Test Id : CHIKV
Chikungunya IgM and IgG, Antibody, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of recent infection with Chikungunya virus in patients with recent travel to endemic areas and a compatible clinical syndrome
Highlights
This test may be used as an aid to diagnose recent or past infection with Chikungunya virus (ChikV) in patients with recent travel to endemic regions and a compatible clinical syndrome.
IgM and IgG antibodies to ChikV are typically detectable 3 to 4 days and 6 to 7 days following onset of symptoms, respectively.
IgM antibodies to ChikV typically remain detectable for 3 to 4 months after infection, whereas IgG antibodies to ChikV remain detectable for years.
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CHIKM | Chikungunya IgM, Ab, S | No | Yes |
| CHIKG | Chikungunya IgG, Ab, S | No | Yes |
| CHIKI | Chikungunya Interpretation | No | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Mosquito-borne Disease Laboratory Testing.
Method Name
A short description of the method used to perform the test
CHIKM, CHIKG: Enzyme-Linked Immunosorbent Assay (ELISA)
CHIKI: Technical Interpretation
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Chikungunya
ChikV
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Mosquito-borne Disease Laboratory Testing.
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering Guidance
Testing a patient in a convalescent period is recommended because specimens collected too early following infection may be negative for antibodies to Chikungunya virus.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.4 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 30 days | |
| Frozen | 30 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of recent infection with Chikungunya virus in patients with recent travel to endemic areas and a compatible clinical syndrome
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Mosquito-borne Disease Laboratory Testing.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Chikungunya virus (ChikV) is a single-stranded RNA alphavirus and a member of the Togaviridae family of viruses. The name Chikungunya is derived from the language of the Makonde ethnic groups in southeast Africa and means "that which bends" or "stooped walk." This is in reference to the hunched-over appearance of infected individuals due to the characteristically painful and incapacitating arthralgia caused by the virus. ChikV is endemic throughout Africa, India, and, more recently, the Caribbean islands. In 2014, the first case of autochthonous, or local transmission, in the United States occurred in Florida.
Humans are the primary reservoir for ChikV and Aedes species mosquitos are the primary vectors for transmission. Unlike other mosquito-borne viruses, such as West Nile virus and Dengue, the majority of individuals who are exposed to ChikV become symptomatic, with the most severe manifestations observed at the extremes of age and in those with suppressed immunity. Once exposed to ChikV, individuals develop lasting immunity and protection from reinfection.
Prior to development of symptoms, the incubation period ranges, on average, from 3 to 7 days. Infected patients typically present with sudden-onset high fever, incapacitating joint pain, and often a maculopapular rash lasting anywhere from 3 to 10 days. Notably, symptom relapse can occur in some individuals 2 to 3 months following resolution of initial symptoms. Currently, there are no licensed vaccines and treatment is strictly supportive care.
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.
IgM: Negative
IgG: Negative
Reference values apply to all ages.
Interpretation
Provides information to assist in interpretation of the test results
IgM and IgG Negative:
-No serologic evidence of exposure to Chikungunya virus. Repeat testing on a new specimen collected in 5 to 10 days is recommended if clinical suspicion persists.
IgM and IgG Positive:
-IgM and IgG antibodies to Chikungunya virus detected, suggesting recent or past infection. IgM antibodies to Chikungunya virus may remain detectable for 3 to 4 months post-infection.
IgM Positive, IgG Negative:
-IgM antibodies to Chikungunya virus detected, suggesting recent infection. Repeat testing in 5 to 10 days is recommended to demonstrate anti-Chikungunya virus IgG seroconversion to confirm current infection.
IgM Negative, IgG Positive:
-IgG antibodies to Chikungunya virus detected, suggesting past infection.
IgM and/or IgG Borderline:
-Repeat testing in 10 to 14 days is recommended.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Specimens collected too early following infection may be negative for antibodies to Chikungunya virus.
Chikungunya and Dengue viruses currently co-circulate in endemic areas and infections can present similarly in symptomatic patients. It is therefore recommended to evaluate at-risk patients for infection with both viruses.
Supportive Data
Accuracy:
IgM Antibodies to Chikungunya Virus:
Originally 87 serum samples tested by the Focus Diagnostics Inc. anti-Chikungunya virus IgM immunofluorescence assay (IFA) were also evaluated by the EuroImmun anti-Chikungunya virus IgM enzyme-linked immunofluorescence assay (ELISA) and the results are indicated in Table 1.
