Lymphocytic Choriomeningitis – Serology and PCR

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Testing Indications

Testing for Lymphocytic Choriomeningitis PCR requires prior approval by PHO Laboratory. Prior to submission - ideally after a physician has seen the patient but before specimens are collected - contact PHO Laboratory’s Customer Service Centre at 416-235-6556/1-877-604-4567 or the After-Hours Emergency Duty Officer at 416-605-3113.

Lymphocytic choriomeningitis virus (LCMV) is a Risk Group 3 pathogen and PHO Laboratory will not aliquot or perform other testing until LCMV is ruled out by the National Microbiology Laboratory (NML). If further testing is required, submit separate specimens and notify laboratory staff that the patient is under investigation for LCMV.

This test is a Referred Out Test. Samples are sent to the Public Health Agency of Canada- Special Pathogens Unit at the National Microbiology Laboratory in Winnipeg.

Lymphocytic Choriomeningitis serology test is performed using an Enzyme Linked Immunosorbent Assay (ELISA) to detect IgG antibodies to Lymphocytic Choriomeningitis Virus.

Lymphocytic Choriomeningitis molecular test is performed using PCR amplification of LCMV virus specific genome.

Reports are sent back to the PHO laboratory - WRA Immunodiagnostics laboratory from the National Microbiology Laboratory and are then forwarded to the ordering physician.

Specimen Collection and Handling

Specimen Requirements

Test Requested	Required Requisition(s)	Specimen Type	Minimum Volume	Collection Kit
Serology	General Test Requisition	Serum or plasma	5.0 ml blood or 1.0 ml serum	Blood, clotted - vacutainer tubes (SST)
PCR	General Test Requisition	Whole blood	0.5 ml minimum sample whole blood	Blood, clotted - vacutainer tubes (SST)
PCR	General Test Requisition	Serum	0.5 ml	EDTA, heparin or citrate tubes. Can submit as aliquots in sterile 1.5 - 2.0 ml screw cap tubes
PCR	General Test Requisition	CSF	1.5 - 2.0 ml	1.5 - 2.0 mL tube
PCR	General Test Requisition	Tissues	0.5 ml	Plastic containers

Submission and Collection Notes

Complete the following on the General Test Requisition form:

onset date
symptoms

Instructions for using SST tubes are found in the document titled: LAB-SD-008, Blood Collection using Serum Separator Tubes.

Limitations

Haemolysed, icteric, lipemic or microbially contaminated sera or plasma are not recommended for testing.

Storage and Transport

Centrifugation of serum tubes is not needed and should be avoided.
Place specimen in a biohazard bag and seal. Specimens should be stored at 2-8 ◦C following collection and shipped to the laboratory on ice packs.

Specimen Processing, Storage and Shipping: Store samples (collected in SST or red topped tube) in refrigerator until being shipped for testing. Ship refrigerated specimens on ice packs.

PCR:
Specimen Processing, Storage and Shipping: Store samples in refrigerator or frozen until being shipped for testing. Serum can be shipped refrigerated or frozen. Avoid freezing whole blood samples. Tissues should be shipped frozen. Ship frozen specimens on dry ice and refrigerated specimens on ice packs. Formalin-fixed samples can be sent at room temperature.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

TAT is up to 28 days from receipt at PHO.

Reporting

Results are reported to the ordering physician or health care provider as indicated on the requisition.

References

LAB-SD-008, Blood Collection using Serum Separator Tubes

Additional Information

Accompanying Documentation: Complete Special Pathogens Requisition. Include sender name, address and telephone number. Patient information including name or identifier, date of birth, and all relevant patient history including clinical diagnosis, underlying diseases, exposure risk and travel history. Indicate type of specimen collected and all specimen information. Select all required tests. If possible, attach lab results that have already been done at local or provincial laboratories.

All patient history must be included; sample without adequate patient history to justify testing are subject to rejection.

Patient Criteria: Symptomatic and /or contact with mice or their droppings.