{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:55:59Z","timestamp":1777877759208,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vector-Borne and Zoonotic Diseases"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>\n                    West Nile virus (WNV) and Zika virus (ZIKV) are mosquito-borne viruses in the family\n                    <jats:italic toggle=\"yes\">Flaviviridae<\/jats:italic>\n                    . Residents in, and travelers to, areas where the viruses are circulating are at risk for infection, and both viruses can cause an acute febrile illness. Given known cross-reactivity in flavivirus serologic assays, it is possible a patient with acute WNV infection could be misdiagnosed as having ZIKV infection if appropriate testing is not conducted. To understand how frequently persons with WNV infection have detectable cross-reactive ZIKV immunoglobulin M (IgM) antibody, we used archived serum samples from patients in the United States with recent WNV infection confirmed by a microsphere-based immunoassay test for IgM antibody and neutralizing antibody testing. Samples were tested for ZIKV IgM antibody with the Centers for Disease Control and Prevention (CDC) ZIKV IgM antibody capture enzyme-linked immunosorbent assay. Among 153 sera from patients with acute WNV infection, the ZIKV IgM antibody result was positive in 56 (37%; 95% confidence interval [CI] 29\u201344%) and equivocal in 28 (18%; 95% CI 13\u201325%). With 55% of samples having cross-reactive antibodies, it is important for health care providers to request appropriate testing based on the most likely cause of a patient's possible arboviral infection considering their clinical symptoms and signs, travel history, and place of residence. For cases where the epidemiology does not support the preliminary IgM findings, confirmatory neutralizing antibody testing should be performed. These measures will avoid an incorrect diagnosis of ZIKV infection, based on cross-reactive antibodies, in a person truly infected with WNV.\n                  <\/jats:p>","DOI":"10.1089\/vbz.2021.0013","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T12:40:48Z","timestamp":1626957648000},"page":"817-821","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Frequency of Zika Virus Immunoglobulin M Antibody in Persons with West Nile Virus Infection"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1408-6047","authenticated-orcid":false,"given":"Susan L.","family":"Hills","sequence":"first","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janeen","family":"Laven","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad J.","family":"Biggerstaff","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Kosoy","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Erin","family":"Staples","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Panella","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"e_1_3_5_2_1","unstructured":"CDC. Zika MAC-ELISA. Available at https:\/\/www.cdc.gov\/zika\/pdfs\/zika-mac-elisa-instructions-for-use.pdf"},{"key":"e_1_3_5_3_1","unstructured":"Euroimmun. Anti-Zika Virus ELISA (IgM). Available at https:\/\/www.euroimmun.com\/documents\/Indications\/Infections\/Zika-virus\/EI_2668_D_UK_B.pdf"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2512.191022"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjx088"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1108.050289b"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix434"},{"key":"e_1_3_5_8_1","unstructured":"Inbios ZIKV Detect\u2122 2.0 IgM Capture ELISA Instructions for Use. Available at http:\/\/i8sit3w4v3z1h99oi1gmrx61-wpengine.netdna-ssl.com\/wp-content\/uploads\/2020\/08\/LBL-0093-03-IVD-ZIKV-Detect-2.0-IgM-Capture-ELISA.pdf"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2005.5.137"},{"key":"e_1_3_5_10_1","first-page":"566","article-title":"Duplex microsphere-based immunoassay for detection of anti-West Nile virus and anti-St. Louis encephalitis virus immunoglobulin M antibodies","volume":"12","author":"Johnson AJ","year":"2005","unstructured":"Johnson AJ, , Noga AJ, , Kosoy O, , Lanciotti RS, et al. Duplex microsphere-based immunoassay for detection of anti-West Nile virus and anti-St. Louis encephalitis virus immunoglobulin M antibodies. Clin Diagn Lab Immunol, 2005b; 12:566\u2013574.","journal-title":"Clin Diagn Lab Immunol"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1408.080287"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.4.6.503-510.1976"},{"key":"e_1_3_5_13_1","first-page":"1","article-title":"Surveillance for human West Nile virus disease\u2014United States, 1999-2008","volume":"59","author":"Lindsey NP","year":"2010","unstructured":"Lindsey NP, , Staples JE, , Lehman JA, , Fischer M. Surveillance for human West Nile virus disease\u2014United States, 1999-2008. 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Clin Diagn Lab Immunol, 2002; 9:544\u2013549.","journal-title":"Clin Diagn Lab Immunol"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.5.1823-1826.2000"},{"key":"e_1_3_5_17_1","first-page":"1130","article-title":"Evaluation of a diagnostic algorithm using immunoglobulin M enzyme-linked immunosorbent assay to differentiate human West Nile virus and St. Louis encephalitis virus infections during the 2002 West Nile Virus epidemic in the United States","volume":"11","author":"Martin DA","year":"2004","unstructured":"Martin DA, , Noga A, , Kosoy O, , Johnson AJ, et al. Evaluation of a diagnostic algorithm using immunoglobulin M enzyme-linked immunosorbent assay to differentiate human West Nile virus and St. Louis encephalitis virus infections during the 2002 West Nile Virus epidemic in the United States. 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