Human Serology Testing

UPDATE We will no longer accept specimens collected in lavender top/EDTA tubes.

Who can submit specimens?

Testing of human serology specimens for rabies antibody: the Rabies Laboratory will test human serology specimens from employees of governmental agencies, non-profit agencies, Cornell University College of Veterinary Medicine, SUNY veterinary technician programs, animal rehabilitators, veterinarians and veterinary technicians who participate with local and state health departments in preparing and submitting rabies specimens, individuals participating in rabies vaccine clinics, and in situations where there is immediate concern for human health.

The Rabies Laboratory will no longer routinely test serum for non-participating veterinarians, nuisance wildlife control, private research institutes and universities, and travelers to other countries. Individuals in these groups should submit specimens to Kansas State University_[1].

New York State County Health Departments, physicians and other authorized persons as indicated in SubPart 58-1 _[2]may request human serum testing and submit human serum specimens for rabies antibody testing to the New York State Department of Health Rabies laboratory. Please contact your local health department_[3] for assistance identifying an authorized person. Veterinarians may not order the test.

Human serum is tested for rabies antibody in two instances:

To determine the need for booster vaccination in order to maintain pre-exposure immunization status.
- Testing will be performed as mandated by occupation; e.g. every 6 months for individuals with a high likelyhood of exposure; every 2 years for veterinarians in clinical pratice.
- If an adequate antibody titer (0.5 IU or greater) is demonstrated, testing will be repeated as required by occupation as described above.
- Testing for rabies antibody is not appropriate when a previously immunized individual is exposed to rabies. Previously immunized is defined for this purpose as a patient that received pre- or post-exposure vaccination with a currently licensed vaccine according to the manufacturer's recommendations, or vaccinated by any other means and at any time had serologically-confirmed adequate response (0.5 I.U. or greater).
- Two 1 ml doses must be administered intramuscularly as soon as possible after the exposure, regardless of current antibody titer.
Following post-exposure prophylaxis or initial pre-exposure immunization. Serologic confirmation of adequate response (0.5 IU or greater) is not routinely necessary. Testing will be performed when:
- The patient is suspected to be immunocompromised
- A vaccine is employed which is not licensed for use in the U.S.
- Terms of administration (schedule, dose, route) are other than those in the manufacturer's recommendation

Specimen Collection, Storage and Shipping

2 mL of serum is the minimum volume required.
When testing follows pre- or post-exposure vaccination, the sample should be collected 2-4 weeks after administration of the last dose of vaccine.
Spin collection tube to separate the serum
Ship the serum, as soon as possible after collection.
May be stored for up to 10 days at room temperature.
Ship the serum in sealed plastic tube (can be plastic spun vacutainer) at room temperature.
If longer than 10 days after collection, contact laboratory
No glass containers will be accepted.
Rabies serology samples can be submitted directly to the laboratory.
Rabies Serology Kits, which include the necessary form and instructions, can be ordered by calling 518-474-4175 and requesting Kit # DOH 3542.
One kit can be used for multiple specimens, but each specimen must be properly labelled and individually wrapped.

Required Specimen Submission Information

If you have access to the Health Commerce System (HCS) and the Clinical Laboratory Information Management System (CLIMS), follow steps below:

Log onto the Health Commerce System (HCS)_[4]
Select 'CLIMS'
Select 'Remote Order'
Click on the tab that indicates the type of sample you would like to submit: human, animal, environmental, etc.
Fill in the screens, ‘Place the Order’, print form and submit with specimen.

This method provides many advantages over paper submission including specimen tracking, notification when results become available, online access to results and access to testing catalog. Should you encounter difficulty, please access the Reference Guide in the Remote Order application or contact CLIMS_[5].

Note: If you are from a licensed clinical laboratory with a valid PFI number or county or regional health department your HIN/HCS coordinator can grant you access to CLIMS (and create your HCS account if needed). For all other access, the Request for Access to the Wadsworth Center Laboratory Information Management System (CLIMS) form must be completed, signed and faxed to (518) 474-8140 or (518) 473-1326.

If you do not have access to HCS/CLIMS, complete the Infectious Diseases Requisition form_[6], print and send with the specimen.

For each non-CLEP certified test, complete a Non-permitted Laboratory Test Form_[7].

Instructions for completing the form (with or without access to Health Commerce)

Enter full name of patient, date of birth and address, include county.
Fill in submitter’s reference number.
Fill in hospital name and complete address where the report is to be sent.
Provide full name of physician and phone number and indicate who should be contacted with results.
Examination requested is Serology Other -Rabies Human antibody
All known CLINICAL HISTORY should be completed.
Important information to provide, if known, would be previous vaccination and /or previous exposure.
Print a copy to include with the specimen during shipping.

Results

Electronic copies can be accessed by logging in to the Health Commerce System_[8].
Serology results will be available on the Health Commerce System (HCS) to the submitter identified on the order form.
Results will be uploaded to the HCS within three weeks of receipt. Testing may be delayed over the Holidays, please allow 4 weeks from the date of receipt.