Test Catalog

Test Id : POWV

Powassan Virus, IgM, Enzyme-Linked Immunosorbent Assay, Serum

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

Diagnosis of Powassan virus infection.

 

This test should not be used as a screening procedure for the general population.

 

This test should not be used as a "test of cure."

Highlights

This test should be used for patients with at least 7 days of symptoms consistent with Powassan virus (POWV) infection and exposure history.

 

Specimens positive for POWV may require confirmatory testing by a POWV neutralization assay.

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

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

Method Name
A short description of the method used to perform the test

Enzyme-Linked Immunosorbent Assay (ELISA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Powassan Virus, IgM, ELISA, S

Aliases
Lists additional common names for a test, as an aid in searching

POWV

Powassan

Powassan virus

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

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

For patients with less than 7 days of symptoms, the recommended testing is molecular analysis for detection of Powassan virus (POWV) RNA. Contact either a local Public Health Laboratory or the Centers for Disease Control and Prevention.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Aliquot Tube, 5 mL (T465)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.6 mL

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

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 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
Heat inactivated specimen 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) 14 days
Frozen 30 days

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

Diagnosis of Powassan virus infection.

 

This test should not be used as a screening procedure for the general population.

 

This test should not be used as a "test of cure."

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

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

Powassan virus (POWV) is an emerging tick-borne virus, harbored by Ixodes species ticks, which are the same ticks that transmit Lyme disease (Borrelia spp.), Babesia spp., and Anaplasma phagocytophilum, among other pathogens. POWV is a member of the Flavivirus genus, which includes other arthropod-borne viruses (arboviruses) such as West Nile virus and St. Louis encephalitis virus. Two lineages of POWV have been identified, sharing approximately 94% amino acid sequence identity, including Lineage 1, which is the prototypical POWV lineage transmitted by Ixodes marxi and Ixodes cookei, and Lineage 2, which includes deer tick virus and is transmitted by Ixodes scapularis. POWV is maintained in the environment in groundhogs, skunks, squirrels, and white footed mice. Unlike other tick-borne pathogens, following tick attachment to a host, POWV can be transmitted in as little as 15 minutes.

 

Following infection, the incubation period can last anywhere from 4 to 14 days, after which approximately 66% of patients will remain asymptomatic. Symptomatic patients may present with a nonspecific influenza-like illness, including high fever, fatigue, malaise, and myalgia. Approximately 30% of symptomatic patients will progress to develop neurologic manifestations, most commonly encephalitis. While some patients may recover, over 50% of individuals will have persistent neurologic sequelae. POWV has been associated with an overall mortality rate of 10%. Although there is no targeted antiviral therapy and treatment is entirely supportive care, diagnosis is important for a number of reasons, including the ability to discontinue empiric antibiotics and to provide prognostic information for patients and families.

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.

Negative

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

Negative:

No antibodies to Powassan virus detected. Negative results may occur in samples collected too soon following infection, prior to the development of a robust immune response, or in immunocompromised patients.

 

Positive:

Antibodies to Powassan virus detected. Confirmatory testing through a local public health laboratory and/or the Centers for Disease Control and Prevention is recommended. False positive results may occur in patients with current or prior infection with other flaviviruses (West Nile virus, Zika virus, dengue virus, etc).

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

False-negative results may occur in severely immunosuppressed individuals who are unable to mount a detectable humoral immune response. False-negative results may also occur in samples collected too soon following infection (<7 days post-symptom onset).

 

False-positive results may occur in patients with prior or current infection with other flaviviruses. Contact your local public health laboratory to determine whether confirmatory testing via a neutralization assay is required or recommended.

 

This test should not be used as a "test of cure" as antibodies to Powassan virus (POWV) may persist for months to years after resolution of the infection.

 

This test should be ordered in patients with suspected, symptomatic disease who have had recent exposure to ticks in geographic regions endemic for POWV, including Minnesota, Wisconsin, and the northeast United States. POWV is also prevalent in ticks in Russia and certain regions of Asia.

 

False-positive results may occur in patients screened for POWV who are not at sufficient risk or do not have an exposure history to suggest infection.

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

1. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD): Powassan virus disease. CDC; Updated January 10, 2019. Available at www.cdc.gov/ticks/tickbornediseases/powassan.html

2. Kemenesi G, Banyai K: Tick-borne Flaviviruses, with a focus on Powassan virus. Clinical Microbiology Reviews. 2019;32(1):e00106-00117

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

Method Description
Describes how the test is performed and provides a method-specific reference

The test kit contains microtiter strips each with 8 break-off reagent wells coated with recombinant Powassan virus antigens. In the first reaction step, diluted patient samples are incubated in the wells. In the case of positive samples, specific IgM (also IgA and IgG) antibodies will bind to the antigens. To detect the bound antibodies, a second incubation is carried out using an enzyme-labelled anti-human IgM (enzyme conjugate) catalyzing a color reaction.(Package insert: Anti-Powassan virus ELISA (IgM) Test instruction. EUROIMMUN Medizinische Labordiagnostika AG; EI_266fM_A_UK_B01 Version: 11/2017)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

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.

Tuesday, Thursday

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.

Same day/1 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

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.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. 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. This test 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.

86790

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
POWV Powassan Virus, IgM, ELISA, S 29855-4
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.
POWV Powassan Virus, IgM, ELISA, S 29855-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Create a PDF

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports