Aiding in the diagnosis of Western equine encephalitis using spinal fluid specimens
For more information see Mosquito-borne Disease Laboratory Testing.
Immunofluorescence Assay (IFA)
Alphavirus (Old Arbovirus, Group A)
Arbovirus Serology
Encephalitis Antibodies
Western Equine Encephalitis (WEE)
For more information see Mosquito-borne Disease Laboratory Testing.
CSF
This assay detects Western 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.
Container/Tube: Sterile vial
Preferred: Vial number 1
Acceptable: Any vial
Specimen Volume: 0.8 mL
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
0.7 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Refrigerated (preferred) | 14 days | |
Frozen | 14 days |
Aiding in the diagnosis of Western equine encephalitis using spinal fluid specimens
For more information see Mosquito-borne Disease Laboratory Testing.
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. The onset may be more abrupt in infants and children than for adults. WEE should be suspected in any case of febrile central nervous system (CNS) disease from an endemic area. Infants are highly susceptible to CNS disease, and about 20% of cases are patients 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 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.
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. WEE tends to produce the most severe clinical infections in young persons.
IgG: <1:1
IgM: <1:1
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.
All results must be correlated with clinical history and other data
False-positive results may be caused by breakdown of the blood-
Western equine encephalitis and Eastern equine encephalitis viruses show some cross-
1. Markoff L: Alphaviruses (Chikungunya, Eastern equine encephalitis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:1997-20062
2. Piantadosi A, Kanjilal S: Diagnostic approach for arboviral infections in the United States. J Clin Microbiol. 2020 Nov 18;58(12):e01926-19. doi: 10.1128/JCM.01926-19
The indirect immunofluorescent antibody (IFA) assay is a 2-stage “sandwich” procedure. In the first stage, the patient cerebrospinal fluid (CSF) is diluted in Pretreatment Diluent for IgM and phosphate buffered saline (PBS) for IgG, added to appropriate slide wells in contact with the substrate, and incubated. Following incubation, the slide is washed in PBS, which removes unbound CSF antibodies. In the second stage, each antigen well is overlaid with fluorescein-labeled antibody to IgM and IgG. The slide is incubated allowing antigen-antibody complexes to react with the fluorescein-labeled anti-IgM and anti-IgG. After the slide is washed, dried, and mounted, it is examined using fluorescence microscopy. Positive reactions appear as cells exhibiting bright apple-green cytoplasmic fluorescence against a background of red negative control cells. Semi-quantitative endpoint titers are obtained by testing serial dilutions of positive specimens. (Package inserts: Arbovirus IFA IgM and Arbovirus IFA IgG Instructions for Use. Focus Diagnostics; Rev 02, 05/01/2018)
May through October: Monday through Friday
November through April: Monday, Wednesday, Friday
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.
86654 x 2
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
WEEPC | West Equine Enceph Ab Panel, CSF | 69036-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
26371 | West Equine Enceph Ab, IgG, CSF | 9315-3 |
26372 | West Equine Enceph Ab, IgM, CSF | 9316-1 |