The preferred specimens for laboratory diagnosis of Zika virus infection are serum and urine. The following is a summary of the various specimen types and collections that may be considered:
- Serum: Serum must be submitted for all patients to be tested for Zika virus infection. Serum can be used if testing for both the IgM antibody methods and the molecular methods for Zika RNA. It can also be tested simultaneously for dengue and chikungunya virus. Serum levels of anti-Zika IgM antibodies in infected individuals typically rise shortly after symptom onset and persist for eight to 12 weeks.
- Urine: Urine should be tested alongside a patient-matched serum specimen by molecular methods for Zika virus RNA only if the method has been validated for this specimen type. Antibody testing of urine is not recommended. Since evidence has suggested that the Zika virus RNA may be detected in urine for a longer period of time than in serum, the CDC recommends that urine be collected alongside serum from symptomatic patients presenting up to 14 days post onset of symptoms and from asymptomatic pregnant women.
- Other specimen types: CSF, amniotic fluid, and various tissue specimens may be also tested for Zika virus; however, these specimens typically must be submitted alongside a patient-matched serum specimen.
