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Enterovirus by Nucleic Acid Amplification

Meningitis, Viral, Virus, URI, Upper Respiratory Infection, PCR, Real-Time PCR

Test Codes

EPIC: LAB7676, Beaker: XENTV, Warde: EVPCR

Department

Send Outs

Specimen Collection Criteria

Collect: One of the following specimen types:

1. Cerebrospinal Fluid (CSF) in a sterile collection container. (Minimum: 0.5 mL)
• Specimen must be refrigerated within one hour or collection.
2. Nasopharyngeal (NP) Swab in viral transport media (UVT, UTM).
• NP swabs should be held in the nasopharynx for 30 seconds and gently rotated.
• Please see the Specimen Collection Manual for NP Swab Collection.
3. Bronchoalveolar lavage/wash in sterile screw-capped plastic container 1.0 mL (Minimum: 0.5 mL).
4. Stool in sterile screw-capped plastic container 2.0 mL (Minimum: 1.0 mL) for liquid stool or marble-size solid stool.
5. Urine in a sterile screw cap container (Minimum: 1.0 mL)
6. Bone Marrow in EDTA, 1.0 mL (Minimum: 0.5 mL).
7. Whole blood in EDTA, 2.0 mL (Minimum: 1.0 mL).
8. Swab specimens (throat, oral, dermal, ocular, esophagus) in viral transport medium (UVT, UTM).
9. Biopsy/tissue specimens in saline or viral transport medium (Snap frozen -20°C).

Physician Office/Draw Specimen Preparation

• CSF: Maintain specimen refrigerated (2-8°C or 36-46°F). Specimens not received in the Laboratory within 24 hours of collection must be frozen (-20°C/-4°F or below).
• NP Swabs: Maintain specimen in viral transport medium (UVT, UTM), refrigerated (2-8°C or 36-46°F) or frozen (-20°C/-4°F or below).
• Biopsy/tissue specimens:  Maintain specimen frozen (-20°C/-4°F or below)

For all other specimen types: Maintain specimen refrigerated (2-8°C or 36-46°F).

Preparation for Courier Transport

Transport: CSF in a sterile collection container (Minimum: 0.5 mL), NP swab in viral transport medium, throat, oral, dermal, ocular, or esophagus swabs in viral transport medium, bone marrow in EDTA (Minimum: 0.5 mL), whole blood in EDTA (Minimum: 1.0 mL), biopsy/tissue specimens in saline or viral transport medium: refrigerated (2-8°C or 36-46°F) or frozen (-20°C/-4°F or below).

Rejection Criteria

• Swabs in Ruhof-brand VTM, or any other Viral Transport containing guanidine-thiocyanate

• Specimens submitted on dry swabs.
• Specimens submitted in bacterial transport systems.
• Specimens submitted on cotton or calcium alginate swabs, or on wooden shaft swabs.

Storage

Specimen Stability for Testing:

Cerebrospinal Fluid (CSF)
Room Temperature (20-26°C or 68-78.8°F): 1 hour
Refrigerated (2-8°C or 36-46°F): 24 hours
Frozen (-20°C/-4°F or below): 3 months

Nasopharyngeal (NP) Swabs
Room Temperature (20-26°C or 68-78.8°F): 1 hour
Refrigerated (2-8°C or 36-46°F): 48 hours
Frozen (-20°C/-4°F or below): 3 months

Biopsy/Tissue specimens
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): 14 days
Frozen (-70°C/-94°F): 3 Months

All other Specimen Types
Room Temperature (18-25°C): 3 days
Refrigerated (2-8°C): 14 days
Frozen (-20°C): 14 days
Frozen (-70°C): 3 months

Specimen Storage in Department Prior to Disposal:

CSF: Refrigerated (2-8°C or 36-46°F): 30 days
NP Swabs: Refrigerated (2-8°C or 36-46°F): 7 days 

Laboratory

Sent to Warde Medical Laboratory, Ann Arbor, MI 

Performed

Monday – Saturday
Results available 2-4 days. 

Reference Range

Negative.

Test Methodology

Nucleic Acid Amplification.

Interpretation

A negative result does not rule out Enterovirus infection.

Clinical Disease

The Enteroviruses consist of a group of small RNA viruses within the family Picornaviridae and include the poliovirus and the non-polioviruses: coxsackieviruses group A and B, echoviruses and the numbered enteroviruses. Enterovirus infections include aseptic meningitis, encephalitis, and upper respiratory tract infections.

Epidemiology

The World Health Organization has estimated that three-quarters of enteroviral infections occur in children under the age of 15 years, with the highest rate occuring in infants under 1 year of age. Infection is through the ingestion of fecally contaminated food or water. The infectious agent differs markedly each season with the most frequently isolated serotypes being echoviruses 11 and 9 followed by Coxsackie virus B5.

Incubation Period

The incubation period ranges from 2-14 days and with a mean of 3-5 days.

CPT Codes

87498

Contacts

Last Updated

10/2/2023