Zika and Pregnancy

Zika Virus: Information for Providers

You can get information and resources about how to treat patients who have been exposed to the Zika virus or otherwise may be at risk. This page will feature regular updates to clinical care guidance and how to access laboratories for testing in the city.

Clinical Guidance

Pregnant Women and Infants

For questions about possible Zika exposure during pregnancy, or to order testing for infants with findings concerning for possible congenital Zika virus infection (e.g., microcephaly, intracranial abnormalities, contractures), call the Provider Access Line at (866) 692-3641.

  • Updated Guidance for the Evaluation and Management of Pregnant Women and Infants with Possible Zika Virus Exposure (October 2017, PDF)
    • Zika virus testing is no longer routinely recommended for:
      • Asymptomatic pregnant women who have possible Zika virus exposure.
      • Well-appearing infants born to mothers with possible Zika virus exposure, but without laboratory evidence of Zika virus infection.
    • Evaluation of infants born to mothers with laboratory evidence of Zika infection during pregnancy should include comprehensive ophthalmologic exam and hearing screening by automated auditory brainstem response, in addition to cranial ultrasound and Zika testing.
  • Ongoing Risk of Zika Virus-Related Birth Defects Related to Travel to Areas with Active Zika Virus Transmission (May 2017, PDF)
    • Zika virus infection and its associated complications in fetuses and newborns can be prevented by avoiding travel to areas with active Zika transmission.
    • Providers and facilities in the city should use commercial clinical laboratories for routine Zika virus testing of adults, including the testing of pregnant women and normal-appearing infants.
    • Testing for special cases, such as infants with findings concerning for possible congenital Zika virus infection (e.g., microcephaly, intracranial abnormalities, contractures), unusual neurologic manifestations or risk exposures, or, for uninsured/underinsured patients, should be done through the City’s Public Health Laboratory (PHL). To order Zika testing at PHL, call the Provider Access Line at (866) 692-3641.
  • CDC: Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection — United States, October 2017
  • CDC: Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States (Including U.S. Territories), July 2017
  • CDC: Measuring Head Circumference (PDF)
  • CDC: Measuring Head Circumference Instructional Video
  • Sexual Transmission

    Testing for Zika

    When to Test

    Common symptoms of Zika virus include red eyes, fever, joint pain or rash. If an adult patient (pregnant or not) is experiencing or has recently experienced these symptoms, ask the following questions:

    1. Does the patient live in — or has the patient recently traveled to — an area with Zika?
      1. If Yes: Test for Zika
      2. If No: Has the patient had unprotected sex with a partner who has lived in or traveled to an area with Zika?
        1. If Yes: Test for Zika
        2. If No: Do not test for Zika

    For pregnant women with ongoing Zika virus exposure (e.g., living in or recurrent travel to an area with ongoing transmission), read:

    Testing of adults may also be recommended in other special cases, such as when a patient has an unusual clinical presentation associated with Zika (e.g., Guillain-Barré Syndrome or other neurologic manifestation).

    Testing is also recommended for all infants born to mothers with laboratory evidence of Zika virus infection, and for infants with findings concerning for possible congenital Zika virus infection, regardless of maternal test results.

    Which Tests to Order

    Testing at Commercial Laboratories

    Providers caring for NYC residents should use commercial laboratories for routine Zika virus testing, including the testing of pregnant women and normal-appearing infants. Also, the Health Department will provide testing if the provider cannot use a commercial clinical laboratory or the patient is uninsured.

    To report Zika-positive cases diagnosed by a commercial laboratory, call (866) 692-3641, or log in to Reporting Central via NYCMED.

    Commercial Laboratories Approved by New York State Department of Health to Conduct Zika Virus Testing

    Note: some laboratories may offer more tests; the tests listed below are the only tests approved by New York State.

     

    Zika virus RNA testing(by PCR or other nucleic acid amplification testing)

    IgM
      serum urine plasma serum
    ARUP Laboratories  
    Bioreference  
    LabCorp  
    Quest Diagnostics  
    ViraCor
    Mayo Medical Laboratories

    Testing at the Public Health Laboratory

    Pre-approval is required for the testing of Zika lab specimens at the Public Health Laboratory (PHL).

    Providers should only send specimens to the PHL, and not to a commercial lab, in the following situations:

    • Infants with findings concerning for possible congenital Zika virus infection (e.g., microcephaly, intracranial abnormalities, contractures), born to an exposed mother, even if maternal Zika virus testing results were negative.
    • Possible Guillain-Barré syndrome or any unusual neurologic manifestation.
    • Possible unusual modes of transmission (e.g., transfusion, organ transplantation).

    The NYC Health Department will also provide testing for patients whose insurance does not cover the cost of testing at a commercial laboratory.

    To request Zika testing for city residents and to arrange the transport of specimens to the PHL, call (866) 692-3641, Monday to Friday, 9 a.m. to 5 p.m.

    For urgent matters, such as abnormal fetus/infant of an exposed woman, or Guillain-Barré syndrome in an exposed person, call (866) 692-3641 at any time.

    How to Interpret Tests

    For assistance interpreting test results, call (866) 692-3641, Monday to Friday, 9 a.m. to 5 p.m.

    Educational Materials for Patients

    Additional Resources