Virology Test Request - Missouri State Public Health Laboratory Page 2
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2MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES
101 NORTH CHESTNUT STREET, PO BOX 570
JEFFERSON CITY, MO 65101
MISSOURI STATE PUBLIC HEALTH LABORATORY
(573) 751-3334
VIROLOGY TEST REQUEST
Testing Information
Hepatitis A IgM - Hepatitis A IgM testing is available for people who have had known exposure to Hepatitis A.
Please consult with your local public health department before submitting specimens.
Hepatitis B - In support of the prenatal and refugee screening programs.
Influenza - Respiratory virus surveillance activities are performed through a series of sentinel providers to
monitor influenza activity throughout the transmission season. Requests from non-sentinel providers will be
considered on a case-by-case basis. Routine testing for influenza virus is NOT offered.
virology/respiratoryvirustesting.php
Measles and Rubella IgM Serology - Available for diagnosis of suspect measles or rubella cases. It is
recommended to collect samples 72 hours after onset of rash to allow for the IgM titer to rise to detectable levels.
Please consult with your local public health department before submitting specimens. IgG testing is not provided.
Norovirus - Testing is provided as part of outbreak investigations and is not available as a routine test. Please
refer to the norovirus instructions prior to collecting specimens.
virology/pdf/NorovirusInstructions.pdf
Rabies - “Significant potential exposure” applies to bite and nonbite exposures from all mammals, but is of
special consideration when evaluating bat exposures. Submitters should be familiar with guidelines related to
preventing human rabies acquired from bats, as detailed in Human Rabies Prevention - United States, 2008,
Recommendations of the Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and
Prevention, MMWR, May 7, 2008, Vol. 57, page 13, “Bat Exposures” (on the web at
resources/acip_recommendations.html). While each case must be decided on its own merits, the recommendations
generally state that if a person is “awake and aware” when in the presence of a bat (for example, “in the same
room as the bat” in a house), then the person “should not be considered as having been exposed to rabies.” This
implies that, since the person should not be considered as having been exposed, he/she should not receive RPEP
even if the bat is not available for testing. This approach provides an objective manner in which patient risk can
be assessed and helps ensure that RPEP is not given when exposure is unlikely to have occurred. The latter is
particularly important since the administration of RPEP is not without risk to the patient, the production of human
rabies biologics is limited and periodic shortages occur, and RPEP is expensive. Logically, if RPEP is not
indicated in those instances where a person is “awake and aware” in the presence of a bat (even if the bat is not
subsequently available for testing), there is no reason to submit for testing bats encountered under such
circumstances even if the bats are available. Thus, a “significant potential exposure” to a bat or other mammal is
one in which a medical provider would recommend RPEP for the patient after conducting a rabies risk assessment
in accordance with CDC guidelines if the animal was not available for testing. For additional information
pertaining to rabies testing, refer to virology/rabiestesting.php.
Rash Disease - Testing is performed in support of the Smallpox immunization program, or to identify cases of
unknown rash illness. virology/rashinvestigation.php
West Nile (Arbovirus) IgM Serology - Testing is available for human serum and CSF specimens. Further
information is at virology/wnvtesting.php
MO 580-2941 (06-11)
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LAB 158
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