Table 1. Comparison of the EuroImmun ChikV IgM ELISA and the Focus Diagnostics ChikV IgM IFA
| | Focus Diagnostics ChikV IgM IFA | ||
| Positive | Negative | ||
| EuroImmun ChikV IgM EIA | Positive | 43 | 0 |
| Negative | 3 | 41 | |
| Borderline | 0 | 0 | |
Positive Agreement: 93.5 (43/46); 95% CI: 81.9%-98.4%
Negative Agreement: 100% (41/41); 95% CI: 89.8%-100%
Overall Agreement: 96.6% (84/87); 95% CI: 89.9%-99.2%
IgG Antibodies to Chikungunya Virus:
Originally 101 serum samples tested by the Focus Diagnostics Inc. anti-Chikungunya virus IgG IFA were also evaluated by the EuroImmun anti-Chikungunya virus IgG ELISA and the results are indicated in Table 2.
Table 2. Comparison of the EuroImmun ChikV IgG ELISA and the Focus Diagnostics ChikV IgG IFA
| | Focus Diagnostics ChikV IgG IFA | ||
| Positive | Negative | ||
| EuroImmun ChikV IgG EIA | Positive | 39 | 2 |
| Negative | 7* | 50 | |
| Borderline | 0 | 3 | |
*All 7 samples were positive by both the Focus and EuroImmun IgM assays. Also, 4 of 7 samples had low titers (< or =1:20) by the IFA assay.
Positive Agreement: 84.8 (39/46); 95% CI: 71.5%-92.7%
Negative Agreement: 90.9% (50/55); 95% CI: 80.0%-96.5%
Overall Agreement: 88.1% (89/101); 95% CI: 80.2%-93.2%
Reference Range:
Of serum samples collected from normal donors, 74/75 (98.7%) and 90/90 (100%) were negative by the EuroImmun anti-Chikungunya virus IgG and IgM assays, respectively.
Analytical Specificity:
1. Sixty serum samples previously characterized as positive for IgG-class antibodies to West Nile virus (n=29), Dengue virus (n=15), St. Louis encephalitis virus (n=8), California encephalitis virus (n=6), and Western equine encephalitis virus (n=2) were analyzed by the EuroImmun anti-Chikungunya virus IgG assay. One sample, positive for IgG antibodies to Dengue virus was also positive by the Chikungunya IgG assay, giving an overall specificity of 98.3% (59/60).
2. Thirty-three serum samples previously characterized as positive for IgM-class antibodies to West Nile virus (n=8), Dengue virus (n=11), St. Louis encephalitis virus (n=6), California encephalitis virus (n=6), and Western equine encephalitis virus (n=2), were analyzed by the EuroImmun anti-Chikungunya virus IgM assay. Two samples, positive for IgM antibodies to Dengue virus were also positive by the Chikungunya IgM assay, giving an overall specificity of 93.9% (31/33).
Note: Dengue and Chikungunya virus cocirculate in endemic areas and are transmitted by the same mosquito genera, so the 3 specimens with antibodies to both viruses may indicate coinfection or past exposure to both viruses.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
Lwande OW, Obanda V, Bucht G, et al. Global emergence of Alphaviruses that cause arthritis in humans. Infect Ecol Epidemiol. 2015;5:29853. doi:10.3402/iee.v5.29853
Method Description
Describes how the test is performed and provides a method-specific reference
For both the Chikungunya virus IgM and IgG assays, polystyrene microwells are coated with recombinant Chikungunya antigen. Diluted serum samples and controls are incubated in the wells to allow anti-Chikungunya antibodies (if present in the sample) to react with the antigen. Nonspecific reactants are removed by washing. Next, peroxidase-conjugated antihuman antibody is added to the wells and will react with human antibodies bound to the antigen. Excess conjugate is removed by washing. Enzyme substrate and chromogen are added, and the color is allowed to develop. After adding the Stop Reagent, the resultant color change is quantified by a spectrophotometric reading of optical density (OD). Sample OD readings are compared with reference cut-off OD readings to determine the qualitative results.(Package inserts: Anti-Chikungunya virus ELISA IgG. , Euroimmun Ag; v. 12/20/2018; Anti-Chikungunya virus ELISA. IgM Euroimmun Ag;12/20/2018)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Bimonthly on the second and fourth Wednesday; fifth Wednesday when applicable
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
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- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86790 x2
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| CHIKV | Chikungunya IgM and IgG, Ab, S | 93976-9 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| CHIKI | Chikungunya Interpretation | 69048-7 |
| CHIKG | Chikungunya IgG, Ab, S | 88630-9 |
| CHIKM | Chikungunya IgM, Ab, S | 88629-1 |