○ Contact the UHN/SH medical microbiologist on call for requests for testing on alternative specimen types (e.g. CSF, amniotic fluid)
○ Serum must be submitted for all patients investigated for Zika virus infection regardless of other specimen types collected. Serum is the preferred blood specimen for both molecular and serologic testing.
○ Urine is more sensitive than serum for detection of Zika virus RNA. It is recommended to collect urine in addition to serum on all patients, including neonates (within 48h postpartum).
○ Clotted blood/serum and urine specimens for PCR testing should be collected ASAP after symptom onset, but no later than 14 days after onset of illness. Pregnant women can be tested up to 12 weeks following symptom onset or last potential exposure to ZIKV (if asymptomatic).
○ Please refer to https://www.canada.ca/en/public-health/services/publications/diseases-conditions/zika-virus-prevention-treatment-recommendations.html for indications of testing.
○ Whole blood/serum: serum separator tubes or red top tube; 2 tubes if possible, of 2-5 mL each. Minimum for neonates is 1 tube of 1,5 mL. ○ Plasma: EDTA tube (2-5 mL) ○ Urine: Sterile container (5 mL) ○ CSF: Sterile container (0,5 mL) ○ Tissue: sterile container
Whole blood/serum/plasma: ○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine. ○ If both molecular and serologic identification requested, collect in two separate tubes
CSF: ○ Decontaminate skin, collect at least 0.5 mL of CSF by lumbar puncture (second or third tubes should be sent to microbiology depending on which is less bloody) Urine: ○ Collect urine into a clean, sterile container. Transport to the microbiology laboratory ASAP.
Amniotic fluid: ○ Collect at least 0.5 mL of uncontaminated fluid by amniocentesis, Caesarean section or by aspiration with a transcervical intrauterine catheter in a clean, sterile container and/or anaerobic transport container if bacteriological analysis also required.
Tissue: ○ Collect in a clean, sterile container with a small amount of sterile saline
Refer to section Sample Processing / Delivery
PHOL
○ PCR: Up to 5 days; longer if supplementary testing is required ○ Serology: 5 days (IgM and IgG screening); 1 month for PRNT confirmatory serology performed at NML
416-586-4800 extension 4651
YES; notify laboratory if this agent is suspected prior to collecting specimens
○ Label specimen container. Place specimens in biohazard bag and seal.
○ Store and transport specimens to UHN/SH Microbiology Laboratory at refrigeration temperature (2-8˚C) ASAP and notify the laboratory prior to collecting specimens.
○ The specimen will be referred to the Public Health Ontario Laboratory for testing