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Virology - Laboratory Services

To the right, specific information for submitters is provided including acceptable specimen types, minimum sample volume, packaging and shipping information and a description of the testing performed.

Below please find general information about the viruses tested including a description of the disease, transmission, whether or not a vaccine is available and geographic and seasonal distribution.

VIRUSES

Adenovirus

Disease:

Upper respiratory tract disease with fever, nasal congestion, and sore throat with cough. Some serotypes can cause gastroenteritis with diarrhea, vomiting and fever, while others can cause conjunctivitis and keratoconjunctivitis.

Transmission:

Via the fecal-oral route through droplets or contact with objects contaminated with virus

Vaccination:

No widespread use; a vaccine against some types has been given to military personnel in other countries

Age Association:

All ages, often young children

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

Nasopharyngeal swabs, stool, rectal swabs, urine, eye swabs, CSF

Test Methods:

Culture: Conventional tube culture; neutralization for serotyping
Molecular: Real-time and conventional PCR; Genmark RVP (Subgroups B & C, and E)
Antibodies:
Other Methods:

Cache Valley virus (CVV)

Disease:

Fever or more severe disease, including infection of the brain (encephalitis) or the lining around the brain and spinal cord (meningitis).

Transmission:

Usually spread through the bite of an infected mosquito

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Has been found in mosquitoes in many places in North America and in parts of Central America with only human cases reported in North Carolina, Missouri, Wisconsin, and New York

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

CSF and serum

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies:
Other Methods:

California sero-group viruses (CaV) including LaCrosse & Jamestown Canyon

Disease:

Generally asymptomatic, but after an incubation period of 3–7 days a febrile illness may develop, and central nervous system involvement may lead to encephalitis or meningoencephalitis

Transmission:

Mosquitos

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Northern United States and Canada

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

CSF and serum

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies: IgG IFA
Other Methods:

Chikungunya virus

Disease:

Most common symptoms of infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash.

Transmission:

From the bite of infected mosquito.

Vaccination:

For individuals 18 years of age and older who are at increased risk of exposure to chikungunya virus.

Age Association:

Any age ranges

Geographic Distribution:

Americas on islands in the Caribbean and countries in Africa, Asia, Europe, and the Indian and Pacific Oceans

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

Serum and CSF

Test Methods:

Culture:
Molecular: real time-PCR
Antibodies: IgG and IgM ELISA
Other Methods:

Coxsackie Virus

Disease:

Mild upper respiratory disease or flu-like illness with fever and muscle aches; rash illness (hand, foot and mouth disease); encephalitis; herpangina (Coxsackie A); pleurodynia (Coxsackie B)

Transmission:

Via the fecal-oral route and during the acute stage by the respiratory route

Vaccination:

None available at this time

Age Association:

All ages, often young children

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Summer
  2. Fall

Preferred Specimens:

Nasopharyngeal swabs, stool, rectal swabs, CSF

Test Methods:

Culture: Conventional tube culture; immunofluroescence assay for typing
Molecular: Real-time and conventional RT-PCR
Antibodies:
Other Methods:

Cytomegalovirus

Disease:

Often asymptomatic; mild mononucleosis-like illness with fever and malaise; multiple organ disease (immunosuppressed patients); retinitis and polyradiculomyelopathy (AIDS patients); cytomegalic inclusion disease (fetus or transplanted tissues and organs); encephalitis. Infection results in latency. Periodic reactivation with disease is usually only seen in immunosuppressed patients.

Transmission:

Close physical contact, infected semen, blood transfusions. Maternal-fetal (from a reactivation or primary infection) and perinatal via cervical secretions or milk

Vaccination:

None available at this time

Age Association:

All age groups, but most often infants and young children

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

Urine, bronchoalveolar lavage, blood, CSF

Test Methods:

Culture: Conventional tube culture
Molecular: Real time and conventional PCR
Antibodies:
Other Methods:

Dengue virus (DenV)

Disease:

Symptoms can be mild or severe. Symptoms of dengue can be confused with other illnesses that cause fever, aches and pains, or a rash. There are 4 serotypes and after the first dengue infection subsequent infections can lead to more severe illness.

