Alert from Dr. Mullendore with Buncombe County DHHS Regarding Zika Testing

June 7, 2017

Please see the attached updated guidance for Zika virus testing. Click here to see the form for providers to use.

In 2016, 98 travel-associated cases of Zika virus disease were reported in NC. As of 5/17/17, there have been 3 cases reported in NC in 2017.

  • So far, all reported cases of Zika virus infection in NC have been associated with travel.
  • In 2016, there were cases of Zika locally acquired via mosquitoes in the continental US (South Florida and Texas).

Remember that physicians are required to report suspected or confirmed Zika virus infection.

  • Please contact the Communicable Disease Branch at 919-733-3419 or your local health department (828-250-5109 for Buncombe County Disease Control; available 24/7) if Zika virus infection is suspected, or if a fetal ultrasound shows abnormalities that are consistent with congenital Zika syndrome and the pregnant patient had potential exposure to Zika virus.

Who should be tested for Zika virus?

  • Pregnant women
    • Who are asymptomatic and live in or traveled to an area with Zika or had unprotected sex with a partner who lives in or traveled to an area with active Zika virus transmission
      OR
    • Who have symptoms consistent with Zika virus infection (fever, maculopapular rash, arthralgia, conjunctivitis, myalgia, headache)
  • Non-pregnant women
    • Who have symptoms consistent with Zika virus infection
      AND
    • Who live in or traveled to an area with Zika or had unprotected sex with a partner who lives in or traveled to an area with active Zika virus transmission
  • Men
    • Who have symptoms consistent with Zika virus infection 
      AND
    • Who live in or traveled to an area with Zika or had unprotected sex with a partner who lives in or traveled to an area with active Zika virus transmission

What tests should be ordered and when?

  • See the attached memo.
  • The CDC also has an interactive tool at https://www.cdc.gov/zika/pregnancy/widget.html to help healthcare providers determine if Zika testing is indicated, what labs need to be ordered, or how to interpret test results.

New guidance on Zika IgM interpretation

  • It has been shown that Zika virus infection may result in prolonged IgM response, so that IgM detection may not always indicate a recent infection. For more info, go to https://emergency.cdc.gov/han/han00402.asp

Where is Zika virus testing available?

  • Private/commercial labs
  • For testing through the NC State Lab of Public Health, see the attached memo and “Special Serology” lab form.
    • PLEASE NOTE THAT WE DO NOT PERFORM ZIKA VIRUS TESTING AT THE BUNCOMBE COUNTY DEPT. OF HEALTH.

For further info on Zika for healthcare providers, including guidance on preconception counseling, see https://www.cdc.gov/zika/hc-providers/index.html

This updated memo will also be posted on the NC DHHS Communicable Disease webpage on Zika:  http://epi.publichealth.nc.gov/zika/

As always, contact Buncombe County Disease Control at 828-250-5109 if you have any questions regarding this or other communicable disease matters.

Thanks,
Jenni
Jennifer Mullendore, MD, MSPH
Medical Director
Buncombe County Health and Human Services

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