Enterovirus Quantitative Real-time RT-PCR

Test Code: 1400

Some specimen types for this assay are reported as qualitative results; please see our Specimen Information section below for more information.

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Clinical and Procedure
Clinical Utility

The enteroviruses are well-known etiologic agents of viral meningitis, viral encephalitis, myocarditis, and respiratory tract disease as well as a wide variety of other clinical conditions. Quantitative PCR can be used to detect the presence of the virus as well as track the course of infection.

About Enterovirus

Human enteroviruses are ubiquitous viruses that are transmitted from person to person via direct contact with virus shed from the gastrointestinal tract or respiratory tract. Enteroviruses cause a wide range of infections, ranging from mild illness to clinically significant infection, especially in immunocompromised populations.1-2  Most infections are subclinical, especially in young children, but clinically apparent disease can cause an array of clinical conditions, ranging from rashes and upper respiratory tract infections, to meningitis and other neurological diseases.3

Procedure

Extraction of enterovirus nucleic acid from specimen, followed by reverse transcription of viral RNA, then amplification and detection of cDNA using real-time, quantitative PCR. An internal control is added to ensure the extraction was performed correctly and the PCR reaction was not inhibited. Eurofins Viracor's assay design includes multiple targets to account for viral mutations, which significantly reduces the chance of false negative results. This test has not been cleared or approved for diagnostic use by the U.S. Food and Drug Administration.

Specificity

Detects the entire spectrum of human enteroviruses, including coxsackie A viruses, coxsackie B viruses, echoviruses, polioviruses, and enteroviruses 68 through 71. The assay does not differentiate between serotypes. This assay is designed to specifically detect enteroviruses; however, rhinoviruses are a closely related and highly diverse group of pathogens. Cross-reactivity has been observed with some strains of rhinoviruses.  Results should be used in conjunction with clinical findings and should not form the sole basis for a diagnosis or treatment decision.

Turnaround Time

Same day (within 8 - 12 hours from receipt of specimen), Monday through Saturday, with the exception of Tissue and Fecal specimens. Tissue and Fecal specimens are expected to report within 18-24 hours from receipt of specimen, Monday-Saturday.

Specimen Information
Specimen Type Test Code CPT Code NY Approved Volume Assay Range Special Instructions
plasma 1401 87799 Yes

2 mL (min. 0.5 mL)

211 copies/mL to 1x108 copies/mL
  • Collect 4-5 mL whole blood in EDTA or ACD tube.
  • Avoid using gel separator tubes; samples collected in gel separator tubes have increased rate of PCR inhibition.
  • Centrifuge and transfer 2 mL plasma to sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 7 days of collection.
CSF 1403 87799 Yes

2 mL (min. 0.5 mL)

83 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Store frozen and ship on dry ice for overnight delivery.
Fresh Frozen Tissue [Qual] 1405 87498 No 5 mg fresh tissue (approximately ½ of a pencil eraser size) Detected/Not Detected
  • Place fresh tissue in a sterile, screw top container.
  • The preferred handling is to not add water, saline or other fluid media to the tissue container; however, fluid media filled containers will be accepted for qualitative results.
  • Store frozen and ship on dry ice for overnight delivery.
  • Formalin fixed, paraffin embedded tissue will not be accepted.
fecal 1408 87498 No Size of pea, or 2 mL liquid stool Detected/Not Detected
  • Collect and place in a sterile, screw top tube.
  • Store frozen and ship on dry ice for overnight delivery.
BAL 1409 87799 Yes

2 mL (min. 0.5 mL)

224 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 7 days of collection.
serum 1410 87799 Yes

2 mL (min. 0.5 mL)

211 copies/mL to 1x108 copies/mL
  • Collect 4-5 mL whole blood in red top tube.
  • Avoid using gel separator tubes; samples collected in gel separator tubes have increased rate of PCR inhibition.
  • Centrifuge and transfer 2 mL serum to sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 7 days of collection.
nasal wash 1413 87799 Yes

2 mL (min. 0.5 mL)

150 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
trach asp 1419 87799 Yes

2 mL (min. 0.5 mL)

224 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 7 days of collection.
throat gargle 1423 87799 Yes

2 mL (min. 0.5 mL)

150 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
NP aspirate 1424 87799 Yes

2 mL (min. 0.5 mL)

150 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
NP swab 1425 87498 Yes

2 mL

Detected/Not Detected
  • Place sterile swab placed in 2 mL sterile saline, M4, or viral transport media in a sterile, screw top tube.
  • Do not use calcium alginate swab or wood shafted swab.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
bronch wash 1426 87799 Yes

2 mL (min. 0.5 mL)

224 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 7 days of collection.
nasal swab 1430 87498 Yes

2 mL

Detected/Not Detected
  • Place sterile swab placed in 2 mL sterile saline, M4, or viral transport media in a sterile, screw top tube.
  • Do not use calcium alginate swab or wood shafted swab.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
nasal asp 1431 87799 Yes

2 mL (min. 0.5 mL)

150 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
NP wash 1447 87799 Yes

2 mL (min. 0.5 mL)

150 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 96 hrs. of collection.
trach wash 1448 87799 Yes

2 mL (min. 0.5 mL)

224 copies/mL to 1x108 copies/mL
  • Collect in a sterile, screw top tube.
  • Can be shipped at ambient or frozen temperature Monday through Friday.
  • Specimens shipped at ambient temperature must be received within 7 days of collection.
Shipping

Ship Monday through Friday. Friday shipments must be labeled for Saturday delivery. All specimens must be labeled with patient's name and collection date. A Eurofins Viracor test requisition form must accompany each specimen. Multiple tests can be run on one specimen. Ship specimens FedEx Priority Overnight® to: Eurofins Viracor, 18000 W 99th St. Ste, #10, Lenexa, KS 66219

Causes for Rejection

Whole blood frozen, grossly hemolyzed plasma/serum specimens, specimens beyond their acceptable length of time from collection as listed in the specimen handling, specimens received in trap containers or specimen types other than those listed.

Disclaimer

Specimens are approved for testing in New York only when indicated in the Specimen Information field above.

The CPT codes provided are based on Eurofins Viracor's interpretation of the American Medical Association's Current Procedural Terminology (CPT) codes and are provided for informational purposes only. CPT coding is the sole responsibility of the billing party. Questions regarding coding should be addressed to your local Medicare carrier. Eurofins Viracor assumes no responsibility for billing errors due to reliance on the CPT codes illustrated in this material.

References

1 Chakrabarti S, Osman H, Collingham KE, et al. Enterovirus infections following T-cell depleted allogeneic transplants in adults. Bone Marrow Transplant. Feb; 33(4):425-30.

2 Gonzalez Y, Martino R, Badell I, et al. Pulmonary enterovirus infections in stem cell transplant recipients. Bone Marrow Transplant. 1999 Mar, 23(5):511-3.

3 Pallansch MA, Roos RP: Enteroviruses: polioviruses, coxsackieviruses, echoviruses, and newer enteroviruses. In Fields Virology. 4th edition. Edited by Knippe DM, Howley PM. Philadelphia, PA: Lippincott Williams and Wilkins; 2001:723-75.

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