Transmission:

Dengue viruses are spread to people through the bites of infected Aedes species mosquitoes (Ae. aegypti or Ae. albopictus).

Vaccination:

Available in some countries for people aged 9 to 45 years. Recommended only for persons with confirmed previous dengue virus infection.

Age Association:

Any age ranges

Geographic Distribution:

Caribbean (including Puerto Rico), Central and South America, Southeast Asia, and the Pacific Islands. In US local outbreaks have occurred in Texas, Florida, and Hawaii.

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

Serum or Plasma

Test Methods:

Culture:
Molecular: real-time RT-PCR with typing available
Antibodies: Flavivirus IgG-IgM-IgA Microsphere Immunofluorescence Assay - Serological testing may be more sensitive depending on timing of specimen collection.
Other Methods:

Eastern Equine Encephalitis virus (EEE)

Disease:

Extremely rare but serious and often fatal infection that causes encephalitis or inflammation of the brain. Some cases may be asymptomatic.

Transmission:

Maintained in a cycle between mosquitoes and avian hosts in freshwater hardwood swamps.

Vaccination:

Equine vaccination available only

Age Association:

Any age ranges

Geographic Distribution:

Eastern and Gulf Coast states in U.S.

Seasonal Distribution:

  1. Spring
  2. Summer

Preferred Specimens:

CSF and serum

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies: IgG IFA
Other Methods:

Enterovirus (Including Coxsackie and Echovirus)

Disease:

Mild upper respiratory disease or flu-like illness with fever and muscle aches; rash illness (hand, foot and mouth disease); fever and muscle aches, followed by paralysis (polio virus); herpangina (Coxsackie A); pleurolynia (Coxsackie B) and encephalitis

Transmission:

Via the fecal-oral route, oral-oral route, respiratory route, and fomite

Vaccination:

Vaccine is available only for poliovirus

Age Association:

All ages, often young children

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

Nasopharyngeal swabs, stool, rectal swabs, CSF

Test Methods:

Culture: Conventional tube culture; immunofluorescence assay for subtyping
Molecular: Real-time and conventional RT-PCR
Antibodies:
Other Methods:

Epstein-Barr Virus (EBV)

Disease:

Also known as human herpesvirus 4, is a member of the herpes virus family. EBV can cause infectious mononucleosis, also called mono, and other illnesses.

Transmission:

EBV spreads most commonly through bodily fluids, especially saliva. However, EBV can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantations.

Vaccination:

There is no vaccine to protect against EBV infection.

Age Association:

All ages, often young children show no signs of symptoms. Symptoms are more prominent in teenagers and adults.

Geographic Distribution:

Worldwide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

CSF

Test Methods:

Culture:
Molecular: real time PCR - Please note that a positive real-time PCR result for EBV may indicate a latent or a current infection if there are lymphocytes present in the CSF.
Antibodies:
Other Methods:

Hantavirus

Disease:

The Virology Laboratory no longer offers testing for Hantavirus. Please contact Diagnostic Immunology for information on forwarding specimens to the CDC.

Transmission:

Vaccination:

Age Association:

Geographic Distribution:

Seasonal Distribution:

Preferred Specimens:

Test Methods:

Culture:
Molecular:
Antibodies:
Other Methods:

Heartland virus (HRTV)

Disease:

Patients infected with Heartland virus experience fever, fatigue (feeling tired), decreased appetite, headache, nausea, diarrhea, and muscle or joint pain.

Transmission:

Spread through the bite of an infected tick.

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Midwestern and Southern U.S.

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

CSF serum and whole blood

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies:
Other Methods:

Herpes simplex viruses Types I and II (HSV 1,2)

Disease:

Vesicular disease characterized by lesions in or around the mouth or genital region; fever and malaise; encephalitis. Infection results in latency with periodic reactivation.

Transmission:

Oral herpes is contracted by direct physical contact. Genital herpes is a sexually transmitted disease.

