Ebola other diagnostic studies: Difference between revisions

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{{Ebola}}
{{Ebola}}
{{CMG}}; {{AE}} {{GRN}}
==Overview==
==Overview==
Ebola virus can be detected in [[fatal]] cases from a [[skin]] specimen using [[immunohistochemistry]] or RT-PCR tests developed by the Centers for Disease Control and Prevention (CDC). The skin specimen is fixed in [[formalin]] or [[chaotrope]] which kills the [[virus]]. The specimen is no longer [[infectious]] once it is placed in formalin or chaotrope and the outside of the vial has been decontaminated. This vial can be shipped by mail or hand carried to the lab without risk. Results are available within a week after the specimen arrives at the CDC.<ref name=CDC63>{{cite web | title = CDC: Ebola Hemorrhagic Fever, Diagnosis | url = http://www.cdc.gov/vhf/ebola/diagnosis/index.html }}</ref>
While the diagnosis of Ebola may be suspected based on clinical findings, the diagnosis of [[Ebola]] can be confirmed by [[antigen]]-capture [[enzyme-linked immunosorbent assay]] ([[ELISA]]) testing, [[IgM]] [[ELISA]], [[polymerase chain reaction]] ([[PCR]]), and [[virus]] isolation, within few days of the onset of [[symptoms]]. Persons tested later in the course of the disease, or after recovery, can be tested for [[IgM]] and [[IgG]] [[antibodies]]. The disease can also be diagnosed in deceased patients by using [[immunohistochemistry]] testing, [[virus]] isolation, or [[PCR]].<ref name=CDC>{{cite web | title = Ebola Hemorrhagic Fever Information Packet  | url = http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/Fact_Sheets/Ebola_Fact_Booklet.pdf }}</ref>


==Other Diagnostic Test==
==Other Diagnostic Test==
* Antigen-capture enzyme-linked immunosorbent assay ([[ELISA]]) testing, [[IgM]] [[ELISA]], [[polymerase chain reaction]] ([[PCR]]), and [[virus]] isolation can be used to diagnose a case of Ebola virus disease within a few days of the onset of [[symptoms]].
* [[Ebola virus]] can be detected in [[fatal]] cases, from a [[skin]] specimen using [[immunohistochemistry]] or [[RT-PCR]] tests developed by the [[Centers for Disease Control and Prevention]] ([[CDC]])
* Persons tested later in the course of the disease or after recovery can be tested for [[IgM]] and [[IgG]] [[antibodies]].
* The [[skin]] specimen is fixed in [[formalin]] or [[Chaotropic agent|chaotrope]] to kill the [[virus]]
* The Ebola virus disease can also be diagnosed retrospectively in deceased patients by using [[immunohistochemistry]] testing, [[virus]] isolation, or [[PCR]].<ref name=CDC>{{cite web | title = Ebola Hemorrhagic Fever Information Packet  | url = http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/Fact_Sheets/Ebola_Fact_Booklet.pdf }}</ref>
* The specimen is no longer [[infectious]] once it is placed in [[formalin]] or [[Chaotropic agent|chaotrope]]and the outside of the vial has been decontaminated.
 
* This vial can be shipped by mail or hand carried to the lab without risk, and the results are available within a week after the specimen arrives at the [[CDC]].<ref name=CDC63>{{cite web | title = CDC: Ebola Hemorrhagic Fever, Diagnosis | url = http://www.cdc.gov/vhf/ebola/diagnosis/index.html }}</ref>
 
* The following table summarizes other diagnostic tests (adapted from ''WHO: Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting'' <ref name=WHO25>{{cite web | title = Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting | url = http://www.who.int/csr/resources/publications/ebola/whoemcesr982sec1-4.pdf }}</ref>):
 


