TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: WEEPC    
Western Equine Encephalitis Antibody Panel, IgG and IgM, Spinal Fluid

Useful For Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of Western equine encephalitis

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

See Mosquito-borne Disease Laboratory Testing in Special Instructions.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The virus that causes Western equine encephalitis (WEE) is widely distributed throughout the United States and Canada; disease occurs almost exclusively in the western states and Canadian provinces. The relative absence of the disease in the eastern United States probably reflects a paucity of the vector mosquito species, Culex tarsalis, and possibly a lower pathogenicity of local virus strains.

 

The disease usually begins suddenly with malaise, fever, and headache, often with nausea and vomiting. Vertigo, photophobia, sore throat, respiratory symptoms, abdominal pain, and myalgia are also common. Over a few days, the headache intensifies; drowsiness and restlessness may merge into a coma in severe cases. The onset may be more abrupt in infants and children than for adults. WEE should be suspected in any case of febrile central nervous system (CNS) disease from an endemic area. Infants are highly susceptible to CNS disease and about 20% of cases are under 1 year of age. There is an excess of male patients with WEE clinical encephalitis, averaging about twice the number of infections detected in female patients. After recovery from the acute disease, patients may require several months to 2 years to overcome the fatigue, headache, and irritability. Infants and children are at a higher risk of permanent brain damage after recovery than adults.

 

Infections with arboviruses can occur at any age. The age distribution depends on the degree of exposure to the particular transmitting arthropod relating to age, sex, and occupational, vocational, and recreational habits of the individuals. Once humans have been infected, the severity of the host response may be influenced by age. WEE tends to produce the most severe clinical infections in young persons.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

IgG: <1:1

IgM: <1:1

Reference values apply to all ages.

Interpretation Provides information to assist in interpretation of the test results

Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may suggest central nervous system (CNS) infection. However, these results are unable to distinguish between intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and clinical data prior to a diagnosis of CNS infection.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

All results must be correlated with clinical history and other data available to the attending physician.

 

False-positive results may be caused by breakdown of the blood-brain barrier, or by the introduction of blood into the cerebrospinal fluid at collection.

 

Western equine encephalitis and Eastern equine encephalitis viruses show some cross-reactivity; however, antibody response to the infecting virus is typically at least 8-fold higher.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Gonzalez-Scarano F, Nathanson N: Bunyaviruses. In Fields Virology. Vol 1. Second edition. Edited by BN Fields, DM Knipe. Raven Press, 1990, pp 1195-1228

2. Donat JF, Rhodes KH, Groover RV, Smith TF: Etiology and outcome in 42 children with acute nonbacterial meningoencephalitits. Mayo Clin Proc 1980;55:156-160

3. Tsai TF: Arboviruses. In Manual of Clinical Microbiology. Seventh edition. Edited by PR Murray, EJ Baron, MA Pfaller, et al. ASM Press, 1999, pp 1107-1124

4. Calisher CH: Medically important arboviruses of the United States and Canada. Clin Microbiol Rev 1994;7:89-116

5. Markoff L: Alphaviruses (Chikungunya, Eastern equine encephalitis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:1997-2006

Special Instructions Library of PDFs including pertinent information and forms related to the test