flavivirus most recently infected a patient, clinicians can use epidemiologic links to a lab-confirmed case of dengue or Zika to help identify the most likely virus affecting their patient. Clinical features and circulating viruses in the area may also be considered.”