Zika Virus: Information For Providers
Indications for Zika Virus Testing
The Indiana State Department of Health (ISDH) will assist in coordinating Zika virus testing based on the following CDC guidelines:
- Individuals with any of the FRAC (fever, rash, arthralgia, conjunctivitis) symptoms up to 12 weeks after symptom onset with travel to an area with Zika or who had unprotected sex with someone who has traveled to an area with Zika
- Pregnant women with any of the FRAC symptoms up to 12 weeks after symptom onset who have traveled to an area with Zika or had unprotected sex with someone who traveled to an area with Zika
- Any pregnant woman with recent possible Zika virus exposure who have ultrasonographic evidence of fetal abnormalities consistent with congenital Zika syndrome
If your patient meets these testing criteria, please complete the ISDH Zika Virus Authorization Form and follow the protocol below.
The CDC no longer recommends routine testing for:
- Asymptomatic pregnant women with apparently healthy babies who do not have ongoing Zika virus exposure
- These patients will no longer be eligible for testing at the ISDH Laboratories.
- If you believe an asymptomatic pregnant woman with an apparently healthy baby should be tested for Zika virus, then you may consider commercial testing. You are encouraged to consider factors such as type and duration of travel, the patient's use of prevention measures, timing of pregnancy, and current epidemiology of Zika virus transmission when making this decision.
These testing recommendations are based on the CDC Updated Interim Guidance, published July 2017.
Zika Virus Authorization Protocol for Providers
- Ensure symptomatic patient meets testing criteria using the ISDH Indications for Zika Virus Testing above.
- If patient meets criteria, complete the ISDH Zika Virus Authorization Form. Ensure all fields are completed and easily legible. Incomplete forms will result in a delay in authorization. Please ensure the “point of contact email address” provided is correct.
- Fax the completed ISDH Zika Virus Authorization Form to the ISDH Epidemiology Resource Center at 317-234-2812 to the attention of Emily Potts, Zika Virus Clinical Coordinator.
- If the specimen meets testing criteria, the point of contact will receive an approval email within one business day of submission. This email will include instructions and guidelines for specimen collection and submission to the ISDH Laboratories.
- Specimens received at the ISDH Laboratories with all appropriate paperwork will be tested and analyzed. The ISDH Laboratories offer two tests for Zika virus.
- Trioplex RT-PCR - This test can be performed on a blood or urine specimen to identify present virus.
- IgM Antibody (MAC-ELISA) - This test can be performed on a blood specimen to identify a recent past infection after virus is no longer present in blood or urine.
- Zika virus results may require 3 weeks turnaround time. In some cases, additional testing for Zika and dengue antibodies is needed via a complex virus neutralization test called PRNT (plaque reduction neutralization test). This test is done by the CDC and may take four to eight weeks.
- If a specimen does not meet testing criteria, the point of contact will receive an email from the Zika Virus Clinical Coordinator to discuss testing guidelines.
For questions regarding specimen authorization, please contact Emily Potts, Zika Virus Clinical Coordinator, at 317-232-3084.
Notice to Providers on Zika in the United States
CDC designates areas for Zika virus transmission prevention in the continental United States and Hawaii as red or yellow.
- Zika active transmission area (red area): A geographical area where local, state, and CDC officials have determined that the intensity of Zika virus transmission presents a significant risk to pregnant women. The intensity of Zika virus transmission is determined by several factors including geographic distribution of cases, number of cases identified, known or suspected links between cases and population density.
- Zika cautionary area (yellow area): A geographic area where local transmission has been identified, but evidence is lacking that the intensity of transmission is comparable to that in a red area. Although the specific level of risk in yellow areas is unknown, there is still a risk to pregnant women. Additionally, areas adjacent or close to red areas may have a greater likelihood of local Zika virus transmission and are considered to pose a risk to pregnant women.
As of June 2, 2017, the Zika cautionary (yellow) area designation in Miami-Dade County was lifted in collaboration with the Florida Department of Health. Lifting the yellow area designation means there are no longer any travel recommendations related to Zika virus for Miami-Dade County.
Testing is still recommended for pregnant women who lived in or traveled to Miami-Dade County between August 1, 2016, and 8 weeks after June 2, 2017, and who conceived up to 8 weeks after June 2, 2017.
As of December 14, 2016, the CDC has designated the city of Brownsville, TX as a Zika cautionary (yellow) area. This guidance applies to pregnant women, women of reproductive age, and their sexual partners who live in or traveled to Brownsville on or after October 29, 2016.
ISDH is now authorizing Zika testing for the following persons with travel or epi-link to the yellow areas:
- Symptomatic pregnant women who lived in, traveled to, or had sex without a condom with someone who lived in or traveled to a yellow area.
For more information, please visit: https://www.cdc.gov/zika/geo/domestic-guidance.html
Zika Resources for Clinicians
Please view the updated Resource Guide for Clinicians below to identify resources to assist you with caring for pregnant women, women of reproductive age, and infants affected by Zika.
For more information for healthcare providers, please visit: https://www.cdc.gov/zika/hc-providers/index.html
For questions please contact Emily Potts, Zika Virus Clinical Coordinator, at 317-232-3084 or Taryn Stevens, Vector-Borne Epidemiologist, at 317-234-9727.
Page last updated: August 1, 2017
Page last reviewed: August 1, 2016