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Test Code CHIKC Chikungunya Virus, PCR, Molecular Detection, Spinal Fluid


Additional Testing Requirements


Due to the short period in which chikungunya RNA may be detected in cerebrospinal fluid (CSF), testing serum for IgM- and IgG-class antibodies to chikungunya virus is also recommended. See CHIKV / Chikungunya IgM and IgG, Antibody, Serum.



Specimen Required


Collection Container/Tube: Vial number 2

Submission Container/Tube: Sterile screw cap vial

Specimen Volume: 0.5 mL

Collection Instructions: Do not centrifuge or heat inactivate.


Useful For

Qualitative detection of chikungunya virus in cerebrospinal fluid after early symptom onset (ideally <7 days)

 

This test is not recommended for screening healthy patients.

Method Name

Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR)/DNA Probe Hybridization

Reporting Name

Chikungunya Virus, PCR, CSF

Specimen Type

CSF

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

Heat-inactivated specimen Reject

Clinical Information

Chikungunya virus (CHIK) is an RNA virus of the genus Alphavirus, family Togaviridae transmitted mainly through the bite of infected mosquitoes in the genus Aedes (Aedes aegypti and Aedes albopictus). This is the same mosquito that transmits dengue, yellow fever, and Zika viruses. Most people infected with chikungunya virus will develop some symptoms, most commonly fever and joint pain. There is no specific antiviral treatment for chikungunya virus infection.

 

Most cases of disease have occurred in Africa, Asia, Europe, and the Indian and Pacific Oceans, but transmission of CHIK has been identified in Caribbean countries and South American regions, as well as foci in the southern United States. Infection with chikungunya virus may be suspected based on symptoms (fever, joint pain, and headache) and recent history of travel. A diagnosis of CHIK infection can be confirmed through laboratory tests on serum or cerebrospinal fluid.

 

This assay is designed to detect only species of clinical significance and is to be used for patients with a clinical history and symptoms consistent with chikungunya infection.

Reference Values

Negative

Reference values apply to all ages.

Interpretation

A positive test result indicates the presence of chikungunya virus RNA in the specimen.

 

A negative test result with a positive internal control indicates that chikungunya virus RNA is not detectable in the specimen.

 

A negative test result with a negative internal control is considered evidence of polymerase chain reaction inhibition or reagent failure. A new specimen should be collected for testing if clinically indicated.

Cautions

This assay is designed to be used for patients with a clinical history and symptoms consistent with chikungunya infection.

 

Negative chikungunya virus real-time reverse transcription polymerase chain reaction results do not preclude infection with chikungunya virus and should not be used as the sole basis for patient treatment or management decisions. All results should be interpreted by a trained professional in conjunction with review of the patient's exposure history and clinical signs and symptoms.

 

False-negative results may arise from degradation of chikungunya virus RNA during incorrect shipping or storage, and specimen collection after the period that chikungunya virus RNA is typically found in the patient (7 days after onset of symptoms).

Method Description

The RealStar Chikungunya Virus RT-PCR Kit was developed by Altona Diagnostics to assist in the diagnosis of chikungunya (CHIK) infection by testing cerebrospinal fluid for CHIK RNA. The Altona RealStar Chikungunya (ARS CHIK) RT-PCR Kit 2.0 is a qualitative reverse transcription-PCR (RT-PCR) assay targeting the nonstructural protein 1 (NS1) gene. The assay includes a heterologous amplification system (internal control: IC) to identify possible RT-PCR inhibition and to confirm the integrity of the reagents of the kit. Testing will be performed per the manufacturer's instructions using the LightCycler 480 following extraction with the NucliSENS easyMag (bioMerieux).

 

Real-time RT-PCR technology utilizes a reverse-transcriptase reaction to convert RNA into complementary DNA, PCR for the amplification of specific target sequences, and target specific probes for the detection of the amplified DNA. The probes are labelled with fluorescent reporter and quencher dyes. Probes specific for CHIK RNA are labelled with the fluorophore FAM. The probe specific for the IC is labeled with the fluorophore JOE. Using probes linked to distinguishable dyes enables the parallel detection of CHIK specific RNA and the IC in corresponding detector channels of the real-time PCR instrument.(Package insert: RealStar Chikungunya RT-PCR Kit 2.0. Altona Diagnostics; 01/2017)

Day(s) Performed

Tuesday, Thursday

Report Available

Same day/1 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CHIKC Chikungunya Virus, PCR, CSF 81153-9

 

Result ID Test Result Name Result LOINC Value
603832 Chikungunya Virus, PCR, CSF 81153-9

Testing Algorithm

For more information see Mosquito-borne Disease Laboratory Testing