Recommendations for Laboratory Detection and Diagnosis of Arbovirus Infections in the Region of the Americas

Abstract

Human infection with arboviruses, such as dengue, yellow fever, chikungunya and zika, occurs through the bite of blood-sucking arthropods (mosquitos, ticks and midges, among others). There are more than 100 types of arboviruses and the infections they trigger range in severity from asymptomatic to life-threatening. In addition, constant evolution of many of these viruses have generated different genotypes and viral variants that migth eventually impact the public health systems. Outbreaks caused by these viruses are increasingly common throughout tropical and sub-tropical regions, including much of the Americas, making them an issue of international concern. According to the World Health Organization, almost 4 billion people live in areas where arboviruses are current public health threats.

This publication provides technical recommendations for public health laboratories involved in arbovirus diagnostic and surveillance. It covers the types of specimens most useful for diagnosing infections; lists minimum clinical datasets for sample labelling and analysis; and describes best practices for processing and handling of samples, along with recommended workflows and biosafety considerations. The most appropriate tests for each of the most common arboviruses are presented with recommended diagnostic algorithms. Both direct diagnostic methods – through genome detection, antigen detection and viral isolation – and indirect serological methods (which detect the immune response to viral infection rather than the virus itself) are included.

In addition to its primary target audience of public health laboratory staff, this publication will be also useful to research centers that identify arboviral infections as part of their research.