Vaccination:

None available at this time

Age Association:

Oral herpes: all ages; genital herpes: beginning at age of sexual activity

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

Vesicle/lesion swab, genital swab, CSF

Test Methods:

Culture: Conventional tube culture; immunofluorescence for confirmation and typing
Molecular: Real time PCR
Antibodies:
Other Methods:

Human Herpes virus 6 (HHV6)

Disease:

Set of two closely related herpes viruses known as HHV-6A and HHV-6B. HHV-6B infects nearly 100% of human beings, typically before the age of three and often results in fever, diarrhea, sometimes with a rash known as roseola. In rare cases encephalitis occurs. Little is known about the prevalence of HHV-6A. Infection results in latency with periodic reactivation.

Transmission:

Human herpes virus 6 is spread from person to person via secretions from the respiratory tract.

Vaccination:

Not available currently

Age Association:

Usually occurs in infants or children with rare cases in immunocompetent adults.

Geographic Distribution:

Worldwide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

CSF

Test Methods:

Culture:
Molecular: real time PCR
Antibodies:
Other Methods:

Human metapneumovirus (hMPV)

Disease:

Acute upper and/or lower respiratory tract infection with fever and cough. More severe in infants and young children, most likely presenting as bronchiolitis or pneumonia. May cause secondary bacterial infection and is difficult to distinguish from RSV and other respiratory viral infections in children.

Transmission:

Via the respiratory route by aerosols

Vaccination:

None available at this time

Age Association:

Infants and young children are most commonly affected. In adults presents as influenza-like illness or pneumonia.

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Nasopharyngeal swab, wash, or aspirate; oropharyngeal swab; bronchial wash

Test Methods:

Culture:
Molecular: Real-time RT-PCR; Genmark RVP
Antibodies:
Other Methods:

Influenza Viruses A and B

Disease:

Lower respiratory disease characterized by sudden onset of fever and malaise; possible secondary bacterial infections and encephalitis

Transmission:

Via aerosols

Vaccination:

Vaccine should be administered yearly. Inactivated influenza vaccine is administered by injection to those over 6 months old. Live attenuated virus is administered by nasal spray to healthy individuals 5 - 49 years old.

Age Association:

All ages

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Nasopharyngeal swab, wash, or aspirate; oropharyngeal swab, bronchial wash, and CSF

Test Methods:

Culture: Conventional tube culture; hemadsorbtion assay. Serology is performed by the Diagnostic Immunology Laboratory.
Molecular: Real-time RT-PCR; conventional RT-PCR for subtyping; Genmark RVP; sequencing for strain analysis (selected samples only)
Antibodies:
Other Methods:

Measles Virus

Disease:

Highly contagious upper respiratory disease characterized by a maculopapular rash, fever, cough, or conjunctivitis; encephalitis

Transmission:

Respiratory secretions by direct contact, droplets, or airborne aerosols

Vaccination:

Available

Age Association:

Children

Geographic Distribution:

•World wide

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Nasopharyngeal swab, wash, or aspirate; oropharyngeal swab, bronchial wash, or nasal swab, CSF

Test Methods:

Culture: Conventional tube culture; hemadsorbtion assay; immunofluorescence assay
Molecular: Real-time and conventional RT-PCR
Antibodies:
Other Methods:

Mumps Virus

Disease:

Acute and painful enlargement of the parotid salivary glands with slight/moderate fever. Most common complications include meningitis and orchitis

Transmission:

Inhalation of virus-containing aerosols

Vaccination:

Usually given to children at 15-24 months

Age Association:

Most common in unvaccinated children 5-7 years of age. Usually asymptomatic in infants and very young children.

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Throat swab near areas around Stensen's ducts, urine, CSF

Test Methods:

Culture: Conventional tube culture; hemadsorbtion assay; immunofluorescence for confirmation
Molecular: Real-time and conventional RT-PCR
Antibodies:
Other Methods:

Parainfluenza Viruses 1-4 (PIV 1-4)

Disease:

Acute respiratory tract disease with slight fever, malaise, cough, and hoarseness. Most common cause of croup. May cause bronchiolitis and pneumonia.

Transmission:

Close contact with infected person or inhalation of virus-containing aerosols

Vaccination:

None to date

Age Association:

Children under 5 years- lower respiratory tract infection. Causes upper respiratory tract infection in infants, children and adults.

