Updated MDHHS Zika Virus Testing Guidance for Healthcare Providers - August 3, 2016

​Message Details
Date Sent: 08/03/2016 04:47 PM EDT
Sender: Michigan Health Alert Network
Subject: Updated MDHHS Zika Virus Testing Guidance for Healthcare Providers - August 3, 2016

Message:
The CDC has recently issued updated guidance for healthcare providers caring for Pregnant Women with Possible Zika Virus Exposure and Prevention of Sexual Transmission.  In addition, limited local transmission of Zika virus has recently been identified in an area of Miami, Florida.  As a result, MDHHS has updated the guidance provided to Michigan healthcare providers in a Memo dated May 6, 2016 regarding specimens that will be accepted for Zika virus testing of patients in Michigan.  The updated guidance is as follows:
Criteria for Diagnostic Testing of Potentially Exposed Individuals
Testing is currently indicated for the following individuals:

• Pregnant women who have:
  
  • History of travel to an area with ongoing Zika virus transmission*
    
    • And have clinical illness consistent with Zika virus infection (one or more of the following: fever, rash, joint pain, red irritated eyes) within two weeks of travel
      
    • Or have no symptoms, and are within 12 weeks after their return from travel
      
  • Had sex without barrier protection with a partner with possible Zika virus exposure* (neither partner need to be symptomatic)
    
• A person who has a clinical illness consistent with Zika virus infection (one or more of the following: fever, rash, joint pain, red irritated eyes) and within two weeks of illness onset and
  
  • Has a history of travel to an area with ongoing Zika virus transmission* OR
    
  • May have been exposed to Zika virus through sex without barrier protection with a person who has a history of travel to an area with ongoing Zika virus transmission* 
    
• A fetus or infant with suspected or confirmed microcephaly or intracranial calcifications (diagnosed prenatally or at birth) whose mother:
  
  • Spent time in an area with ongoing Zika virus transmission*
    
  • During pregnancy, had sex without barrier protection with a partner who spent time in an area with active Zika virus transmission*
    
• A person who developed Guillain-Barre syndrome after spending time in an area with active Zika virus transmission*
  

*Utilize the CDC website for the most current information about areas with active Zika virus transmission both outside and within the U.S.:http://www.cdc.gov/zika/geo/index.html

[At present, Zika virus testing for the assessment of risk for sexual transmission is of uncertain value, because current understanding of the duration and pattern of shedding of Zika virus in the male and female genitourinary tract is limited. Therefore, testing of specimens to assess risk for sexual transmission is currently not recommended.] 

Specimen Requirements for Diagnostic Testing:

• Serum, urine, or CSF
  
• Collect and submit both serum and urine on:
  
  • All pregnant patients
    
    • For symptomatic and asymptomatic pregnant patients tested
      
  • Symptomatic patients within 14 days of their illness onset
    
• Amniotic fluid, urine, tissue and other specimens may be submitted to assess the utility of these samples to detect virus, contact MDHHS Epi at 517-335-8165 for instructions on specimen collection and handling
  
• All specimens other than serum must be accompanied by a serum sample
  

For information about submitting specimens to MDHHS BOL, see the specimen collection and submission page athttp://www.michigan.gov/emergingdiseases/0,4579,7-186-77096_77098-377958--,00.html.

How to request Zika testing at MDHHS:
Healthcare providers must contact their local health department (www.malph.org) to request Zika virus testing for Michigan residents. This process assures that the appropriate tests are ordered and that specimens are correctly collected, labeled, processed, packaged, and transported. Public health agencies will assist providers with deciding on the appropriate test and completing the required forms. Testing may be delayed if specimens are received without prior approval. 
Finally, Zika virus is a reportable condition in Michigan (under “Arboviral” on the list posted athttp://www.michigan.gov/documents/mdch/Reportable_Diseases_Michigan_by_Pathogen_478489_7.pdf). Any healthcare provider or laboratory must report suspect and confirmed cases of Zika virus to the appropriate Michigan local public health department.


--This message is being sent to the following statewide HAN roles: Communicable Disease / Infection Prevention | Epidemiology | HAN Coordinator | Health Officer | Healthcare | Laboratory | Physician / Medical Director--