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Available Tests

Specimen Sources, Test List by Alphebetical Order ->

Vector-Borne Diseases

  • 410 Babesia microti by Real-Time PCR
    • Clinical significance: Babesia species are the causative agent of babesiosis. Babesia are probably the most frequent mammalian intraerythrocytic parasites, with the exception of trypanosomes. In the host, intraerythrocytic Babesia species vary in size from 1 to 5µm in length and are oval, round or pear-shaped. Babesia and Borrelia burgdorferi are transmitted by the same vector, black-legged ticks of the genus Ixodes. The disease is transmitted to humans mostly by the nymph and occasionally by the adult ticks. In general, patients infected with Babesia do not recall receiving a tick bite. After an incubation period of 1 to 4 weeks (or 6 to 9 weeks following transmission by blood transfusion), symptoms and signs gradually appear. The symptoms are not specific and can include fatigue, anorexia, myalgia, nausea, depression and dark urine. In this assay, DNA is extracted from the specimen and subjected to PCR amplification.
      • Method:
      • Real-Time PCR
      • Turn around time:
      • 24-48 hours
  • 433 Babesia microti by ELISA
    • Clinical significance: Human babesiosis is an emerging tick-borne disease that may be life-threatening. Laboratory tests for babesiosis include blood smear examination, inoculation of hamsters with patient blood, and immunofluorescent antibody assays (IFA). These methods are either relatively insensitive, time-consuming, labor-intensive or expensive. Babesia ELISA can provide an accurate assessment for the detection of the long-lasting human immune system response, or IgG antibodies, to Babesia antigen, as well as primary and early infections through the detection of IgM antibodies.
      • Method:
      • ELISA
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours. Test performed on Wed.
  • 431 Babesia WA1 by Real-Time PCR
    • Clinical significance: Babesiosis is a zoonotic disease which requires transmission from an animal reservoir to humans via a tick vector. In the northeastern United States, the black-legged deer tick Ixodes scapularis, the same vector that transmits Lyme disease, is the principal vector for the transmission of the etiologic agent of Babesiosis, Babesia microti. Babesia species from rodents, primarily the white-footed deer mouse but also the field mouse, vole, rat, and chipmunk, are transmitted to humans during tick bites in endemic areas. Human infections occurring on the West Coast of the United States have been caused by Babesia-like organisms designated WA-1 type Babesia (where the prefix “WA” stands for Washington State in which the first human case was described). Based upon sequencing data, WA-1 type Babesia shows more affinity to small babesial isolates from dogs and wildlife in California than to B. microti. Although WA1 is morphologically similar to B. microti, several differences were noted, including antigenic cross-reactivity, virulence in hamsters (100% fatality within 10 days), and Southern restriction fragment length polymorphisms of DNA digests. All of these data indicated that WA1 is a new human pathogen that is distinct from B. microti.
      • Method:
      • Real-Time PCR
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours
  • 317 Bartonella henselae by Real-Time PCR
    • Clinical significance: B. henselae is the causative agent of Cat Scratch Disease (CSD) as well as other conditions. It is commonly seen in immunocompromised patients, particularly those suffering from HIV infection. The classic clinical presentation of CSD is a self-limiting, regional lymphadenopathy, usually caused by a cat scratch or bite. The disease starts with a lesion at the site of infection, which may become a papule. Transmission of the disease has been linked to cats and is also suspected to occur via fleas and ticks. Recently, Bartonella has been detected in immunocompromised patients as well as in Ixodes scapularis ticks, the same ticks that transmit Lyme disease. Evidence is mounting that Bartonella species are also transmitted from ticks to humans and can contribute to the disease manifestations of Lyme disease. Proper identification is essential such that the necessary treatments are administered. In this assay, DNA is extracted from the specimen and subjected to PCR amplification.
      • Method:
      • Real-Time PCR
      • Turn around time:
      • 24-48 hours
  • 355 Bartonella henselae by ELISA

