Acute Communicable
Disease Control

 

Contact Information
County of Los Angeles
Department of Public Health
Acute Communicable Disease Control
313 N. Figueroa Street, #212
Los Angeles, CA 90012
Phone: (213) 240-7941
Fax: (213) 482-4856
Email:acdc2@ph.lacounty.gov

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Main Zika Page    Zika Information for Healthcare Providers
Zika Virus Testing and Notification (for Los Angeles County residents only)

This page contains information on Zika virus testing and reporting for suspect cases residing in Los Angeles County. It also contains information for notifying Public Health for special cases. If you need to report or consult on a case residing outside Los Angeles County, please click here for a listing of other Health Departments.

LAC West Nile Virus and Other Arboviral Diseases Report: October 6, 2017 (10-6-17)

Zika Virus Testing Eligibility

Health Advisory: Updated Guidance for Health Care Providers Caring for Pregnant Women with Zika Virus Exposure  (8-3-17)

Preventing Zika Virus Infection and its Consequences: Update and Guidance for Clinicians [1 credit CME available]

Zika Virus Testing and Report Form form

Use the section headings below to navigate to the pertinent sections of this page: 

Indications for Zika Virus Testing and Notification

Obtain clinical and travel history

Providers who suspect a case of Zika virus infection should obtain a relevant clinical history including previous dengue/chikungunya/West Nile virus infection, travel history, Japanese encephalitis virus/yellow fever/tickborne encephalitis vaccination history, as well as the results of relevant diagnostic tests, if performed (e.g., ultrasound imaging, TORCH serology panel, West Nile virus serology, dengue serology, chikungunya serology).

Visit the CDC website for an updated list of countries with active Zika virus transmission.

 

Testing at Los Angeles County Public Health Laboratories (PHL)

The PHL offers access to all recommended Zika and related arbovirus testing services. Public Health is able to complete all required screening and confirmatory testing for Zika as well as dengue and chikungunya. Some of this testing is sent to the California State laboratory and/or CDC.

In order for specimens to be processed for Zika testing, the PHL Zika Virus Testing and Report Form must be completed. Failure to complete required fields on the requisition forms will result in specimen rejection or delayed testing. The form includes a two page reporting and test requisition form as well as the specimen requirements and submission instructions found below. A separate test requisition form must be submitted for each specimen type. Click here to access the Zika Virus Testing and Report Form.

Specimen Requirements for Zika Testing
Note: requested sample volumes are for adults.
Specimen Requirements for Zika Testing

* Specimens must be received within 24 hours of collection.
**Do not use glass vacutainer tube for blood collection. Do not use tubes that contain anti-coagulants.
***To optimize evaluation of possible Zika virus infection on fetal tissues, please provide both formalin fixed and unfixed tissues. If it is not possible to provide both types of tissues, prioritize formalin fixed tissues. For additional information regarding collection of fetal or infant tissues, please contact the Public Health Laboratories for guidance.

Instructions for test requests

Samples submitted with incomplete intake information, incomplete patient history, incomplete or discrepant patient sample identifiers and labeling information, or incomplete test request forms will not be tested.

Provider may be required to complete additional forms for receiving results by fax if not currently a client of the Los Angeles County PHL.

Convalescent serum or an additional serum sample may be requested depending on laboratory results.

  1. Download and complete the required information for Zika Virus Testing and Report Form. Separate testing forms (both pages 1 and 2) must accompany each specimen type.
  2. The following information must be included on the form:
    1. Facility/Submitter name, address, phone, and fax
    2. Requesting provider name (Last, First) and contact information to enable reporting of results.
    3. Patient name or unique patient identifier
    4. Patient sex
    5. Patient date of birth
    6. Test(s) to be performed
    7. Specimen source
    8. Date and time of specimen collection
  3. If the patient or provider are unable to obtain phlebotomy services, contact the Los Angeles Acute Communicable Disease Control Program (ACDC) for assistance, approval and referral to a Los Angeles County Public Health Clinic.
  4. Specimens must be labeled with the following information:
    1. Patient name (Last, First)
    2. Date of Birth
    3. Collection Date and Collection Time

Specimen processing and packaging

Proper storage and transport conditions preserve analyte integrity within the sample. Leaking specimens will also be rejected.

