Communicable Disease

West Nile Virus Health Advisories

HEALTH ALERT - August 23, 2002

From: David Persaud, M.D., M.P.H.
Medical Director

West Nile Virus Testing and Specimen Submission Procedures

The Kent County Health Department would like to update laboratories and area physicians with current West Nile Virus (WNV) testing and specimen submission procedures. The following information was adapted from a recent MDCH bulletin.

With the first probable human cases of WNV reported in Michigan last week, arbovirus testing requests have risen dramatically at the Michigan Department of Community Health (MDCH) Bureau of Laboratories. Despite guidance from the Centers for Disease Control and Prevention (CDC) that testing be limited to cases meeting selective criteria (encephalitis, meningitis and/or Guillain-Barre), samples are being submitted to the MDCH laboratory from patients with a broad range of symptoms, from mild to severe.

The WNV and other arbovirus testing performed at the MDCH laboratory uses procedures and reagents supplied by CDC, designed to provide a high specificity and sensitivity in detection of antibodies in CSF and sera. CDC provides these reagents to all public health laboratories, many which are currently experiencing a large number of specimen submissions. Due to the high demand nationwide, MDCH is not receiving the full consignment of reagents requested from CDC. MDCH is concerned that test demands may exceed the ability to perform testing for the highest priority specimens.

To assure testing is available for the most severely ill patients, please apply the following guidelines before submitting specimens for testing:

  • Currently only hospitalized patients who present with a meningoencephalitic or Guillain-Barre picture will be eligible to have CSF or sera samples tested by the MDCH laboratory

  • The following steps must occur for a specimen to receive prompt attention by the lab:

  • Completion of MDCH laboratory requisition form (DCH-0583); these can be downloaded from the MDCH Laboratory web page

  • Provide the additional information required by MDCH (on a separate piece of paper) including:

    1. Dates of hospitalization
    2. Date of onset
    3. Date of collection
    4. Travel history within the past 30 days
    5. Vaccine history (especially dengue or yellow fever vaccines)
    6. Symptoms of meningitis/encephalitis
    7. Was a lumbar puncture performed?

  • Communicable disease reporting rules mandate that all suspect cases be reported to local public health. Please also fax the laboratory requisition form and the seven points listed above for each case to: (616) 336-2432, attention: KCHD Communicable Disease (CD) unit.

  • The specimen should be submitted directly to the MDCH lab and must include the requisition form, the seven points listed above and be properly packaged.

If you have any questions or concerns please call the KCHD CD unit at:
(616) 632-7190.

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