    • Serum required

    • Clinical significance: B. henselae is the causative agent of cat scratch disease (CSD) as well as other conditions. It is commonly seen in immunocompromised patients, particularly those suffering from HIV infection. The classic clinical presentation of CSD is a self-limiting regional lymphadenopathy, usually caused by a cat scratch or bite. The disease starts with a lesion at the site of infection, which may become a papule. Transmission of the disease has been linked to cats and is also suspected to occur via fleas and ticks. Recently, Bartonella has been detected in immunocompromised patients as well as in Ixodes scapularis ticks, the same ticks that transmit Lyme disease. Evidence is mounting that Bartonella species are also transmitted from ticks to humans and can contribute to the disease manifestations of Lyme disease. Traditionally, clinical diagnostics have relied on direct culturing and Immunofluorescent antibody (IFA) technologies. The culturing of Bartonella from blood samples is technically challenging and is a low-yield procedure with recommended growth conditions including lengthy incubation periods of at least 21 days. B. henselae IFAs have high sensitivity and specificity. However, cross-reactivity with other human pathogens has been reported. In addition, IFAs rely heavily on technicians for the determination of test results, are time-consuming to score, and require expensive fluorescent microscopes. Detection of antibodies using an ELISA assay allows diagnosis of an infection when other methods, such as culture or IFA, are impractical or yield negative results. In this assay, patient serum is analyzed by ELISA for the presence of Bartonella henselae-specific IgG and IgM antibodies.
      • Method:
      • ELISA
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours. Test performed on Wed.
  • 424 Borrelia afzelii by Real-Time PCR
    • Clinical significance: Borrelia afzelii and Borrelia garinii are part of the "B. burgdorferi sensu lato" group and are distinguished from the species "B. burgdorferi sensu stricto" (strict sense of B. burgdorferi). Human infection due to B. burgdorferi sensu lato may involve multiple organs or tissues, resulting in skin, cardiac, neurological and musculoskeletal disorders. B. burgdorferi sensu stricto is widely distributed in the Northeast, Midwest and Western regions of the United States. B. burgdorferi sensu stricto, B. garinii, and B. afzelii have been documented in Europe. The principal vectors of B. burgdorferi sensu lato are ticks of the I. ricinus complex, including I. scapularis and I. pacificus in the United States, I. ricinus in Europe, and I. persulcatus in Asian Russia, China and Japan. The European sheep tick, I. ricinus, has been recognized as a vector of all three human pathogenic Borrelia species, B. burgdorferi sensu stricto, B. garinii, and B. afzelii. Acrodermatitis chronica atrophicans (ACA) is associated with B. afzelii infection. ACA is a late cutaneous manifestation of LB characterized by chronic and long-lasting progressive red and bluish-red lesions, usually on the extensor of the extremities. Molecular studies of ACA isolates from patients in several European countries have provided evidence that B. afzelii is the predominant etiologic agent of ACA. Lyme carditis is a well known clinical manifestation in both North American and European patients with LB. Neuroborreliosis is the most frequent manifestation of disseminated infection in Europe and is a common symptom in North American LB patients as well. All three species, B. burgdorferi sensu stricto, B. garinii, and B. afzelii, are known to cause Lyme neuroborreliosis. In European patients, B. garinii constituted 72% of the Borrelia isolates or DNAs detected in human CSF samples, whereas 8% and 20% of the specimens were identified as B. burgdorferi sensu stricto and B. afzelii, respectively.
      • Method:
      • Real-Time PCR
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours
  • 425 Borrelia garinii by Real-Time PCR
    • Clinical significance: Borrelia afzelii and Borrelia garinii are part of the "B. burgdorferi sensu lato" group and are distinguished from the species "B. burgdorferi sensu stricto" (strict sense of B. burgdorferi). Human infection due to B. burgdorferi sensu lato may involve multiple organs or tissues, resulting in skin, cardiac, neurological and musculoskeletal disorders. B. burgdorferi sensu stricto is widely distributed in the Northeast, Midwest and Western regions of the United States. B. burgdorferi sensu stricto, B. garinii, and B. afzelii have been documented in Europe. The principal vectors of B. burgdorferi sensu lato are ticks of the I. ricinus complex, including I. scapularis and I. pacificus in the United States, I. ricinus in Europe, and I. persulcatus in Asian Russia, China and Japan. The European sheep tick, I. ricinus, has been recognized as a vector of all three human pathogenic Borrelia species, B. burgdorferi sensu stricto, B. garinii, and B. afzelii. Acrodermatitis chronica atrophicans (ACA) is associated with B. afzelii infection. ACA is