Arbovirus IgM EIA, St. Louis Encephalitis and West Nile
Laboratory Fee Schedule
Procedure: MZZ0085A
CPT: 86653, 86789
 
	| Synonym(s): | 
	Flavivirus, Arbovirus IgM, SLEV IgM, WNV IgM  | 
	| Requisition Form | 
	G-2A. | 
	| Test Description | 
	Capture Enzyme Immunoassay for the detection of IgM Antibodies to West Nile and St. Louis Encephalitis Viruses. | 
	| Pre-Approval Needed | 
	N/A | 
	| Supplemental Information Required | 
	N/A | 
	| Supplemental Form(s) | 
	N/A | 
	| Performed on Specimens from (sources) | 
	Human | 
	| Sample/Specimen Type for Testing | 
	
	
	- Serum 1.0 ml
 
	- Cerebral Spinal Fluid (CSF) 400 uL
 
	 
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	| Minimum Volume/Size Required | 
	
	
	- Serum 1.0 mL
 
	- Cerebral Spinal Fluid (CSF) 400 µL 
 
	 
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	| Storage/Preservation Prior to Shipping | 
	
	
	- Store specimens at 2°C to 8°C for up to 48 hours.
 
	- For storage longer than 48 hours, store at -20°C or below. 
 
	 
	 | 
	| Transport Medium | 
	N/A | 
	| Specimen Labeling | 
	
	
	- Two patient-specific identifiers required on specimen (e.g., patient full name, date of birth, medical record number).
 
	- Three patient identifiers are preferred.
 
	- Patient identifiers on specimen label must exactly match identifiers on submission form (e.g., abbreviated name on label and full name on form is not acceptable.) 
 
	- Additional DSHS Laboratory specimen labeling guidelines available online here. 
 
	 
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	| Shipping and Specimen Handling Requirements | 
	
	
	- Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49.
 
	- Category B Biological Substance, UN3373 shipping requirements apply. 
 
	- Handle as infectious agent using universal precautions. 
 
	- Triple' contain in accordance with federal shipping regulations for infectious agents. 
 
	- Submitters are responsible for packaging and shipping specimens according to regulatory requirements. 
 
	- Additional DSHS Laboratory specimen shipping guidelines online here. 
 
	- If specimens will arrive at the Lab within 48 hours of collection, refrigerate at 2°C –8°C and ship overnight on cold packs.
 
	- If specimens will arrive at the Lab more than 48 hours after time of collection, freeze at -20°C or colder, and ship overnight on dry ice.
 
	 
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	| Method | 
	IgM Antibody Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA). | 
	| Turn-around Time | 
	8 working days. | 
	| Interferences/Limitations | 
	
	
	- Reliable results are dependent on adequate specimen collection. 
 
	- Cross-reactions can occur between flaviviruses. 
 
	- Specific IgG can compete with IgM and may result in a false negative. 
 
	- Rheumatoid factor in presence of specific IgG may result in a false positive. 
 
	 
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	| Common Causes for Rejection | 
	
	
	- Insufficient quantity
 
	- Unacceptable specimen type or source
 
	- Improper shipping conditions
 
	- Expired media or collection container
 
	- Expired reagents/media/collection container. 
 
	- Discrepancies between G-2V submission form and specimen label. 
 
	- Missing/incomplete/illegible submission form or label.
 
	 
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	| Additional Information | 
	
	
	- Results serve only as an aid in diagnosis and should be interpreted in relation to patient travel history, clinical symptoms, other diagnostic findings, and epidemiological data.
 
	- The absence of detectable IgM antibody does not rule out the possibility of recent or current infection.
 
	- Convalescent serum specimen should be tested if an early acute CSF or serum is negative. 
 
	- For most, IgM is detectable 8 days post-onset of symptoms and can persist for at least 45 days and sometimes for up to 90 days. 
 
	- Reactive samples will be forwarded to CDC for confirmatory testing by Plaque Reduction Neutralization Test (PRNT).
 
	- Minimum volume for CDC confirmation testing is 0.5 mL.
 
	 
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