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Epic Code LAB848 Eastern Equine Encephalitis Antibody Panel, IgG and IgM, Spinal Fluid

Important Note

Order as Reference Miscellaneous #LAB848; indicate complete test name when ordering.

Reporting Name

East Equine Enceph Ab Panel, CSF

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Clinical Information

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.

 

Central nervous system 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% EEE.

 

Infections with arboviruses can occur at any age. The age distribution depends on the degree of exposure to the particular transmitting arthropod, relating to age, sex, and occupational, vocational, and recreational habits of the individuals. Once humans have been infected, the severity of the host response may be influenced by age.

Useful For

Aiding in the diagnosis of Eastern equine encephalitis

Specimen Type

CSF
Laboratory Test Directory Note:

Lab Central Staff: All CSF specimens to Hematology first.


Ordering Guidance


This assay detects Eastern equine antibodies only. For a complete arbovirus panel, order ABOPC / Arbovirus 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

0.70 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis OK
Gross lipemia OK

Day(s) Performed

May through October: Monday through Friday

November through April: Monday, Wednesday, Friday

Reference Values

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.

Cautions

All results must be correlated with clinical history and other data available to the attending physician.

 

False-positive results may be caused by breakdown of the blood-brain barrier, or by the introduction of blood into the cerebrospinal fluid at collection.

 

Eastern equine encephalitis viruses show some cross-reactivity; however, antibody response to the infection virus is typically at least 8-fold higher.

Clinical Reference

1. Gonzalez-Scarano F, Nathanson N: Bunyaviruses. In: Fields BM, 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 meningoencephalitis. Mayo Clin Proc. 1980:55:156-160

3. Tsai TF: Arboviruses. In: Murray PR, Baron EF, 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

Method Name

Immunofluorescence Assay (IFA)

Method Description

Dilutions of cerebrospinal fluid (CSF) are prepared and allowed to react with substrate cells infected with the appropriate arbovirus. If antibodies to this virus are present in the CSF of the patient, an antigen-antibody complex will develop that can be detected by a fluorescein-labeled antibody directed to human globulin.(Tsai TF: Arboviruses. In: Murray PR, Baron EF, Pfaller MA, eds. Manual of Clinical Microbiology. 7th ed. ASM Press; 1999:1107-1124; Beaty BJ, Casals J, Brown KL, et al: Indirect fluorescent-antibody technique for serological diagnosis of LaCrosse [California] virus infections. J Clin Microbiol. 1982;15;429-443; Beckham JD, Tyler KL: Arbovirus Infections. Continuum (Minneap Minn). 2015 Dec;21(6 Neuroinfectious Disease):1599-1611. doi: 10.1212/CON.0000000000000240)

Report Available

Same day/1 to 4 days

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 US Food and Drug Administration.

CPT Code Information

86652 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EEPC East Equine Enceph Ab Panel, CSF 69035-4

 

Result ID Test Result Name Result LOINC Value
26369 East Equine Enceph Ab, IgG, CSF 10897-7
26370 East Equine Enceph Ab, IgM, CSF 10899-3

Forms

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