a late cutaneous manifestation of LB characterized by chronic and long-lasting progressive red and bluish-red lesions, usually on the extensor of the extremities. Molecular studies of ACA isolates from patients in several European countries have provided evidence that B. afzelii is the predominant etiologic agent of ACA. Lyme carditis is a well known clinical manifestation in both North American and European patients with LB. Neuroborreliosis is the most frequent manifestation of disseminated infection in Europe and is a common symptom in North American LB patients as well. All three species, B. burgdorferi sensu stricto, B. garinii, and B. afzelii, are known to cause Lyme neuroborreliosis. In European patients, B. garinii constituted 72% of the Borrelia isolates or DNAs detected in human CSF samples, whereas 8% and 20% of the specimens were identified as B. burgdorferi sensu stricto and B. afzelii, respectively.
      • Method:
      • Real-Time PCR
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours
  • 430 Borrelia lonestari by Real-Time PCR
    • Clinical significance: In the southeastern and south central United States, the prevalence of Lyme disease caused by B. burgdorferi sensu stricto is much lower than that found in the northeastern United States. However, another Lyme disease-like illness that develops following the bite of the Lone Star tick, Amblyomma americanum, has been described. Individuals affected with this illness, termed "southern tick-associated rash illness", or STARI, commonly develop a localized expanding circular skin rash (erythema migrans [EM]) at the site of the tick bite similar to that seen with classic Lyme disease. A mild illness characterized by generalized fatigue, headache, stiff neck, and occasionally fever and other constitutional signs also develop. STARI appears to respond to antibiotic treatment and has been attributed to infection with an as-of-yet-uncultivated spirochete tentatively referred to as Borrelia lonestari. Cases consistent with this clinical presentation have been reported from several southeastern and south central states, including Missouri, Maryland, Georgia, South Carolina, and North Carolina. The majority of patients with STARI do not have laboratory evidence of infection with B. burgdorferi sensu stricto. Moreover, a new spirochete, B. lonestari, was described from A. americanum on the basis of polymerase chain reaction (PCR) amplification of the flagellin and 16s rRNA genes. Virtually identical sequences have been found in ticks from geographic regions as disparate as New Jersey and Texas, suggesting this organism is widely distributed. Likewise, Borrelia spirochetes have been detected in A. americanum and I. scapularis ticks in Alabama. Despite relatively widespread documentation of this organism in ticks, a vertebrate reservoir host that could be responsible for maintaining infection in the tick population has not yet been identified.
      • Method:
      • Real-Time PCR
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours
  • 411 Ehrlichia chaffeensis (HME) & Anaplasma phagocytophila (HGE) by Real-Time PCR
    • Clinical significance: Ehrlichia is the causative agent of Ehrlichiosis. This obligate intracellular bacteria is transmitted by the Ixodes tick, the same vector implicated in Lyme disease and Babesiosis. Human Ehrlichiosis was described in the United States for the first time in 1986. Unusual inclusions are noted in patient’s mononuclear cells and were later recognized as being characteristic of the genus Ehrlichia. Human Ehrlichiosis has a fatality rate approaching 5% if treatment with the appropriate antibiotic is not administered in a timely fashion. Two types of human Ehrlichiosis have been recognized, depending on the type of infected blood cells. Human monocytotropic Ehrlichiosis (HME) is caused by infection of mononuclear cells and Human Granulocytic Ehrlichiosis (HGE) is caused by infection of granulocytes. In this assay, DNA is extracted from the specimen and subjected to PCR amplification.
      • Method:
      • Real-Time PCR
      • Turn around time:
      • 24-48 hours
  • 305 Lyme disease (B. burgdorferi) by Real-Time PCR
    • Clinical significance: Borrelia burgdorferi is the causative agent of Lyme disease. Transmission of Lyme disease occurs primarily by way of infected black-legged ticks of the genus Ixodes. If left untreated the bacterium usually travels through the bloodstream, establishes itself in various body tissues, and can cause a number of symptoms ranging from a relatively benign skin rash to severe arthritic, neurologic and cardiac manifestations. The clinical symptoms of Lyme disease vary among individuals and during the course of an infection. The characteristics of Borrelia burgdorferi infections makes diagnosis of the disease difficult. Most of the displayed associated clinical symptoms are not unique to Lyme disease. In this assay, DNA is extracted from the specimen and subjected to PCR amplification.
      • Method:
      • Real-Time PCR
      • Turn around time:
      • 24-48 hours
  • 417 Lyme disease C6 Peptide by ELISA

