Dr KK Aggarwal
The United States Centers for Disease Control and
Prevention (CDC) has issued updated guidance for diagnostic evaluation of Zika
and dengue virus infection in symptomatic patients. According to the guideline,
nucleic acid amplification tests (NAATs) are the preferred method of diagnosis
for patients with suspected dengue or Zika virus disease.
The key recommendations are:
·
For symptomatic nonpregnant
persons, dengue and Zika virus NAATs should be done on serum collected ≤7 days
after symptom onset. A positive NAAT in symptomatic
persons with possible exposure to dengue and Zika virus typically provides
evidence of acute infection, and no antibody testing is indicated.
·
If NAAT is negative or serum
is collected >7 days after symptom onset, dengue and Zika virus IgM antibody
tests should be done.
·
Positive IgM antibody test
results with negative NAAT results should be confirmed by neutralizing antibody
tests when clinically or epidemiologically indicated, including for all
pregnant women.
·
Pregnant women with a
clinically compatible illness and recent possible exposure to dengue and Zika
virus should have concurrent diagnostic testing for dengue and Zika virus
infection performed by NAAT and IgM antibody testing on a serum specimen and
NAAT on a urine specimen to diagnose Zika virus infection
·
If either dengue or Zika virus
IgM antibody testing is positive without a positive NAAT or NS1 antigen test,
and definitive diagnosis is needed for clinical or epidemiologic purposes,
confirmatory Plaque reduction neutralization tests (PRNTs) should be performed
against dengue, Zika, and other flaviviruses endemic to the region where
exposure occurred.
(Source: MMWR Recomm Rep. 2019 Jun 14; 68(1): 1–10).
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President
IMA
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