Unusual Laboratory Results Suggest Late Development of Zika Virus-Specific Neutralizing Antibodies

Benjamin D. Hornstein, Rebecca J. Rubinstein, Patricia Peña, Leann Liu, Brian C. Reed, Dana Beckham, Les Becker, Umair A. Shah

Abstract


Zika virus is an emerging infectious disease that is not yet fully understood. Laboratory testing guidelines were established based on research on related flaviviruses, such as dengue. However, recent evidence has suggested differences in immunological response to infections between dengue and Zika virus. Interim US Centers for Disease Control and Prevention (CDC) guidance in interpretation of Zika laboratory test results cannot cover every possible scenario. Here, we present a case of an asymptomatic patient with conflicting laboratory results from a specimen drawn 8 days after moving to the USA from an area of Zika risk. The patient was found to be both positive and negative for Zika virus RNA by different laboratories, positive for Zika-specific IgM antibodies and negative for Zika-specific and dengue-specific neutralizing antibodies. Because this specimen was drawn shortly after a potential exposure, we hypothesized that the patient had been infected, but had yet to develop neutralizing antibodies against Zika. After drawing a new specimen approximately 9 weeks after the original, the patient was found to have neutralizing antibodies, suggesting that she had been recently infected with Zika virus. This case illustrates that patients with unusual laboratory results should be considered in the context of their potential risk factors and the nuances of interpreting laboratory testing.




J Med Cases. 2018;9(9):281-283
doi: https://doi.org/10.14740/jmc3029w

Keywords


Zika virus; Laboratory testing; Pregnancy

Full Text: HTML PDF
 
Home     |     Log In     |      About     |      Search     |      Current     |      Archives     |      Submit      |     Subscribe


 

     

Aims and Scope

Current Issues

Conflict of Interest

About Publisher

Editorial Board

Archives

Copyright

Company Profile

Editorial Office

Misconduct and Retraction

Permissions

Company Registration

Contact Us

Abstracting and Indexing

ICMJE

Ownership

Instructions to Authors

Access

Declaration of Helsinki

Contact Publisher

Submission Checklist

Reprints

Terms of Use

Company Address

Submit a Manuscript

Open Access Policy

Privacy Policy

Browse Journals

Publishing Fee

Publishing Policy

Disclaimer

Recent Highlights

Peer-Review Process

Publishing Quality

Code of Ethics

Advertising Policy

Manuscript Tracking

Advanced Search

For Librarians

Careers

Publishing Process

Publication Frequency

For Reviewers

Propose a New Journal

       
       

Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.        
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.journalmc.org   editorial contact: editor@journalmc.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

DECLARATION: THIS JOURNAL SITE OUTLOOK IS DESIGNED BY THE PUBLISHER AND COPYRIGHT PROTECTED. DO NOT COPY!