Missouri Department of Health & Senior Services West Nile Virus (Arbovirus) Testing
Brief Description
EIA and MIA testing for West Nile and St. Louis encephalitis viruses (flavivirus)
FA testing for EEE, WEE, and Calif/LaCrosse virus
NOTE: All specimens received for Arbovirus serology will be tested against antigens of the Flavivirus group1, which include West Nile Virus (WNV) and St. Louis Encephalitis (SLE).
Laboratory Unit
Virology
Methodology
Enzyme Immunoassay, Microparticle Immunoassay, Fluorescent Immunoassay
IgM antibody detection on single acute, convalescent serum or CSF utilizing ELISA (Enzyme-Linked ImmunoSorbent Assay); and/or
IgM antibody detection on single acute, convalescent serum or CSF utilizing MIA (Microsphere Immunoassy).
Note: Testing for Eastern Equine Encephalitis (EEE), Western Equine Encephalitis (WEE), and LaCrosse/California Encephalitis Group is available only after consultation with the West Nile Virus Program (573-751-6113 or (toll-free) 1-866-628-9891).
Note: Due to low specificity, IgG antibody tests are not useful in the diagnosis of acute WNV infection. An IgG positive test result, either alone or in conjunction with an IgM negative test, is not diagnostic for acute infections and is NOT considered a case of WNV. For this reason, IgG serology for WNV has been discontinued at the MSPHL.
Specimen Collection
Virus Serology Kit
The ideal timing to collect acute serum is 3 to 10 days after onset of symptoms.
Collect CSF as soon as possible after onset of symptoms.
Collect serum in a redtop Vacutainer tube. Serum is the preferred specimen but whole blood will be accepted.
Whole blood may be sent if no method is available for removing the serum.
At least 1 ml of serum and 1.5 ml of CSF is required for serological testing.
Storage/Transport
Store refrigerated until transport
Acceptable Specimen
Type(s)
Blood, Serum, CSF
Test Request Form(s)
Possible Results
Serum and CSF: All serum specimens will be tested against an IgM antibody panel that includes WNV and SLE by EIA and/or MIA.
If indicated, EEE, WEE, and LaCrosse/California will be performed by Fluorescent Antibody testing.
CSF specimens will be tested for WNV and SLE IgM antibodies only.
Upon completion of testing the results will be mailed to the submitter.
IgM Serology by ELISA:
Positive (CSF) - Indicates recent infection.
Positive (Serum) - Indicates infection.*
Equivocal - Results of borderline significance (Convalescent specimen required for proper interpretation).
Negative - Results fail to indicate an infection with WNV or SLE.
If there is a significant difference between the P/N value (>2X) for WN or SLE, this would be indicative of an infection for the virus with the higher reading.
Examples:
WNV P/N 24.0, SLE P/N 6.0 = Indicative of an infection with WNV.
WNV P/N 10.0, SLE P/N 36.0 = Indicative of an infection with SLE.
WNV P/N 6.0, SLE P/N 4.0 = Indicative of infection with a Flavivirus, Convalescent sample needed to distinguish between WN and SLE if possible.
* West Nile Virus IgM antibody may remain for more than one year. Thus it will be difficult to determine if a positive IgM (from serum) is from an acute WNV infection. In this case clinical correlation is required to determine infection.
Reference Range
Antibody so specified arbovirus not identified.
Unacceptable Conditions
Specimen not identified
Hemolyzed
Interfering Substances
N/A
Result Reported
3 to 10 days after receipt of specimen. May vary during high and low volume testing periods.
Fees
N/A
CPT Codes
N/A
LOINC/SNOMED Codes
N/A
Additional Information
N/A