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Test ID ABOPC Arbovirus Antibody Panel, IgG and IgM, Spinal Fluid

Useful For

Aiding in the diagnosis of arboviral encephalitis (California [LaCrosse], St. Louis, Eastern equine, and Western equine encephalitis)

Profile Information

Test ID Reporting Name Available Separately Always Performed
CAVPC Calif(LaCrosse) Encep Ab Panel, CSF Yes Yes
EEPC East Equine Enceph Ab Panel, CSF Yes Yes
STLPC St. Louis Enceph Ab Panel, CSF Yes Yes
WEEPC West Equine Enceph Ab Panel, CSF Yes Yes

Method Name

Immunofluorescence Assay (IFA)

Reporting Name

Arbovirus Ab Panel IgG and IgM, CSF

Specimen Type

CSF


Advisory Information


This panel tests for 4 arboviruses; to test for a specific arbovirus, the following tests are individually orderable:

-CAVPC / California Virus (La Crosse) Encephalitis Antibody Panel, IgG and IgM, Spinal Fluid

-EEPC / Eastern Equine Encephalitis Antibody Panel, IgG and IgM, Spinal Fluid

-STLPC / St. Louis Encephalitis Antibody Panel, IgG and IgM, Spinal Fluid

-WEEPC / Western Equine Encephalitis Antibody Panel, IgG and IgM, Spinal Fluid

 

New York State clients: This test is not available for specimens originating in New York.



Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 0.8 mL


Specimen Minimum Volume

0.7 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 14 days
  Frozen  14 days

Clinical Information

California (LaCrosse) Virus

California (LaCrosse) virus is a member of the Bunyaviridae family and it is one of the arthropod-borne encephalitides. It is transmitted by various Aedes and Culex mosquitoes and is found in such intermediate hosts as the rabbit, squirrel, chipmunk, and field mouse. California meningoencephalitis is usually mild and occurs in late summer. Ninety percent of infections are seen in children younger than 15 years of age, usually from rural areas. The incubation period is estimated to be 7 days and acute illness lasts 10 days or less in most instances. Typically, the first symptoms are nonspecific, lasting 1 to 3 days, and are followed by the appearance of central nervous system (CNS) signs and symptoms such as stiff neck, lethargy, and seizures, which usually abate within 1 week. Symptomatic infection is almost never recognized in those over 18 years old. The most important sequela of California virus encephalitis is epilepsy, which occurs in about 10% of children; almost always in patients who have had seizures during the acute illness. An estimated 2% of patients have persistent paresis. Learning disabilities or other objective cognitive deficits have been reported in a small proportion (2%) of patients. Learning performance and behavior of most recovered patients are not distinguishable from comparison groups in these same areas.

 

Eastern Equine Encephalitis

Eastern equine encephalitis (EEE) is within the alphavirus group. It is a low-prevalence cause of human disease in the eastern and Gulf Coast states. EEE is maintained by a cycle of mosquito/wild bird transmission, peaking in the summer and early fall, when man may become an adventitious host. The most common clinically apparent manifestation is a mild undifferentiated febrile illness, usually with headache. CNS involvement is demonstrated in only a minority of infected individuals, and is more abrupt and more severe than with other arboviruses, with children being more susceptible to severe disease. Fatality rates are approximately 70%.

 

St. Louis Encephalitis

Areas or outbreaks of St. Louis encephalitis (SLE) since 1933 have involved the western United States, Texas, the Ohio-Mississippi Valley, and Florida. The vector of transmission is the mosquito. Peak incidence occurs in summer and early autumn. Disease onset is characterized by generalized malaise, fever, chills, headache, drowsiness, nausea, and sore throat or cough, followed in 1 to 4 days by meningeal and neurologic signs. The severity of illness increases with advancing age; persons over 60 years have the highest frequency of encephalitis. Symptoms of irritability, sleeplessness, depression, memory loss, and headaches can last up to 3 years.

 

Western Equine Encephalitis

The virus that causes Western equine encephalitis (WEE) is widely distributed throughout the United States and Canada; disease occurs almost exclusively in the western states and Canadian provinces. The relative absence of the disease in the eastern United States probably reflects a paucity of the vector mosquito species, Culex tarsalis, and possibly a lower pathogenicity of local virus strains. The disease usually begins suddenly with malaise, fever, and headache, often with nausea and vomiting. Vertigo, photophobia, sore throat, respiratory symptoms, abdominal pain, and myalgia are also common. Over a few days, the headache intensifies; drowsiness and restlessness may merge into a coma in severe cases. In infants and children, the onset may be more abrupt than for adults. WEE should be suspected in any case of febrile CNS disease from an endemic area. Infants are highly susceptible to CNS disease and about 20% of cases are under 1 year of age. There is an excess of male patients with WEE clinical encephalitis, averaging about twice the number of infections detected in female patients. After recovery from the acute disease, patients may require from several months to 2 years to overcome the fatigue, headache, and irritability. Infants and children are at a higher risk of permanent brain damage after recovery than adults.

Reference Values

CALIFORNIA VIRUS (La CROSSE) ENCEPHALITIS ANTIBODY

IgG: <1:1

IgM: <1:1

Reference values apply to all ages.

 

EASTERN EQUINE ENCEPHALITIS ANTIBODY

IgG: <1:1

IgM: <1:1

Reference values apply to all ages.

 

ST. LOUIS ENCEPHALITIS ANTIBODY

IgG: <1:1

IgM: <1:1

Reference values apply to all ages.

 

WESTERN EQUINE ENCEPHALITIS

IgG: <1:1

IgM: <1:1

Reference values apply to all ages.

Interpretation

Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may suggest central nervous system (CNS) infection. However, these results are unable to distinguish between intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and clinical data prior to a diagnosis of CNS infection.

Clinical Reference

1. Gonzalez-Scarano F, Nathanson N: Bunyaviruses. In: Fields BN, Knipe DM eds. Fields Virology. Vol 1. 2nd ed. Raven Press;1990:1195-1228

2. Donat JF, Rhodes KH, Groover RV, Smith TF: Etiology and outcome in 42 children with acute nonbacterial meningoencephalitits. Mayo Clin Proc. 1980;55:156-160

3. Tsai TF: Abroviruses. In: Murray PR, Baron EJ, Pfaller MA eds. Manual of Clinical Microbiology. 7th ed. ASM Press;1999:1107-1124

4. Calisher CH: Medically important arboviruses of the United States and Canada. Clin Microbiol Rev. 1994;7:89-116

5. Beckham JD, Tyler KL: Arbovirus Infections. Continuum (Minneap Minn). 2015 Dec;21(6 Neuroinfectious Disease):1599-1611. doi: 10.1212/CON.0000000000000240

Day(s) and Time(s) Performed

May through October: Monday through Friday; 9 a.m.

November through April: Monday, Wednesday, Friday; 9 a.m.

Analytic Time

Same day/1 day

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86651 x 2-California virus (La Crosse) encephalitis antibody, IgG and IgM

86652 x 2-Eastern equine encephalitis antibody, IgG and IgM

86653 x 2-St. Louis encephalitis antibody, IgG and IgM

86654 x 2-Western equine encephalitis antibody, IgG and IgM

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ABOPC Arbovirus Ab Panel IgG and IgM, CSF 49094-6

 

Result ID Test Result Name Result LOINC Value
26365 Calif(LaCrosse) Encep Ab, IgG,CSF 9539-8
26369 East Equine Enceph Ab, IgG, CSF 10897-7
26367 St. Louis Enceph Ab, IgG, CSF 21509-5
26371 West Equine Enceph Ab, IgG, CSF 9315-3
26372 West Equine Enceph Ab, IgM, CSF 9316-1
26368 St. Louis Enceph Ab, IgM, CSF 21510-3
26370 East Equine Enceph Ab, IgM, CSF 10899-3
26366 Calif(LaCrosse) Encep Ab, IgM,CSF 9540-6

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Testing Algorithm

The following algorithms are available in Special Instructions:

-Meningitis/Encephalitis Panel Algorithm

-Mosquito-borne Disease Laboratory Testing