Collection And Submission Form Of Specimens For Viral Encephalitis Testing

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New York State Department of Health
Collection and Submission of Specimens for Viral Encephalitis Testing
The diagnostic facilities of the Wadsworth Center are designed primarily to provide laboratory services
for persons in the state for whom such services are not otherwise available. Please use local or
commercial laboratory services whenever available. Routine HSV and enterovirus molecular testing
should be sent to commercial laboratories.
H
S
L
Fill in the Infectious Diseases Requisition (IDR) as completely as possible. Each
ISTORY AND
PECIMEN
ABELING
specimen must be labeled with patient name, date of birth, and date collected. Unlabeled specimens will be rejected.
For hospitalized patients with a reported current diagnosis of viral encephalitis, CSF will be tested by molecular
CSF
detection methods for a panel of viruses that include adenovirus, enterovirus, HSV 1 and 2, VZV, CMV, EBV, and HHV6.
From June through November, molecular testing will also include the following arboviruses: WNV, SLE, EEE, Cache
Valley, and California serogroup viruses. Enzyme-linked immunoassay (ELISA) for WNV is performed year round on all
specimens submitted with sufficient quantity. CSF submitted on patients no longer hospitalized or with a reported current
diagnosis of viral meningitis will be tested by ELISA for WNV only. Collect at least 1.0ml of CSF within seven days of
onset, in a sterile, labeled container and freeze immediately at -70ºC. Ship frozen specimen overnight on a minimum of 5
lbs (2+ Kg) solid dry ice or more for multiple samples. CSF must be received frozen! For additional information regarding
the viral encephalitis testing program, please visit our website at
If less than 1.0ml of CSF is submitted, the quantity will not be sufficient to perform both ELISA and PCR testing.
1. CSF on patients with viral meningitis will be tested for WNV by ELISA (PCR will not be done since it is less
sensitive for WNV.)
2. CSF on patients with viral encephalitis will be tested according to the physician’s preference below.
Please consider the following in determining which test is most appropriate for your patient:
.
ELISA is more sensitive than PCR for WNV testing and should be considered when there is a stronger
suspicion of WNV than other viruses.
.
PCR is less sensitive for WNV, but tests for a wide range of viruses. PCR should be considered if viruses
other than WNV are suspected.
IF THERE IS LESS THAN 1.0ML OF CSF, PLEASE INDICATE TEST PREFERENCE ON REQUISTION.
Acute Sera: 5-10ml in a red-top tube. Clotted blood should be centrifuged. The sera should be separated
SERUM
from the clot and red cells, and dispensed into another tube for shipping. The specimen should be refrigerated if
shipped alone. If the serum is shipped with CSF, send both frozen on a minimum of 5lbs (2+ Kg) solid dry ice.
Convalescent Sera: 5-10ml in a red-top tube. Clotted blood should be centrifuged. The sera should be
separated from the clot and red cells, and dispensed into another tube for shipping. The specimen should be
refrigerated and shipped on a commercially available frozen ice pack. If shipped with CSF, ship frozen on a
minimum of 5 lbs (2+ Kg) solid dry ice.
Fresh frozen tissue obtained by autopsy or biopsy may be submitted for encephalitis PCR. Tissue must be
TISSUE
collected ASAP after onset of disease or death. Fresh tissue is strongly preferred over fixed. Collect in sterile,
individually labeled containers. Freeze immediately at -70ºC and then ship on a minimum of 5 lbs (2+ Kg) solid dry ice.
Shipping of Specimens for Viral Encephalitis Testing
Send specimens to the Viral Encephalitis Laboratory at the Wadsworth Center as soon as possible after collection. The
IDR and Viral Encephalitis/Meningitis Case Report form must be complete and accompany each specimen.
The shipper must ensure that patient specimens are shipped as Temperature Controlled Biological
Substance Category B according to IATA/DOT regulations. Contact your carrier for shipping instructions.
For frozen CSF specimens, use a MINIMUM of 5 lbs (2+ Kg) solid dry ice, and more for multiple samples.
All specimens must be shipped "Priority Overnight" and CSF received frozen within 24 hours via chosen carrier.
Specimens should be shipped ONLY Sunday through Thursday so that appropriate laboratory personnel can be
present to accept and accession specimens Monday through Friday.
If CSF specimens arrive thawed, all viral encephalitis tests will be cancelled! The only exception is for local
Albany hospitals; fresh specimen must be refrigerated on frozen ice packs and received via courrier within 8 hours.
Shipping address by courier: Viral Encephalitis Laboratory, Wadsworth Center, NYSDOH, David Axelrod Institute, 120
New Scotland Avenue, Albany, NY 12208.
Shipping address by US Postal Service: Viral Encephalitis Laboratory, Wadsworth Center, NYSDOH, David Axelrod
Institute, PO Box 22002, Albany, NY 12201-2002.
Revised 6/2010

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