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Fall
  3. Winter

Preferred Specimens:

Nasopharyngeal swab, wash, or aspirate; oropharyngeal swab; bronchial wash

Test Methods:

Culture: Conventional tube culture; hemadsorbtion assay; immunofluorescence for detection and typing
Molecular: Genmark RVP (Para 1,2,3)
Antibodies:
Other Methods:

Parvovirus B19

Disease:

Erythema infectiosum (EI), or fifth disease that typically appears as a mild rash illness with possible low fever, headache, malaise, and muscle pain. Rash characteristic of "slapped cheek" appearance with lace-like eruption on trunk and extremities. Can cause non-immune hydrops fetalis and spontaneous abortion.

Transmission:

Inhalation of virus-containing aerosols. Maternal-fetal infection can occur.

Vaccination:

None available at this time

Age Association:

Primarily school children aged 5-13 years

Geographic Distribution:

Worldwide, with epidemics occurring every 3-5 years.

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Serum (acute or convalescent)

Test Methods:

Culture:
Molecular: Real time and conventional PCR
Antibodies:
Other Methods:

Powassan virus (POW)

Disease:

Can cause symptoms ranging from mild flu-like symptoms to life threatening encephalitis (inflammation of the brain).

Transmission:

Spread through the bite of an infected tick.

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Northeastern states and the Great Lakes region in U.S. and parts of Canada, and Russia

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

CSF and serum

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies: IgM ELISA
Other Methods:

Respiratory Syncytial Virus (RSV)

Disease:

Acute respiratory tract infection with fever, cough, runny nose, and fatigue. Usually presents in infants and young children as either bronchiolitis or pneumonia.

Transmission:

Contact with infectious material or inhalation of virus-containing aerosols

Vaccination:

Adults aged 60 years and older, infants and pregnant people by CDC guidelines

Age Association:

Infants and young children (lower respiratory tract infection); older children and adults (upper respiratory tract infection caused by reinfection)

Geographic Distribution:

Worldwide, with epidemics occurring every 3-5 years.

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Nasopharyngeal swab, wash, or aspirate; oropharyngeal swab; bronchial wash

Test Methods:

Culture: Conventional tube culture. Antigen detection: EIA for direct antigen detection
Molecular: Real-time RT-PCR; Genmark RVP
Antibodies:
Other Methods:

Rhinovirus

Disease:

Most frequent cause of the common cold, with symptoms of low-grade fever, headache, runny nose, sneezing, sore throat, and cough. Secondary bacterial infections can occur.

Transmission:

Close contact with infected person or inhalation of virus-containing aerosols

Vaccination:

None

Age Association:

All age groups

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Fall

Preferred Specimens:

Nasopharyngeal swab, wash, or aspirate; throat swab; nasal swab

Test Methods:

Culture: Conventional tube culture (by request)
Molecular: Real-time RT-PCR; Genmark RVP
Antibodies:
Other Methods:

Rotavirus

Disease:

Acute gastroenteritis with high-grade fever, diarrhea, and vomiting

Transmission:

Via the fecal-oral route

Vaccination:

Available – FDA approved since 2006

Age Association:

Young children, usually between the ages of 6 months and 3 years

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Stool without additives or preservatives

Test Methods:

Culture: None
Molecular: Real time RT-PCR
Antibodies:
Other Methods:

Rubella Virus (German Measles)

Disease:

Mild disease presenting with rash, fever, joint pain, and swollen lymph nodes. Congenital infection may result in spontaneous abortion or severe malformation.

Transmission:

Inhalation of virus-containing aerosols. Maternal-fetal infection can occur.

Vaccination:

Available

Age Association:

Young children, usually between the ages of 6 months and 3 years

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Summer

Preferred Specimens:

Urine; throat swab; nasopharyngeal swab, wash, or aspirate; oropharyngeal swab or bronchial wash. Blood or stool is also acceptable.

Test Methods:

Culture: None
Molecular: Real time RT-PCR
Antibodies:
Other Methods:

SARS-CoV-2

Disease:

COVID-19

Transmission:

The virus spreads mainly from person to person through respiratory droplets and small particles produced when an infected person coughs, sneezes, or talks.

