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West Nile Virus

HEALTH ADVISORY to LICENSED CLINICAL LABORATORIES

Date: 5/19/05

2005 Season (June-October) Reminder

Send Specimens to State Lab for Arbovirus /WNV Surveillance Testing

Physicians have been advised to report selected cases and write orders to have an aliquot of CSF (1ml) and serum (3ml) sent to the State Laboratory for suspect cases of viral meningitis, encephalitis and Guillain-Barre Syndrome as part of annual arboviral disease surveillance. This is a reminder to all RI licensed clinical laboratories to develop and implement procedures to transport an aliquot of CSF and serum to the State lab upon physician request or by using the following guidelines when no order is received (no pre-authorization required):

1. Age of patient 17 years or older : SendCSF (cell count >10) + serum

Send any CSF specimen with a cell count of more than 10 cells. Also send a serum specimen along with the CSF. If the diagnosis is known to the lab to be a non-infectious condition such specimens do not need to be sent.

2. All ages: Send CSF (any cell count) if diagnosis known by lab to be encephalitis or Guillain Barre Syndrome + serum

Send a CSF and serum specimen to the state lab if the clinical diagnosis is known to the lab to be encephalitis or Guillain Barre Syndrome, regardless of what the CSF cell count is. Also send a serum specimen along with the CSF. We appreciate the fact that labs may not have clinical information.

All other tests ordered (other than arboviral) may go straight to a commercial or hospital lab for testing. However, if a test result in serum or CSF is positive for WNV IgM as reported by a commercial or hospital laboratory and this result is known to the laboratory dispatching the original specimen, such a result must be reported to the Office of Communicable Diseases at 222 2577.

Specimen submission directions :

Use the standard, state lab submission form. Indicate "ARBOVIRUS TESTING" in box 7,8, or 9.

Transport specimens on weekdays only. Hold specimens refrigerated on weekends and holidays.

Turnaround time is 5 working days for test results after receipt at the State lab.

Laboratory surveillance for WNV is complex. Please consult the State Laboratory as needed by calling the Serology lab at 222-5591 or by calling the State Laboratory switchboard at 222-5600 and asking for the Serology Laboratory.

You may also call the Office of Communicable Disease at 222 2577. See http://www.health.ri.gov/topics/wnv.php for most current information and data.