    • Serum required

    • Clinical significance: This assay utilizes a synthetic peptide (C6 peptide) which is derived from the VisE protein of B. burgdorferi. This peptide has been shown to be both specific and highly immunogenic. The peptide sequence is conserved and equally antigenic in humans infected with Borrelia burgdorferi or with European genospecies including B. afzelii and B. garinii. As the antigen represents a defined sequence within the protein, potential cross-reactivity in individuals with unrelated and partially related antigens found in other organisms is greatly reduced. Likewise, cross-reactivity in individuals vaccinated with licensed recombinant OspA Lyme disease vaccine (Lymerix) is not observed.
      • Method:
      • ELISA
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours. Test performed on Mon and Thurs.
  • 427 Lyme disease IgG/IgM by ELISA

    • Serum required

    • Clinical significance: This assay tests for the qualitative detection of total (IgG and IgM) antibodies to Borrelia burgdorferi in human serum. Detection of antibodies allows diagnosis of an infection when other methods, such as culture or antigen detection, are impractical or yield negative results. This test is the first of a two-step system to provide supportive evidence of exposure to B. burgdorferi, which could support a clinical diagnosis of Lyme disease. This assay should not be used as a sole criterion for diagnosis.
      • Method:
      • ELISA
      • Transport:
      • Stable at room temperature
      • Turn around time:
      • 24-48 hours. Test performed on Mon and Thurs.
  • 313 Lyme disease IgG/IgM by Western blot

    • Serum required

    • Clinical significance: This assay is for the qualitative in vitro detection of human IgG or IgM antibodies to individual proteins of Borrelia burgdorferi in human serum. The Western blot is useful for characterizing the specificity of the antibody response to B. burgdorferi. It is utilized as a second-step method to differentiate between IgM and IgG antibodies to specific B. burgdorferi proteins. Other serological tests, such as IFA or EIA, only measure total antibody response.
      • Method:
      • Western blot
      • Transport:
      • Refrigerate
      • Turn around time:
      • 24-48 hours. Test performed on Mon and Thurs.
  • 416 Rickettsia rickettsii (RMSF) by Real-Time PCR
    • Clinical significance: Rickettsia rickettsii is an obligate intracellular parasite that seems to target endothelial cells. It is the causative agent of Rocky Mountain Spotted Fever (RMSF). It is a tick-borne disease that can be transmitted by ticks of the genus Ixodes, the same ticks which transmit Lyme disease, Babesiosis, and Ehrlichiosis. This disease is characterized by fever, myalgia, and headache at onset. The major diagnostic sign is a rash that may characteristically affect the palms of the hands and soles of the feet. Early diagnosis of this disease is important so that appropriate antibiotic therapy may be initiated. Failure to initiate proper therapy within 5 days after onset of symptoms has been associated with increased mortality. Traditional laboratory tests lack sensitivity and can be very time consuming. Recent advances in molecular diagnostic techniques, such as PCR, provide a highly sensitive and specific means of early diagnosis. In this assay, DNA is extracted from the specimen and subjected to PCR amplification.
      • Method:
      • Real-Time PCR
      • Turn around time:
      • 24-48 hours

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•
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