Table 3 Guidelines for collecting, storing, conserving and transporting serological samples, virus isolation and molecular diagnosis in suspected cases of Zika

Serological tests

Serum

Collect around 10 ml of blood from the adult, without anticoagulant: first collection 3–5 days after the start of symptoms and second collection 3–4 weeks later. Separate out at least 2–3 ml of serum for serological tests

Use sterile plastic tube with screw top and sealing ring. Label the tube with the patient’s name, collection date and sample type. Conserve in freezer at −20° C

Pack in biological sample transportation box (category B UN/3373) with recyclable ice

Cerebrospinal fluid

Collect 1 ml

Use sterile plastic tube with screw top and sealing ring. Label the tube with the patient’s name, collection date and sample type. Conserve in freezer at −20° C

Pack in biological sample transportation box (category B UN/3373) with recyclable ice

RT-PCR

Blood/serum

Collect around 10 ml of blood, without anticoagulant, 3–5 days after the start of symptoms. Separate out at least 2–3 ml of serum, for RT-PCR

Use sterile plastic tube with screw top and sealing ring. Label the tube with the patient’s name, collection date and sample type. Conserve in freezer at −20 °C or −70 °C until sending to the laboratory

Pack in biological sample transportation box (category B UN/3373) with dry ice

Cerebrospinal fluid

Collect 1 ml

Use sterile plastic tube with screw top and sealing ring. Label the tube with the patient’s name, collection date and sample type. Conserve in freezer at −20 °C or −70 °C until sending to the laboratory

Pack in biological sample transportation box (category B UN/3373) with dry ice

Urine

Collect 8 ml not more than 8 days after the start of symptoms

Use sterile plastic tube with screw top and sealing ring. Label the tube with the patient’s name, collection date and sample type. Conserve in freezer at −20 °C or −70 °C until sending to the laboratory

Pack in biological sample transportation box (category B UN/3373) with dry ice

Instructions for collecting and sending samples for laboratory diagnosis of deaths suspected to be due to Zika

Viscera

Collect 1 cm³ of brain, liver, heart, lung, kidney and spleen

Use sterile plastic tube with screw top and sealing ring. Label the tube with the patient’s name, collection date and sample type. Conserve in freezer at −20 °C or −70 °C until sending to the laboratory

Pack in biological sample transportation box (category B UN/3373) with dry ice

Histopathology immunohistochemistry

Viscera

Collect 1 cm³ of brain, liver, heart, lung, kidney and spleen

Use sterile flask with screw top containing 10 % buffered formalin. Label the tube with the patient’s name, collection date and sample type. Conserve at room temperature

Pack in biological sample transportation box (category B UN/3373) Without Ice . Conserve at room temperature