Collection and Submission of Body Fluids for Zika Virus Testing

Updated: May 15, 2016

General information

• Before acquiring specimens, obtain appropriate patient consent to collect and test specimens for Zika virus.
• Specimens should NOT be submitted directly to CDC. All submissions should go through your state or local health department.
• Submit CDC Form 50.34 [PDF - 2 pages] with all specimens. For test order name, enter “Zika virus”.
• The EUA for the Trioplex Real-time RT-PCR assay allows serum and cerebrospinal fluid as acceptable specimens for Zika, chikungunya, and dengue testing; urine and amniotic fluid for Zika testing only.
• The EUA for the Zika MAC-ELISA allows serum and cerebrospinal fluid as acceptable specimens for testing.

Serum or cerebrospinal fluid (CSF)

• Real-time reverse transcription-polymerase chain reaction (rRT-PCR) and antibody testing can be performed on serum and CSF.
• At least 1.0 mL* of serum or CSF is required for testing.
• Transfer serum or CSF to a plastic tube measuring approximately 50 mm tall and 15 mm in diameter (e.g., 1.8 mL cryotube or 2.0 mL microtube) with screw cap and secure with thermoplastic, self-sealing lab film.
• For virus isolation testing, specimens should be frozen as soon as possible (-70 °C).
• For antibody and rRT-PCR testing, specimens should be kept cold (2–6 °C) or frozen (-70 °C).

Urine and other body fluids

• rRT-PCR and virus isolation can be performed on other body fluids for diagnostic testing (e.g., urine and amniotic fluid**), or for research purposes (e.g., semen).
• Provide 0.5–1.0 mL of the specimen in a sterile screw capped vial secured with thermoplastic, self-sealing lab film. Please ensure a tight seal as leaking specimens cannot be accepted.
• If collecting both urine and semen, obtain the urine specimen first.
• For rRT-PCR testing specimens should be kept cold (2–6 °C) or frozen (-70 °C) for storage and shipping.
• For virus isolation testing, specimens should be frozen as soon as possible (-70 °C).

Shipping of serum, CSF, and other body fluids

• All specimens should be stored and shipped cold or frozen depending on the test needs described above.  For cold specimens, the sample should be placed in an insulated container with adequate ice packs to ensure specimen (“cold chain”) integrity. For frozen specimens, ship the sample on enough dry ice to ensure specimens remain frozen until received.
• For testing at CDC Fort Collins, CO, ship specimens to:
  Arboviral Diseases Branch Diagnostic Laboratory
  Centers for Disease Control and Prevention
  3156 Rampart Road
  Fort Collins, Colorado 80521
• More information about collecting, handling, and shipping is available here.
• If you have additional questions for the Arboviral Diseases Branch, call 970-221-6400.

Reporting of results

• Test results will be reported to the state health department and the submitting healthcare provider.
• Turnaround time will depend on testing volume and established reporting systems.

* Increased volume to 1.0 mL is recommended to support large volume extraction platforms.
** Saliva has not been shown to improve detection rates above serum and urine, therefore it is no longer recommended.