Alabama Department of Public Health – Health Alert Network
Recommendations for Assessing & Testing Pregnant Patients
8/10/16
Clarification of CDC Update on Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, issued July 2016
  • Providers should assess, not test (unless warranted), all pregnant patients during initial visit and all subsequent visits for possible Zika exposure.
  • Providers with symptomatic pregnant patients with a possible exposure history as defined in the Centers for Disease Control and Prevention’s (CDC) updated guidance should contact the Alabama Department of Public Health (ADPH) Infectious Diseases & Outbreaks Division (ID&O) for consultation and approval for Zika testing.
  • Providers with asymptomatic pregnant patients with possible exposure should contact ID&O for consultation and approval for Zika-specific rRT-PCR testing of serum and urine
  • Providers should contact ID&O for consultation and approval to request rRT-PCR testing after a pregnant patient has a positive or equivocal – Zika IgM antibody test.
  • Providers should request testing of infant blood not “infant blood or cord blood”.

Alabama Department of Public Health Zika Consultation

ADPH requests that all providers contact the Infectious Diseases & Outbreaks Division (ID&O) for consultation prior to ordering Zika testing on patients.  Providers should call ID&O at 1-800-338-8374 to request a Zika Consultation Form.

Reporting Zika Test Results

All test results for arboviral diseases, including Zika virus, are reportable to public health. Physicians, nurses, and laboratory directors are required to report all results (positive, negative, inconclusive, and equivocal) to ID&O within 5 days.

Recommendations for Providers using ADPH’s State Lab to Test for Zika Virus

  • The ADPH Bureau of Clinical Laboratories (BCL) is able to conduct rRT-PCR and MAC-ELISA Zika IgM testing.  Once testing is approved, the specimen collection and shipping instructions will be given to the Provider for testing by the BCL.
    • For specimens submitted to BCL, rRT-PCR requires submission of urine and patient-matched serum specimens within 14 days of symptom onset.
    • For all pregnant women, a urine and serum specimen must be submitted for testing.

Recommendations for Providers using Commercial Laboratories to Test for Zika Virus

  • It is the responsibility of the provider to order the correct test method if using a commercial lab. The appropriate testing method varies according to the window of time between the illness onset and specimen collection date. Testing on asymptomatic patients should only be done on pregnant women.
  • Effective 8/15/16 ADPH will no longer follow up with providers who order Zika testing through commercial labs to ensure the correct test method was ordered.  Negative lab results will not be investigated.  Please note that CDC currently recommends that all negative rRT-PCR tests for Zika be followed with MAC-ELISA testing.  A negative rRT-PCR does not exclude Zika virus infection.

For additional information on Zika testing methods and interpretation of results visit
http://www.cdc.gov/zika/hc-providers/testing-for-zikavirus.html

 

Alabama Department of Public Health – Health Alert Network (HAN)
Recommendations for Assessing & Testing Pregnant Patients
8/10/16
Clarification of CDC Update on Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, issued July 2016
  • Providers should assess, not test (unless warranted), all pregnant patients during initial visit and all subsequent visits for possible Zika exposure.
  • Providers with symptomatic pregnant patients with a possible exposure history as defined in the Centers for Disease Control and Prevention’s (CDC) updated guidance should contact the Alabama Department of Public Health (ADPH) Infectious Diseases & Outbreaks Division (ID&O) for consultation and approval for Zika testing.
  • Providers with asymptomatic pregnant patients with possible exposure should contact ID&O for consultation and approval for Zika-specific rRT-PCR testing of serum and urine.
  • Providers should contact ID&O for consultation and approval to request rRT-PCR testing after a pregnant patient has a positive or equivocal – Zika IgM antibody test.
  • Providers should request testing of infant blood not “infant blood or cord blood”.

Alabama Department of Public Health Zika Consultation

ADPH requests that all providers contact the Infectious Diseases & Outbreaks Division (ID&O) for consultation prior to ordering Zika testing on patients.  Providers should call ID&O at 1-800-338-8374 to request a Zika Consultation Form.

Reporting Zika Test Results

All test results for arboviral diseases, including Zika virus, are reportable to public health. Physicians, nurses, and laboratory directors are required to report all results (positive, negative, inconclusive, and equivocal) to ID&O within 5 days.

Recommendations for Providers using ADPH’s State Lab to Test for Zika Virus

  • The ADPH Bureau of Clinical Laboratories (BCL) is able to conduct rRT-PCR and MAC-ELISA Zika IgM testing.  Once testing is approved, the specimen collection and shipping instructions will be given to the Provider for testing by the BCL.
  • For specimens submitted to BCL, rRT-PCR requires submission of urine and patient-matched serum specimens within 14 days of symptom onset.
  • For all pregnant women, a urine and serum specimen must be submitted for testing.

Recommendations for Providers using Commercial Laboratories to Test for Zika Virus

  • It is the responsibility of the provider to order the correct test method if using a commercial lab. The appropriate testing method varies according to the window of time between the illness onset and specimen collection date. Testing on asymptomatic patients should only be done on pregnant women.
  • Effective 8/15/16 ADPH will no longer follow up with providers who order Zika testing through commercial labs to ensure the correct test method was ordered.  Negative lab results will not be investigated.  Please note that CDC currently recommends that all negative rRT-PCR tests for Zika be followed with MAC-ELISA testing.  A negative rRT-PCR does not exclude Zika virus infection.

For additional information on Zika testing methods and interpretation of results visit
http://www.cdc.gov/zika/hc-providers/testing-for-zikavirus.html