<small> Table adapted from ''WHO: Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting'' <ref name=WHO25>{{cite web | title = Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting | url = http://www.who.int/csr/resources/publications/ebola/whoemcesr982sec1-4.pdf }}</ref></small>
{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 80%;"
{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 80%;"
! style="background: #DCDCDC;" | Diagnostic test  
! style="background: #DCDCDC;" | Diagnostic test  
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| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>[[Lassa]]<br>[[CCHF]]<br>[[Rift Valley]]<br>[[Marburg]]<br>[[Yellow fever]]
| style="background: #F5F5F5; padding: 0 10px; width: 20%;" valign=top | [[Ebola]]<br>[[Lassa]]<br>[[CCHF]]<br>[[Rift Valley]]<br>[[Marburg]]<br>[[Yellow fever]]
|}
|}
<SMALL><sup>†</sup> Whole blood can be used for enzyme-linked immunosorbent assay (ELISA) and may be frozen. Do not centrifuge suspected VHF specimens because this increases risk to the lab worker. If serum specimens have already been prepared these can be used. Place specimens in plastic tubes for shipping and storage and be sure that the tubes are sealed and properly labeled.</SMALL><br>
<SMALL><sup>†</sup> Whole blood can be used for enzyme-linked immunosorbent assay (ELISA) and may be frozen. Do not centrifuge suspected VHF specimens because this increases the risk to the lab worker. If serum specimens have already been prepared these can be used. Place specimens in plastic tubes for shipping and storage and be sure that the tubes are sealed and properly labeled.</SMALL><br>
<SMALL><sup>††</sup> Collect acute-phase specimen when patient is admitted to hospital or diagnosed as suspected case and collect convalescent-phase specimen at death or when discharged from the hospital.</SMALL><br>
<SMALL><sup>††</sup> Collect acute-phase specimen when patient is admitted to hospital or diagnosed as suspected case and collect convalescent-phase specimen at death or when discharged from the hospital.</SMALL><br>
<SMALL><sup>†††</sup> whole blood or tissue is preferred, although serum or plasma may provide results.</SMALL><br>
<SMALL><sup>†††</sup> Whole blood or tissue is preferred, although serum or plasma may provide results.</SMALL><br>
<SMALL><sup>††††</sup> Use both ice packs and dry ice to provide best results. If dry ice or ice packs are not available, sample may be shipped at room temperature and still provide valid results in most cases.</SMALL>
<SMALL><sup>††††</sup> Use both ice packs and dry ice to provide best results. If dry ice or ice packs are not available, sample may be shipped at room temperature and still provide valid results in most cases.</SMALL>
==Gallery==
<gallery>
Image: Ebolavirus05.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a magnification of 50,000X, this scanning electron micrograph (SEM) depicts numerous filamentous Ebola virus particles replicating from an infected VERO E6 cell. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
Image: Ebolavirus03.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell of the African green monkey kidney epithelial cell line. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
Image: Ebolavirus02.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
Image: Ebolavirus01.jpeg| Produced by the National Institute of Allergy and Infectious Diseases (NIAID), under a very-high magnification, this digitally-colorized scanning electron micrograph (SEM) depicts a number of filamentous Ebola virus particles (red) that had budded from the surface of a VERO cell (blue-gray) of the African green monkey kidney epithelial cell line. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
</gallery>


== References ==
== References ==
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[[Category:Zoonoses]]
[[Category:Zoonoses]]
[[Category:Hemorrhagic fevers]]
[[Category:Hemorrhagic fevers]]
[[Category:Infectious disease]]
 
[[Category:Disease]]
[[Category:Disease]]
[[Category:Needs content]]
[[Category:Needs content]]

Latest revision as of 17:38, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]

Overview

While the diagnosis of Ebola may be suspected based on clinical findings, the diagnosis of Ebola can be confirmed by antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM ELISA, polymerase chain reaction (PCR), and virus isolation, within few days of the onset of symptoms. Persons tested later in the course of the disease, or after recovery, can be tested for IgM and IgG antibodies. The disease can also be diagnosed in deceased patients by using immunohistochemistry testing, virus isolation, or PCR.[1]

Other Diagnostic Test

Table adapted from WHO: Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting [3]

Diagnostic test Samples required Preparation & Storage Shipping Viruses to be confirmed
ELISA (serology) detects: Whole blood serum or plasma

Acute and convalescent††

Freeze or refrigerate

(as cold as possible)

Frozen on dry ice or ice packs or both†††† Ebola
Lassa
CCHF
Rift Valley
Marburg
Yellow fever
PCR detects:

DNA, RNA from the virus.

Whole blood or clot††

Tissues (fresh frozen) Serum/plasma

Refrigerate or freeze

Freeze

Frozen on dry ice or ice packs or both†††† Ebola
Lassa
CCHF
Rift Valley
Marburg
Yellow fever
Immunohisto-chemestry (liver) detects:

Viral antigen in cells

Liver biopsy from fatal cases Fix formalin (can be stored up to 6 weeks) Room temperature (do not freeze) Ebola
Lassa
CCHF
Rift Valley
Marburg
Yellow fever
Immunohisto-chemestry (skin) detects:

Viral antigen in cells

Skin biopsy from fatal cases (any site) Fix in formalin (can be stored up to 6 weeks) Room temperature (do not freeze) Ebola
Lassa
Immunohisto-chemestry (other tissues) detects:

Viral antigen in cells

Tissue biopsy from fatal cases

(other tissues, spleen, lung, heart, kidney)

Fix in formalin (can be stored up to 6 weeks) Room temperature (do not freeze) Ebola
Lassa
CCHF
Rift Valley
Marburg
Yellow fever

Whole blood can be used for enzyme-linked immunosorbent assay (ELISA) and may be frozen. Do not centrifuge suspected VHF specimens because this increases the risk to the lab worker. If serum specimens have already been prepared these can be used. Place specimens in plastic tubes for shipping and storage and be sure that the tubes are sealed and properly labeled.
†† Collect acute-phase specimen when patient is admitted to hospital or diagnosed as suspected case and collect convalescent-phase specimen at death or when discharged from the hospital.
††† Whole blood or tissue is preferred, although serum or plasma may provide results.
†††† Use both ice packs and dry ice to provide best results. If dry ice or ice packs are not available, sample may be shipped at room temperature and still provide valid results in most cases.

Gallery

References

  1. "Ebola Hemorrhagic Fever Information Packet" (PDF).
  2. "CDC: Ebola Hemorrhagic Fever, Diagnosis".
  3. "Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting" (PDF).
  4. 4.0 4.1 4.2 4.3 "Public Health Image Library (PHIL)".

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