Arbovirus RNA Detection   

 
IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to NPHL@unmc.edu or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.

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Test: Arbovirus RNA Detection 
Order in NUlirt or complete NPHL Test Order Form with supplemental form
https://nphl.org/documents/2021_CDC_DASH_50.34.pdf  
Synonym: Arbovirus, Arbo Isolation, Barmah Forest virus (BFV), Bourbon virus (BRBV), Cache Valley virus (CVV), Chikungunya virus (CHIKV), Colorado tick fever virus (CTFV), Deer tick virus (DTV), Dengue virus (DENV), Heartland virus (HRTV), Jamestown Canyon virus (JCV), Japanese encephalitis virus (JEV), La Crosse virus (LACV), Mayaro virus (MAYV), Murray Valley encephalitis virus (MVEV), O'nyong nyong virus (ONNV), Powassan virus (POWV), Ross River virus (RRV), Saint Louis encephalitis virus (SLEV), Severe fever with thrombocytopenia syndrome virus (SFTSV), Sindbis virus (SINV), Snowshoe hare virus (SSHV), Tahyna virus (TAHV), Toscana virus (TOSV), West Nile virus (WNV), Western equine encephalitis virus (WEEV), Yellow fever virus (YFV), Zika virus (ZIKV)  
Method:  
Availability: Note: Contact the NPHL for guidance if arbovirus is suspected. 

For more information, please review the current clinical guidelines for Arbovirus testing at:
 https://www.cdc.gov/laboratory/specimen-submission/detail.html?CDCTestCode=CDC-10281

Submit all specimens through the state health departments, NOT directly to the CDC or ARUP. CDC does not accept routine shipments on weekends or holidays. Therefore, ship to NPHL on Monday – Thursday, to guarantee arrival at the CDC by Friday.  
Specimen: https://www.cdc.gov/laboratory/specimen-submission/detail.html?CDCTestCode=CDC-10281   
Collection Device: See link above.
Specimen Labeling: Test subject to CLIA regulations and requires 2 patient identifiers and specimen source on container  
Volume: See link above  
Storage/Transport:

Prior to and during shipment:  Refrigerate 2-8°C.  Centrifuge and aliquot serum into sterile leak-proof tube, ASAP.  Place both CSF and serum at 2-8°C.

Shipping instructions, including specimen-handling requirements during transport:  Seal screw-top tubes with Parafilm™ or tape and place in biohazard bag with absorbent material.
Refrigerate 2-8°C.

Place specimen inside leak proof secondary container (biohazard bag and if transporting by air, use Tyvek™ Envelope) with adsorbent material. The secondary container must be packed inside an approved Category B shipping container filled with frozen gel-packs to keep specimen refrigerated. Position NUlirt packing list or NPHL Test Order form between secondary container and box lid. Seal with tape.  Label outer box as UN3373 Category B, Biological Substance. Transport by NPHL ground courier. If courier not available, ship by FedEx, UPS, or USPS (1st Class, Priority or Express Mail). Follow appropriate DOT/IATA Regulation Guidelines.  For assistance, call NPHL State Training Coordinator at (402) 559-3590.  
See instructions and shipping address: http://nphl.org/

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.

 
Unacceptable: Severely lipemic, icteric or hemolyzed samples; heat-inactivated serum; multiple freeze thaw cycles  
Specimen Stability: See link above  
Reference Interval: NEGATIVE - No significant level of detectable virus RNA 
POSITIVE – Positive virus RNA detected  
Reportable Disease: Report positive Dengue results as Arbovirus infection within 7d to local or state health department. Refer to Nebraska DHHS Title 173, Communicable Diseases.  
Comments: Pre-approval needed from state or local health department.  Send approval to NPHL@unmc.edu or call (402) 559-9444.

Documentation must accompany the specimen to include the following information:  symptoms and date of onset, pregnancy status, travel, and vaccine history. 

During the first 7d of these illnesses, viral RNA can often be identified in serum, and RT-PCR is the preferred test for all arbo4viruses. Refer to Arbovirus Antibody IgM test for specimens collected after 7d.

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.

Test performed at the CDC.  After approval from local or state epi, submit specimens through the NPHL, NOT directly to CDC.  
Revised: 7/15/2021 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.

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