Ebola laboratory tests: Difference between revisions

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{{Ebola}}
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==Overview==
==Overview==
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| style="background: #DCDCDC; padding: 5px;"| [[Proteinuria]]
| style="background: #DCDCDC; padding: 5px;"| [[Proteinuria]]
|}
|}
==Diagnostic tests==
{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 80%;"
! style="background: #DCDCDC;" | Diagnostic test
! style="background: #DCDCDC;" | Samples required
! style="background: #DCDCDC;" | Preparation & Storage
! style="background: #DCDCDC;" | Shipping
! style="background: #DCDCDC;" | Viruses to be confirmed
|-
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[ELISA]] ([[serology]]) detects:
* Viral [[Antigen]]
* [[IgM]] and [[IgG]] [[antibody]]
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Whole [[blood]] [[serum]] or [[plasma]]<sup>†</sup>
Acute and convalescent<sup>††</sup>
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Freeze or refrigerate
(as cold as possible)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Frozen on dry ice or ice packs or both<sup>††††</sup>
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>[[Lassa]]<br>[[CCHF]]<br>[[Rift Valley]]<br>[[Marburg]]<br>[[Yellow fever]]
|-
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[PCR]] detects:
[[DNA]], [[RNA]] from the [[virus]].
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Whole [[blood]] or [[clot]]<sup>††</sup>
[[Tissues]] (fresh frozen)
[[Serum]]/[[plasma]]
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Refrigerate or freeze
Freeze
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Frozen on dry ice or ice packs or both<sup>††††</sup>
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>Lassa<br>[[CCHF]]<br>[[Rift Valley]]<br>[[Marburg]]<br>[[Yellow fever]]
|-
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Immunohisto-chemestry ([[liver]]) detects:
Viral [[antigen]] in [[cells]]
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Liver biopsy]] from fatal cases
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Fix formalin (can be stored up to 6 weeks)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Room temperature (do not freeze)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>Lassa<br>[[CCHF]]<br>[[Rift Valley]]<br>[[Marburg]]<br>[[Yellow fever]]
|-
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Immunohisto-chemestry ([[skin]]) detects:
Viral [[antigen]] in [[cells]]
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Skin biopsy]] from fatal  cases (any site)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Fix in formalin (can be stored up to 6 weeks)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Room temperature (do not freeze)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>[[Lassa]]
|-
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Immunohisto-chemestry (other tissues) detects:
Viral [[antigen]] in [[cells]]
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Tissue [[biopsy]] from fatal cases
(other tissues, [[spleen]], [[lung]], [[heart]], [[kidney]])
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Fix in formalin (can be stored up to 6 weeks)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | Room temperature (do not freeze)
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>[[Lassa]]<br>[[CCHF]]<br>[[Rift Valley]]<br>[[Marburg]]<br>[[Yellow fever]]
|}
<SMALL><sup>†</sup> Whole blood can be used for enzyme-linked immunosorbent assay (ELISA) and may be frozen. Do not centrifuge suspected VHF specimens because this increases risk to the lab worker. If serum specimens have already been prepared these can be used. Place specimens in plastic tubes for shipping and storage and be sure that the tubes are sealed and properly labeled.</SMALL><br>
<SMALL><sup>††</sup> Collect acute-phase specimen when patient is admitted to hospital or diagnosed as suspected case and collect convalescent-phase specimen at death or when discharged from the hospital.</SMALL><br>
<SMALL><sup>†††</sup> whole blood or tissue is preferred, although serum or plasma may provide results.</SMALL><br>
<SMALL><sup>††††</sup> Use both ice packs and dry ice to provide best results. If dry ice or ice packs are not available, sample may be shipped at room temperature and still provide valid results in most cases.</SMALL>
Ebola virus can be        detected in [[fatal]] cases from a [[skin]] specimen using [[immunohistochemistry]]        or RT-PCR tests developed by the Centers for Disease Control and Prevention (CDC). The skin specimen is fixed in        [[formalin]] or [[chaotrope]] which kills the [[virus]]. The specimen is no longer [[infectious]] once        it is placed in formalin or chaotrope and the outside of the vial has been decontaminated.        This vial can be shipped by mail or hand carried to the lab without risk.        Results are available within a week after the specimen arrives at the        CDC.


==References==
==References==

Revision as of 18:41, 26 June 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.; Guillermo Rodriguez Nava, M.D. [2]

Overview

Ebola would be categorized as a viral hemorrhagic fever. Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM ELISA, polymerase chain reaction (PCR), and virus isolation can be used to diagnose a case of Ebola HF within a few days of the onset of symptoms. Persons tested later in the course of the disease or after recovery can be tested for IgM and IgG antibodies; the disease can also be diagnosed retrospectively in deceased patients by using immunohistochemistry testing, virus isolation, or PCR.[1]

Laboratory Findings

There are no specific laboratory findings of Ebola virus disease, the following table shows some nonspecific usually found:[2]

Laboratory findings
Test Findings
White blood cells count Leucopenia
Lymphopenia
Neutrophilia
Blood smear Left shift
Atypical lymphocytes
Liver function tests Raised aspartate aminotransferase
Raised alanine aminotransferase
Extended prothrombin time
Extended partial thromboplastin time
Proteins Hyperproteinemia
Urinalysis Proteinuria

References

  1. "Ebola Hemorrhagic Fever Information Packet" (PDF).
  2. Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.

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