Updated diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories

Memorandum ; Many countries in the Americas now have local transmission of multiple arboviruses that can cause febrile illness with rash, myalgia, or arthralgia. Therefore, laboratory testing has become even more important to confirm the etiology of these diseases. For patients with acute fever, rash, myalgia, or arthralgia and have travelled within the previous 2 weeks to an area with ongoing transmission, Zika, chikungunya, and dengue virus infections should all be considered. Laboratory evidence of recent chikungunya, dengue, or Zika virus infection is generally accomplished by testing serum to detect viral nucleic acid or virus-specific immunoglobulin (Ig) M and neutralizing antibodies. However, serological cross-reactivity is strong between Zika and dengue viruses, so emphasis should be placed on molecular detection in acute specimens. Laboratory testing for all of these agents is currently available at CDC and several state health departments. ; denvchikvzikv-testing-algorithm.pdf