Volume 99, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The recent Zika virus (ZIKV) epidemic swept across Latin America and the Caribbean, where dengue virus (DENV) is endemic. The antigenic similarities of these closely related flaviviruses left researchers and clinicians with challenges to interpret serological tests. Thirty-six women attending a prenatal clinic in Honduras and with positive DENV IgM enzyme-linked immunoabsorbent assays (ELISAs) were screened with a ZIKV immunoglobulin M ELISA, reverse transcription polymerase chain reaction for ZIKV and DENV 1–4, and plaque reduction neutralization tests (PRNTs) for ZIKV and DENV-2. Plaque reduction neutralization test results were interpreted using the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) criteria. Using the WHO criteria of a PRNT90 titer ≥ 20 and a 4-fold difference between ZIKV and DENV titers, we determined that 69.4% of samples had a recent ZIKV infection, compared with 5.6% using CDC criteria. The interpretation of ZIKV PRNTs in a DENV-endemic region is highly dependent on the choice of interpretation criteria.


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  1. Epelboin Y, Talaga S, Epelboin L, Dusfour I, , 2017. Zika virus: an updated review of competent or naturally infected mosquitoes. PLoS Negl Trop Dis 11: e0005933. [Google Scholar]
  2. Wikan N, Smith DR, , 2016. Zika virus: history of a newly emerging arbovirus. Lancet Infect Dis 16: e119e126. [Google Scholar]
  3. Moore CA, 2017. Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians. JAMA Pediatr 171: 288295. [Google Scholar]
  4. Adebanjo T, 2017. Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection—United States, October 2017. MMWR Morb Mortal Wkly Rep 66: 10891099. [Google Scholar]
  5. Safronetz D, Contributors , 2017. Evaluation of 5 commercially available Zika virus immunoassays. Emerg Infect Dis 23: 15771580. [Google Scholar]
  6. Lindsey NP, 2017. Ability to serologically confirm recent Zika virus infection in areas with varying past incidence of dengue virus infection in the United States and U.S. territories in 2016. J Clin Microbiol 56: pii: e01115–17. [Google Scholar]
  7. de Vasconcelos ZFM, Azevedo RC, Thompson N, Gomes L, Guida L, Moreira MEL, , 2018. Challenges for molecular and serological ZIKV infection confirmation. Childs Nerv Syst 34: 7984. [Google Scholar]
  8. Lee WT, 2017. Development of Zika virus serological testing strategies in New York State. J Clin Microbiol 56: pii: e01591–17. [Google Scholar]
  9. Collins MH, McGowan E, Jadi R, Young E, Lopez CA, Baric RS, Lazear HM, de Silva AM, , 2017. Lack of durable cross-neutralizing antibodies against Zika virus from dengue virus infection. Emerg Infect Dis 23: 773781. [Google Scholar]
  10. Buekens P, ZIPH Working Group , 2016. Zika virus infection in pregnant women in Honduras: study protocol. Reprod Health 13: 82. [Google Scholar]
  11. San Martín JS, Brathwaite O, Zambrano B, Solórzano JO, Bouckenooghe A, Dayan GH, Guzmán MG, , 2010. The epidemiology of dengue in the Americas over the last three decades: a worrisome reality. Am J Trop Med Hyg 82: 128135. [Google Scholar]
  12. Lanciotti RS, Kosoy OL, Laven JJ, Velez JO, Lambert AJ, Johnson AJ, Stanfield SM, Duffy MR, , 2008. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis 14: 12321239. [Google Scholar]
  13. Johnson BW, Russell BJ, Lanciotti RS, , 2005. Serotype-specific detection of dengue viruses in a fourplex real-time reverse transcriptase PCR assay. J Clin Microbiol 43: 49774983. [Google Scholar]
  14. Pridjian G, 2016. Prospective study of pregnancy and newborn outcomes in mothers with West Nile illness during pregnancy. Birth Defects Res A Clin Mol Teratol 106: 716723. [Google Scholar]
  15. Lieberman MM, 2009. Immunogenicity and protective efficacy of a recombinant subunit West Nile virus vaccine in rhesus monkeys. Clin Vaccine Immunol 16: 13321337. [Google Scholar]
  16. WHO, 2016. Zika virus infection: global update on epidemiology and potentially associated clinical manifestations. Wkly Epidemiol Rec 91: 7381. [Google Scholar]
  17. Rabe IB, 2016. Interim guidance for interpretation of Zika virus antibody test results. MMWR Morb Mortal Wkly Rep 65: 543546. [Google Scholar]

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  • Received : 20 Mar 2018
  • Accepted : 24 May 2018
  • Published online : 25 Jun 2018

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