Case Definition

Confirmed Case¹

Laboratory confirmation of infection:

• Detection of Zika virus-specific nucleic acid by reverse-transcriptase PCR from an appropriate clinical specimen (e.g. blood, urine)

OR

• Demonstration of specific IgM antibodies in an appropriate clinical specimen (e.g. blood) by enzymeimmuno assay (e.g. Reactive or equivocal ELISA result) AND confirmation through identification of Zika virus-specific neutralizing antibodies in the absence of other flavivirus-specific antibodies (e.g. Reactive Zika PRNT accompanied by negative Dengue PRNT). 
  

Person Under Investigation (PUI)

• A person with two or more symptoms compatible with clinical illness² with onset during or within 2 weeks of travel to a country with ongoing or widespread transmission

OR

•  A person who is epidemiologically-linked to a confirmed case or a person under investigation

OR

•  A female who was pregnant during or within two months of returning from a country with ongoing or widespread Zika virus transmission

OR

• A male returning from a country with ongoing or widespread Zika virus transmission AND has a female partner who is pregnant, becomes pregnant within 2 months of his return, or intends to become pregnant in the following 2 months

OR

• A person with specific IgM antibodies from an appropriate clinical specimen with pending or inconclusive confirmatory testing (e.g. Reactive Zika PRNT with reactive Dengue PRNT)

 Notes:

1. Only confirmed cases are reportable
2. Definition of clinical illness includes: arthralgia (painful joints), conjunctivitis, diarrhea, fever, flaccid paralysis/Guillain-Barré Syndrome (GBS), headache, malaise, myalgia (muscle pain), rash. Please note, symptoms of Zika infection are similar to those by other Arbovirus infections such as West Nile, Dengue, and Chikungunya.