Vaccination:

Available

Age Association:

All ages

Geographic Distribution:

Worldwide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

Nasopharyngeal aspirate, nasopharyngeal swab, oropharyngeal swab

Test Methods:

Culture:
Molecular: Real time RT-PCR
Antibodies:
Other Methods:

Severe Acute Respiratory Syndrome (SARS-coronavirus)

Disease:

Acute respiratory distress syndrome (ARDS) characterized by high fever, headache, and body aches; atypical pneumonia; severe respiratory disease that is often fatal

Transmission:

Close contact with an infected person, direct contact with infectious material, or inhalation of virus-containing aerosols

Vaccination:

None available at this time

Age Association:

All ages

Geographic Distribution:

Currently, there is no known SARS transmission anywhere in the world

Seasonal Distribution:

  1. Spring
  2. Winter

Preferred Specimens:

Nasopharyngeal aspirate, nasopharyngeal swab, oropharyngeal swab, bronchial wash

Test Methods:

Culture: None
Molecular: Real time RT-PCR
Antibodies:
Other Methods:

St. Louis Encephalitis virus (SLE)

Disease:

Extremely rare but serious and often fatal infection that causes encephalitis or inflammation of the brain.

Transmission:

Maintained in a cycle between mosquitoes and birds.

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Most cases have occurred in Eastern and Central U.S. with sporadic cases in Southwest

Seasonal Distribution:

  1. Spring
  2. Summer

Preferred Specimens:

CSF and serum

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies: IgG IFA
Other Methods:

Varicella Zoster Virus (VZV)

Disease:

Chickenpox (Varicella): Primary infection-highly contagious systemic infection presenting with fever and an itchy, generalized vesicular rash. Secondary staphylococcal and streptococcal skin infections can occur. Shingles (Zoster): Reactivation of latent VZV- painful vesicular rash, usually limited to one dermatome, most common on the thorax, neck, and face. Post-herpetic neuralgia. Encephalitis can also occur.

Transmission:

Varicella: Direct contact with skin lesions, inhalation of virus-containing aerosols

Vaccination:

Available

Age Association:

Varicella: primarily young children. Zoster: older or immunocompromised adults

Geographic Distribution:

World wide

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall
  4. Winter

Preferred Specimens:

Vesicular or lesion swab, CSF

Test Methods:

Culture: Conventional tube culture with immunofluorescence for confirmation
Molecular: Real time PCR and conventional RT-PCR
Antibodies:
Other Methods:

West Nile Virus (WNV)

Disease:

WNV may cause a mild illness but may also cause encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord).

Transmission:

Usually spread through the bite of an infected mosquito, spread by blood transfusion in rare cases. Can also be spread from mother to baby during pregnancy, delivery, or breast-feeding in a small number of cases.

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Africa, Europe, the Middle East, North America and West Asia.

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

CSF, serum, urine and whole blood

Test Methods:

Culture:
Molecular: real time-PCR
Antibodies: IgM ELISA serological testing maybe more sensitive depending on timing of specimen collection
Other Methods:

Yellow fever virus (YFV)

Disease:

Fever, chills, headache, backache, and muscle aches. In rare cases people develop serious illness that can lead to bleeding, shock, organ failure, and sometimes death.

Transmission:

From the bite of infected mosquito.

Vaccination:

Available and recommended for travel in travel in area of South America.

Age Association:

Any age ranges

Geographic Distribution:

Tropical and subtropical areas of Africa and South America

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

Serum whole blood and urine

Test Methods:

Culture:
Molecular: real time RT-PCR
Antibodies:
Other Methods:

Zika virus (ZIKV)

Disease:

For most people it is a mild infection with few or no symptoms. However, it has been linked to health problems in some people. It is a serious concern for pregnant women, their partners and couples planning a pregnancy because it can cause serious birth defects. Zika is not spread from person to person by casual contact.

Transmission:

From the bite of infected mosquito

Vaccination:

Not available currently

Age Association:

Any age ranges

Geographic Distribution:

Americas, resulting in an increase in travel-associated cases in U.S., widespread transmission in Puerto Rico and the US Virgin Islands, and limited local transmission in Florida and Texas

Seasonal Distribution:

  1. Spring
  2. Summer
  3. Fall

Preferred Specimens:

Serum whole blood and urine

Test Methods:

Culture:
Molecular: real time-PCR
Antibodies: IgM Lateral Flow
Other Methods: