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HelpEpic Code LAB848 Chikungunya IgM and IgG, Antibody, Serum
Additional Codes
Mayo Test Code: CHIKV
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Aiding in the diagnosis of recent infection with Chikungunya virus in patients with recent travel to endemic areas and a compatible clinical syndrome
Specimen Type
SerumOrdering Guidance
Testing a patient in a convalescent period is recommended because specimens collected too early following infection may be negative for antibodies to Chikungunya virus.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.
Special Instructions
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 30 days | |
| Frozen | 30 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Day(s) Performed
Bimonthly on the second and fourth Wednesday; fifth Wednesday when applicable
Reference Values
IgM: Negative
IgG: Negative
Reference values apply to all ages.
Clinical Information
Chikungunya virus (ChikV) is a single-stranded RNA alphavirus and a member of the Togaviridae family of viruses. The name Chikungunya is derived from the language of the Makonde ethnic groups in southeast Africa and means "that which bends" or "stooped walk." This is in reference to the hunched-over appearance of infected individuals due to the characteristically painful and incapacitating arthralgia caused by the virus. ChikV is endemic throughout Africa, India, and, more recently, the Caribbean islands. In 2014, the first case of autochthonous, or local transmission, in the United States occurred in Florida.
Humans are the primary reservoir for ChikV and Aedes species mosquitos are the primary vectors for transmission. Unlike other mosquito-borne viruses, such as West Nile virus and Dengue, the majority of individuals who are exposed to ChikV become symptomatic, with the most severe manifestations observed at the extremes of age and in those with suppressed immunity. Once exposed to ChikV, individuals develop lasting immunity and protection from reinfection.
Prior to development of symptoms, the incubation period ranges, on average, from 3 to 7 days. Infected patients typically present with sudden-onset high fever, incapacitating joint pain, and often a maculopapular rash lasting anywhere from 3 to 10 days. Notably, symptom relapse can occur in some individuals 2 to 3 months following resolution of initial symptoms. Currently, there are no licensed vaccines and treatment is strictly supportive care.
Cautions
Specimens collected too early following infection may be negative for antibodies to Chikungunya virus.
Chikungunya and Dengue viruses currently co-circulate in endemic areas and infections can present similarly in symptomatic patients. It is therefore recommended to evaluate at-risk patients for infection with both viruses.
Interpretation
IgM and IgG Negative:
-No serologic evidence of exposure to Chikungunya virus. Repeat testing on a new specimen collected in 5 to 10 days is recommended if clinical suspicion persists.
IgM and IgG Positive:
-IgM and IgG antibodies to Chikungunya virus detected, suggesting recent or past infection. IgM antibodies to Chikungunya virus may remain detectable for 3 to 4 months post-infection.
IgM Positive, IgG Negative:
-IgM antibodies to Chikungunya virus detected, suggesting recent infection. Repeat testing in 5 to 10 days is recommended to demonstrate anti-Chikungunya virus IgG seroconversion to confirm current infection.
IgM Negative, IgG Positive:
-IgG antibodies to Chikungunya virus detected, suggesting past infection.
IgM and/or IgG Borderline:
-Repeat testing in 10 to 14 days is recommended.
Reporting Name
Chikungunya IgM and IgG, Ab, SMethod Name
CHIKM, CHIKG: Enzyme-Linked Immunosorbent Assay (ELISA)
CHIKI: Technical Interpretation
Method Description
For both the Chikungunya virus IgM and IgG assays, polystyrene microwells are coated with recombinant Chikungunya antigen. Diluted serum samples and controls are incubated in the wells to allow anti-Chikungunya antibodies (if present in the sample) to react with the antigen. Nonspecific reactants are removed by washing. Next, peroxidase-conjugated antihuman antibody is added to the wells and will react with human antibodies bound to the antigen. Excess conjugate is removed by washing. Enzyme substrate and chromogen are added, and the color is allowed to develop. After adding the Stop Reagent, the resultant color change is quantified by a spectrophotometric reading of optical density (OD). Sample OD readings are compared with reference cut-off OD readings to determine the qualitative results.(Unpublished Mayo method)
CPT Code Information
86790 x2
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CHIKV | Chikungunya IgM and IgG, Ab, S | 93976-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CHIKI | Chikungunya Interpretation | 69048-7 |
| CHIKG | Chikungunya IgG, Ab, S | 88630-9 |
| CHIKM | Chikungunya IgM, Ab, S | 88629-1 |
Report Available
Same day/1 to 14 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Clinical Reference
Lwande OW, Obanda V, Bucht G, et al. Global emergence of Alphaviruses that cause arthritis in humans. Infect Ecol Epidemiol. 2015;5:29853. doi: 10.3402/iee.v5.29853
Highlights
This test may be used as an aid to diagnose recent or past infection with Chikungunya virus (ChikV) in patients with recent travel to endemic regions and a compatible clinical syndrome.
IgM and IgG antibodies to ChikV are typically detectable 3 to 4 days and 6 to 7 days following onset of symptoms, respectively.
IgM antibodies to ChikV typically remain detectable for 3 to 4 months after infection, whereas IgG antibodies to ChikV remain detectable for years.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CHIKM | Chikungunya IgM, Ab, S | No | Yes |
| CHIKG | Chikungunya IgG, Ab, S | No | Yes |
| CHIKI | Chikungunya Interpretation | No | Yes |
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.