Why your doctor might not test you for Zika (and why that’s probably okay)

You have a headache. Maybe you’re feeling kind of sleepy. There’s this weird red blob on your face. Before thinking that you’re tired because went to bed late and that blob happened because you forgot to wash your face, you might think, “OMG, I have Zika.”

Maybe you do, maybe you don’t. Maybe you go to the doctor and ask for a Zika test. But don’t panic when they tell you you don’t need one.

With 28 locally acquired cases in South Florida, Zika’s at the top of everyone’s mind. And everyone’s still trying to figure out how to get a handle on it, doctors included.

“[Zika] is relatively new for most clinicians and physicians. We’ve never been exposed here until recently … so we need to educate not only the public, but also clinicians, doctors, and urgent care clinics so they send diagnostic tests when they’re indicated,” Rodriguez said.

I’ve been turned down before, too. I went to visit a friend in Asheville, North Carolina. When I got there, I broke out in this crazy rash and had a headache and and muscle soreness. I went straight to an urgent care center and asked the physician to test me for Zika, but she refused. I was taken aback.

I asked Patricia Rodriguez, M.D., Senior Pediatric Infectious Diseases Fellow for the UM Miller School of Medicine/Jackson Health Systems, why and it turns out the urgent care sort of made the right call.

Wait you had symptoms and you didn’t get a test? Why not?

Basically this is what goes through a doctor’s head when they decide to test you for Zika:

  • Does the patient have a fever, rash, red eyes, joint pain or muscle aches, or a headache?
  • Has that person traveled to an area where there is “local transmission” aka where there are confirmed cases of the Zika carrying mosquito infecting people?

If you answer yes to both of these questions, you probably should get tested. I answered yes to #1, but at the time I was in Asheville, there was no local transmission and I hadn’t traveled anywhere where there was Zika — so there wasn’t any reasonable way I could have gotten the virus. As far as the doc was concerned, it could have just as easily been an allergic reaction.

Dr. Rodriguez suggests that if you want a quick way to figure out if you should get tested without going all the way to the doctor, call the Department of Health’s Zika Hotline: 1 (855) 622-6735. (I called, they answer pretty quickly and are great at telling you what’s up.)

Who should get a Zika test?

  • If you have the symptoms and you’ve been to Wynwood or another area where there’s local transmission.
  • All pregnant women — whether you have the symptoms or not. Gov. Rick Scott recently announced all pregnant women who want to get Zika testing are able to do so for free via the county health department.
  • The first commercial tests have also recently been approved.

Right now you can only get tested if a health care provider requests it.

What is the test?

There are two tests you can get:

  • PCR: This stands for Polymerase Chain Reaction. It’s a technique that detects the virus using your DNA or RNA. It uses body fluids with DNA or RNA: urine, blood, or saliva. The test can detect a the virus during the 14 days of illness. After 14 days, you’ll have to use a different test. It takes about three days to get a result.
  • MAC-ELISA: This stands for M antibody-capture enzyme-linked immunosorbent. It’s a test that you can use to test the virus anywhere from two weeks to three months of infection. You need a blood sample because this tests for something called antibodies. Basically any time you get sick, your body develops antibodies to fight an infection. If you have “anti-zika” antibodies, welp, it’s likely that you were at some point infected with Zika. It takes about five days to get a result. (P.S. The antibody developed in response to Zika looks a lot like the one for dengue — so you could also get a positive result if you have been infected with dengue.)

What if you test positive, then what?

There’s not much you can do, because there’s no medicine to “cure” Zika.

You just have to treat the symptoms. Have a fever? Take some ibuprofen. Feeling tired? Take some rest. (The CDC recommends that you don’t take “aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS) until dengue can be ruled out to reduce the risk of bleeding.”)

“There is a vaccine that’s being developed right now. It’s still being tested so it’s not available for the general public yet,” Rodriguez said.

Note: If you are pregnant, you should get a fetal ultrasound to make sure there are no abnormalities. If you’ve recently delivered a baby, you should have your placenta, the umbilical cord, or the baby’s cerebrospinal fluid tested for infection.

So if there’s nothing you can do about it, why should you get tested in the first place?

To gather data. It’s important to know where these cases are happening so that the Centers of Disease Control and Department of Health can stop them.

“Usually a Zika infection doesn’t lead to hospitalization and many people actually don’t have symptoms. In general, we could have it and not know about it. [Testing] is a way of controlling … the spread of it,” Rodriguez said.

The test will also help you plan if you’re pregnant or looking to get pregnant. If you get infected, the CDC says a woman needs to wait eight weeks from their first symptom before having sex. A male needs to wait at least six months after his first symptom before having sex.

At the end of the day, “controlling the disease is a community effort. We need to control the spread of it. If you’re not pregnant and not looking to get pregnant and have infection, you have to help prevent the spread of the virus,” Rodriguez said.