Ebola other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
Ebola | While the diagnosis of Ebola may be suspected based on clinical findings, the diagnosis of [[Ebola]] can be confirmed by [[antigen]]-capture [[enzyme-linked immunosorbent assay]] ([[ELISA]]) testing, [[IgM]] [[ELISA]], [[polymerase chain reaction]] ([[PCR]]), and [[virus]] isolation, within 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 in deceased patients by using [[immunohistochemistry]] testing, [[virus]] isolation, or [[PCR]].<ref name=CDC>{{cite web | title = Ebola Hemorrhagic Fever Information Packet | url = http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/Fact_Sheets/Ebola_Fact_Booklet.pdf }}</ref> | ||
==Other Diagnostic Test== | ==Other Diagnostic Test== | ||
* | * [[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 [[Chaotropic agent|chaotrope]] to kill the [[virus]] | ||
* The | * The specimen is no longer [[infectious]] once it is placed in [[formalin]] or [[Chaotropic agent|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, and the results are available within a week after the specimen arrives at the [[CDC]].<ref name=CDC63>{{cite web | title = CDC: Ebola Hemorrhagic Fever, Diagnosis | url = http://www.cdc.gov/vhf/ebola/diagnosis/index.html }}</ref> | |||
<small> Table adapted from ''WHO: Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting'' <ref name=WHO25>{{cite web | title = Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting | url = http://www.who.int/csr/resources/publications/ebola/whoemcesr982sec1-4.pdf }}</ref></small> | <small> Table adapted from ''WHO: Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting'' <ref name=WHO25>{{cite web | title = Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting | url = http://www.who.int/csr/resources/publications/ebola/whoemcesr982sec1-4.pdf }}</ref></small> | ||
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| 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 | [[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> Whole blood can be used for enzyme-linked immunosorbent assay (ELISA) and may be frozen. Do not centrifuge suspected VHF specimens because this increases the 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> 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> | <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> | <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> | ||
==Gallery== | |||
<gallery> | |||
Image: Ebolavirus05.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a magnification of 50,000X, this scanning electron micrograph (SEM) depicts numerous filamentous Ebola virus particles replicating from an infected VERO E6 cell. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Ebolavirus03.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell of the African green monkey kidney epithelial cell line. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Ebolavirus02.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Ebolavirus01.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
</gallery> | |||
== References == | == References == | ||
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[[Category:Zoonoses]] | [[Category:Zoonoses]] | ||
[[Category:Hemorrhagic fevers]] | [[Category:Hemorrhagic fevers]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
Latest revision as of 17:38, 18 September 2017
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Ebola Microchapters |
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Diagnosis |
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Treatment |
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Postmortem Care |
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Case Studies |
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Ebola other diagnostic studies On the Web |
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American Roentgen Ray Society Images of Ebola other diagnostic studies |
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Risk calculators and risk factors for Ebola other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]
Overview
While the diagnosis of Ebola may be suspected based on clinical findings, the diagnosis of Ebola can be confirmed by antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM ELISA, polymerase chain reaction (PCR), and virus isolation, within 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 in deceased patients by using immunohistochemistry testing, virus isolation, or PCR.[1]
Other Diagnostic Test
- 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 to kill the virus
- The specimen is no longer infectious once it is placed in formalin or chaotropeand the outside of the vial has been decontaminated.
- This vial can be shipped by mail or hand carried to the lab without risk, and the results are available within a week after the specimen arrives at the CDC.[2]
Table adapted from WHO: Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting [3]
| Diagnostic test | Samples required | Preparation & Storage | Shipping | Viruses to be confirmed |
|---|---|---|---|---|
| ELISA (serology) detects: | Whole blood serum or plasma†
Acute and convalescent†† |
Freeze or refrigerate
(as cold as possible) |
Frozen on dry ice or ice packs or both†††† | Ebola Lassa CCHF Rift Valley Marburg Yellow fever |
| PCR detects: | Whole blood or clot†† | Refrigerate or freeze
Freeze |
Frozen on dry ice or ice packs or both†††† | Ebola Lassa CCHF Rift Valley Marburg Yellow fever |
| Immunohisto-chemestry (liver) detects: | Liver biopsy from fatal cases | Fix formalin (can be stored up to 6 weeks) | Room temperature (do not freeze) | Ebola Lassa CCHF Rift Valley Marburg Yellow fever |
| Immunohisto-chemestry (skin) detects: | Skin biopsy from fatal cases (any site) | Fix in formalin (can be stored up to 6 weeks) | Room temperature (do not freeze) | Ebola Lassa |
| Immunohisto-chemestry (other tissues) detects: | Tissue biopsy from fatal cases | Fix in formalin (can be stored up to 6 weeks) | Room temperature (do not freeze) | Ebola Lassa CCHF Rift Valley Marburg Yellow fever |
† Whole blood can be used for enzyme-linked immunosorbent assay (ELISA) and may be frozen. Do not centrifuge suspected VHF specimens because this increases the 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.
†† 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.
††† Whole blood or tissue is preferred, although serum or plasma may provide results.
†††† 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.
Gallery
-
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a magnification of 50,000X, this scanning electron micrograph (SEM) depicts numerous filamentous Ebola virus particles replicating from an infected VERO E6 cell. From Public Health Image Library (PHIL). [4]](/images/f/f4/Ebolavirus05.jpeg)
Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a magnification of 50,000X, this scanning electron micrograph (SEM) depicts numerous filamentous Ebola virus particles replicating from an infected VERO E6 cell. From Public Health Image Library (PHIL). [4]
-
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]](/images/1/1e/Ebolavirus03.jpeg)
Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]
-
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]](/images/5/5c/Ebolavirus02.jpeg)
Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]
-
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]](/images/0/03/Ebolavirus01.jpeg)
Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a magnification of 50,000X, this scanning electron micrograph (SEM) depicts numerous filamentous Ebola virus particles replicating from an infected VERO E6 cell. From Public Health Image Library (PHIL). [4]](/index.php/File:Ebolavirus05.jpeg)
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]](/index.php/File:Ebolavirus03.jpeg)
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]](/index.php/File:Ebolavirus02.jpeg)
![Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. From Public Health Image Library (PHIL). [4]](/index.php/File:Ebolavirus01.jpeg)