Zika virus information for health care providers was highlighted at the inaugural Peninsula Infectious Diseases Conference on March 6th, 2018, Bridging the Gap: Integrating Clinical Care and Public Health to Improve Maternal & Pediatric Outcomes.

Please note that these recommendations are intended for medical providers in San Mateo County.  Providers in other counties should contact their local health department for guidance. 

The California Department of Public Health (CDPH) has published updated Zika guidance for health care providers caring for pregnant women and newborns.  This page is in the process of being updated to reflect the new guidance. Routine testing of asymptomatic pregnant patients for Zika virus is no longer recommended.  For details, please visit the CDPH Zika Information for Health Professionals webpage. 

See below for detailed information about eligibility for laboratory testing and testing algorithms. 

Geographic Distribution

• CDC Areas with Zika Risk

CDC recommends that anyone returning from a Zika-affected area avoid mosquito bites for 14 days after symptom onset (if symptomatic) or 21 days after last exposure (if asymptomatic) to minimize the risk of introducing the virus into local mosquito populations. 

Specimen Collection and Storage

Please call San Mateo County Communicable Disease (CD) Control at 650-573-2346 prior to submitting specimens to the San Mateo County Public Health Laboratory to prevent delays in testing and/or rejection of specimen(s).   

• CDPH Zika Laboratory Testing Guidance
• CDC Guidelines for Collecting & Submitting Specimens at Time of Birth for Zika Virus Testing​

Laboratory Forms

• CDPH VRDL Form: one form required for each specimen submitted to the San Mateo County Public Health Laboratory. Form must be completed electronically; handwritten forms will not be accepted. 
  
  The VRDL form opens easily in Internet Explorer.  For other browsers, you may need to download the file to your computer.  To download, right click  on link and select “download” or “save link as” then select the destination.  Go to the folder where the document was saved and click on the file to open.    
  • Instructions for filling out the VRDL form

  CDC DASH Form: additional form required for certain specimens such as amniotic fluid, placenta, or fetal tissue.

  • Instructions for filling out the CDC DASH form

Symptomatic Individuals: Laboratory Testing Algorithms

• CDPH: Zika Screening Algorithm
• CDC algorithm for testing symptomatic individuals following symptom onset (i.e., one or more of fever, rash, arthralgia, or conjunctivitis within 2 weeks of exposure to Zika virus).
  • Recommend steps to prevent mosquito bites for 14 days after symptom onset. Asymptomatic individuals should avoid mosquito bites for 21 days after last exposure. 
  • Recommend steps to prevent sexual transmission of Zika virus (see “Preventing Sexual Transmission” below for more information)
• CDPH VRDL: Zika Laboratory Testing Guidance
• CDPH VRDL Form: one form for each specimen submitted to the San Mateo County Public Health Laboratory
  
  The VRDL form opens easily in Internet Explorer.  For other browsers, you may need to download the file to your computer.  To download, right click  on link and select “download” or “save link as” then select the destination.  Go to the folder where the document was saved and click on the file to open.    
  • Instructions for filling out the VRDL form

Pregnant Women: Laboratory Testing and Clinical Management Algorithms

CDC has issued Zika travel notices and recommends that pregnant women not travel to areas with active Zika virus transmission. If a pregnant woman must travel to one of these areas, she should be counseled to strictly follow steps to avoid mosquito bites and prevent sexual transmission during the trip. 

The California Department of Public Health (CDPH) has published updated Zika guidance for health care providers caring for pregnant women and newborns.  This page is in the process of being updated to reflect the new guidance. Routine testing of asymptomatic pregnant patients for Zika virus is no longer recommended.  For details, please visit the CDPH Zika Information for Health Professionals webpage. 

• CDPH Zika Screening Algorithm
• CDC Areas with Zika Risk
• CDPH Updated Guidance for Health Care Providers: Assessment and Testing for Zika Virus Infection in Pregnant Women and Newborns
• CDC Updated Interim Pregnancy Guidance: SYMPTOMATIC Pregnant Womenwith Possible Zika Virus Exposure
  • If sexual partner traveled to an area with active Zika virus transmission, recommend abstinence or consistent and correct condom use for the duration of pregnancy to prevent additional exposure (see “Preventing Sexual Transmission” below for more information).
• CDPH VRDL: Zika Laboratory Testing Guidance
• CDPH VRDL Form: one form for each specimen submitted to the San Mateo County Public Health Laboratory
  
  The VRDL form opens easily in Internet Explorer.  For other browsers, you may need to download the file to your computer.  To download, right click  on link and select “download” or “save link as” then select the destination.  Go to the folder where the document was saved and click on the file to open.    
  • Instructions for filling out the VRDL form

Infants: Laboratory Testing and Clinical Evaluation Algorithms

Zika virus testing is recommended for:

• Infants born to mothers with laboratory evidence of Zika virus infection during pregnancy.
• Infants who have abnormal clinical or neuroimaging findings suggestive of congenital Zika syndrome and a maternal epidemiologic link suggesting possible transmission, regardless of maternal Zika virus test results.

When Zika virus testing is indicated, specimens should be collected from the infant within 2 days of birth. 

• CDPH: Zika Screening Algorithm
• CDC: Algorithm for Evaluation and Testing of Infants with Possible Congenital Zika virus Infection
• CDC: Evaluation for Infants with Possible Congenital Zika Virus Infection
• CDPH Viral and Rickettsial Disease Laboratory (VRDL): Zika Laboratory Testing Guidance
• CDC Guidelines for Collecting & Submitting Specimens at Time of Birth for Zika Virus Testing​
• CDPH VRDL Form: one form required for each specimen submitted to the San Mateo County Public Health Laboratory.  Form must be completed electronically; handwritten forms will not be accepted. 
  
  The VRDL form opens easily in Internet Explorer.  For other browsers, you may need to download the file to your computer.  To download, right click  on link and select “download” or “save link as” then select the destination.  Go to the folder where the document was saved and click on the file to open.
• CDC DASH Form – additional form required for certain specimens such as amniotic fluid, placenta, or fetal tissue
  • Instructions for filling out the CDC DASH form

Preventing Sexual Transmission

After a Zika virus exposure, CDC recommends delaying conception and taking steps to prevent sexual transmission of Zika virus (practicing abstinence or consistently and correctly using condoms) for the following timeframes:

*Individuals who have one or more of fever, rash, arthralgia, or conjunctivitis are considered to be symptomatic. Individuals without these symptoms are considered asymptomatic. 

For additional information, refer to CDC Clinical Guidance for Healthcare Providers for Prevention of Sexual Transmission of Zika Virus.