Challenges for molecular and serological ZIKV infection confirmation
Zika Virus (ZIKV), member of Flaviviridae family and Flavivirus genus, has recently emerged as international public health emergency after its association with neonatal microcephaly cases. Clinical diagnosis hindrance involves symptom similarities produced by other arbovirus infections, therefore laboratory confirmation is of paramount importance.
The most reliable test available is based on ZIKV RNA detection from body fluid samples. However, short viremia window periods and asymptomatic infections diminish the success rate for RT-PCR positivity. Beyond molecular detection, all serology tests in areas where other Flavivirus circulates proved to be a difficult task due to the broad range of cross-reactivity, especially with dengue pre-exposed individuals.
Altogether, lack of serological diagnostic tools brings limitations to any retrospective evaluation. Those studies are central in the context of congenital infection that could occur asymptomatically and mask prevalence and risk rates.
KeywordsZIKV Arboviruses RT-PCR Serology PRNT Vertical transmission Microcephaly
We thank Fernandes Figueira Institute Pediatric Infectious Disease Team for helpful discussions during this work and field expertise from ZIKVIRUSIFF Cohort study registered on clinicaltrials.gov with identifier NCT03255369.
Compliance with ethical standards
Conflict of interest
The authors declare no financial interests.
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