CDC MMWR Early Release May 10

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 Press Contacts
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> May 10, 2016
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> Up Comparison of Zika virus testing in serum, urine and saliva specimens from travel-associated Zika virus disease cases–Florida, 2016
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> CDC Media Relations
> 404-639-3286
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> Interim guidance for Zika virus testing on urine ― United States, 2016
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> CDC Media Relations
> 404-639-3286
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> Reduced Prevalence of Chikungunya Virus Infection in Communities with Ongoing Aedes Aegypti Mosquito Trap Intervention Studies – Salinas and Guayama, Puerto Rico, November 2015–February 2016
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> CDC Media Relations
> 404-639-3286
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> The MMWR is embargoed until 1:00 PM ET May 10, 2016
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> Synopsis for May 10, 2016
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> Comparison of Zika virus testing in serum, urine and saliva specimens from travel-associated Zika virus disease cases–Florida, 2016
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> As of April 20, 2016, Florida Department of Health Bureau of Public Health Laboratories (BPHL) has tested 913 people who met state and national criteria for Zika virus testing. Of these individuals, 91 met confirmed or probable Zika virus disease case criteria. Based on previous small case studies reporting real time reverse-transcriptase polymerase chain reaction (RT-PCR) detection of Zika virus in urine, saliva, and semen, Florida Department of Health collected multiple specimen types from people with suspected acute Zika virus disease. Test results were evaluated by sample type and date of sample collection related to symptom onset in an effort to determine the most sensitive and efficient testing algorithm for acute Zika virus disease. Overall, urine samples from 65 of 70 cases (93%) collected from 1-20 days post-onset were RT-PCR positive. Of the 55 cases with samples collected on the same date and within 5 days of onset, 95% were urine RT-PCR positive, while only 56% were serum RT-PCR positive. Eighty-two percent (9/11) of urine samples collected more than 5 days after symptom onset were RT-PCR positive but none of the serum samples were positive. No cases had saliva as the only RT-PCR positive specimen type. BPHL testing results suggest urine might be the preferred sample type to diagnose acute Zika virus infections.
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> Interim guidance for Zika virus testing on urine ― United States, 2016
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> Diagnostic testing for Zika virus infection can be accomplished using both molecular and serological methods. Real-time reverse transcription-polymerase chain reaction (RT-PCR) is the preferred test for Zika virus infection because it can be performed rapidly and is very specific. However, in most patients, Zika virus RNA is unlikely to be detected in serum after the first week of illness. Recent reports suggest that Zika virus RNA can be detected for longer duration in urine than in serum. Based on newly available data, CDC recommends that Zika virus RT-PCR be performed on urine collected less than 14 days after illness onset in patients with suspected Zika virus disease.
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> Reduced Prevalence of Chikungunya Virus Infection in Communities with Ongoing Aedes Aegypti Mosquito Trap Intervention Studies – Salinas and Guayama, Puerto Rico, November 2015–February 2016
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> Aedes species mosquitoes transmit chikungunya virus, as well as dengue and Zika viruses. Puerto Rico reported its first laboratory-positive chikungunya case in May 2014 and subsequently identified more than 29,000 suspected cases throughout the island by the end of 2015. Conventional vector control approaches have failed to result in effective and sustainable prevention of infection with viruses transmitted by Aedes mosquitoes. As a tool for surveillance and control, CDC developed an Autocidal Gravid Ovitrap (AGO) to attract and capture the female Ae. aegypti mosquitoes responsible for transmission of infectious agents to humans. AGO traps are simple, low-cost devices that require no use of pesticides and no servicing for an extended period. Since 2012, four communities in southern Puerto Rico have participated in an ongoing field trial of AGO traps to control Ae. aegypti mosquitoes. Two intervention communities used AGO traps and two non-intervention communities used only surveillance traps to monitor mosquito population densities. With three AGO traps per home placed around ~85% of homes in intervention communities (in addition to randomly distributed surveillance traps), captures of adult Ae. aegypti mosquitos fell tenfold compared with non-intervention communities. The introduction of chikungunya virus into the previously unexposed population of Puerto Rico provided a unique opportunity to assess whether the use of AGO traps was associated with reduced incidence of chikungunya virus infection in these communities. Preliminary results from data collection during November 2015 – February 2016 found that the prevalence of anti-chikungunya virus antibody among participants from the two intervention communities was half that of participants from non-intervention communities. AGO traps might reduce arbovirus transmission by reducing mosquito density. CDC produces AGO traps in limited numbers. To increase the availability of AGO traps for control of Ae. aegypti mosquitoes, efforts are underway by private sector companies to mass produce AGO traps of similar quality.
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