  • Clinics able to process specimens may centrifuge blood and transfer serum to a separate, sterile labeled tube.
  • Samples must be sent to PHL as soon as possible and within 24 hours of collection.
  • Each specimen type must come with its own test request form
  • Each specimen must be packaged using individual biohazard specimen transport bags.

Specimen transport

At this time, laboratory samples for Zika testing should not be sent directly to the California State Department of Public Health or the Centers for Disease Control.

Send samples to the Los Angeles County Public Health Laboratories as soon as possible and within 24 hours of collection.

Los Angeles County Public Health Laboratories
12750 Erickson Avenue
Downey, CA 90242
Phone 562-658-1330
Fax 562-401-5999

Specimen transport conditions must be followed or sample will be rejected.

If the provider does not have access to courier services, PHL will help to arrange for sample pick up. Courier arrangements are made by calling PHL Central Accessioning Unit at 562-658-1460.

Questions

For consultation regarding appropriate testing, providers should contact ACDC

  • Call 213-240-7941 during business hours.
  • Call 213-974-1234 after hours, weekends, or holidays and ask the County Operator (option 8) for the Public Health Physician on call.

For questions regarding specimen collection or laboratory interpretation, providers should contact PHL.

  • Call 562-658-1330 during business hours.
  • Call 213-974-1234 after hours, weekends, or holidays and ask the County Operator (option 8) for the Public Health Laboratories Director.

 

Testing at Commercial Laboratories

PCR Testing

Real-time reverse-transcription polymerase chain reaction (rRT-PCR) molecular assays are now becoming available at commercial laboratories. These tests are generally recommended for symptomatic patients as per the indications listed in the Zika Testing and Notification table (shown above).

Appropriate samples for rRT-PCR testing are test dependent. In general, the specimen types include serum samples collected <7 days and urine samples collected <14 days after symptom onset. Urine should always be collected with a patient-matched serum specimen for rRT-PCR testing. A positive result in either specimen type provides evidence of Zika virus infection. Negative PCR results do not rule out Zika infection and require a subsequent serum sample for Zika IgM antibody testing.

Currently, commercial laboratories do not have Zika IgM enzyme-linked immunosorbent assay (ELISA) and confirmatory serologic testing (plaque reduction neutralizing test or PRNT) that are recommended if the PCR testing is negative. Molecular testing on tissue samples, CSF, and amniotic fluid are not currently available at commercial laboratories. For this reason, if a commercial testing laboratory is used for PCR testing, it is recommended that:

  • Providers are familiar with the laboratory-developed/Emergency Use Authorized test performed at the commercial laboratory and corresponding specimen requirements which may differ from that performed at Public Health Laboratories.
  • Providers assure that the commercial laboratory can perform PCR testing at least on both urine and serum specimens.
  • Providers retain and store in a refrigerator (2-8C) an adequate number of blood specimens for patient's serum to perform subsequent Zika IgM ELISA testing through public health if the PCR is negative.
  • For specimens that are PCR negative from the commercial laboratory and no stored serum specimen is available, another serum specimen should be collected within 12 weeks of symptom onset for Zika IgM ELISA testing.

Note: Facilities that do not have the capability to process and adequately store serum samples for subsequent antibody testing, should contact PHL for assistance at 562-658-1330/1300.

If a commercial laboratory is used for Zika PCR testing, providers must report all positive Zika tests by submitting a Confidential Morbidity Report.

The Los Angeles County PHL will continue to offer access to Zika and other related arbovirus testing services (see Testing at Los Angeles County Public Health Laboratories section above).

For additional information on commercial laboratory testing from CDC, see Health Update: Recommendations for Subsequent Zika IgM Antibody Testing (6/21/16).

 

Page last updated 6/23/16.

 
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