West Nile Virus 2001

Protocol for Testing Human Specimens for West Nile Virus (WNV)


Testing of blood and cerebrospinal fluid from New Jersey patients for WNV will be performed at the NDOH Public Health and Environmental Laboratories (PHEL). Specimens with positive and indeterminate results will be sent to the Centers for Disease Control and Prevention (CDC) for confirmation. Due to limited capacity, testing of specimens will be limited to those approved through the Infectious and Zoonotic Diseases Program (IZDP) and meeting the attached surveillance criteria.

To request specimen testing, the following protocol has been established:

  1. The attending physician must call the Infectious and Zoonotic Diseases Program (IZDP) at 609-588-3121 or 609-588-7500 ((609)392-2020 during evenings, weekends and holidays) to request a WNV test. The attending physician should be prepared to review the patient's clinical history with regard to the WNV surveillance criteria. This information will be recorded on a WNV Evaluation/Intake form by IZDP staff.

  2. If approved for testing, the physician will be given instructions for sending the specimen to the Public Health and Environmental Laboratories (PHEL). The physician's telephone number and address will be recorded so that test results can be provided as soon as they are available. The physician should send 5-10 ml of serum (not whole blood) and at least 1cc of CSF.

  3. The IZDP will notify the PHEL daily of all tests that have been approved for submission.

  4. The PHEL will notify the IZDP of all specimens received each working day. IZDP staff will contact the hospital or physician of record for all specimens received without prior approval. Testing will not be done on these specimens until approved by the IZDP.

  5. The PHEL will notify the IZDP of all test results daily.

  6. The IZDP will notify the physician by telephone of all test results as soon as they are received. A printed copy of the test result with interpretation will be mailed to the physician by the PHEL. The PHEL will perform ELISA testing on serum and/or CSF.

    A negative test result on a blood or CSF specimen that was obtained less than 8 days after onset of illness will be reported as "inconclusive." A second (convalescent) specimen, obtained at least 2 weeks after the date of the first specimen, will be needed to make a final determination.

    A positive test result on an unpaired specimen will be reported as "suspect positive." A convalescent specimen, obtained at least 2 weeks after the date of the first specimen, will be needed to make a final determination. Suspect positive test specimens and convalescent serum will be sent to the CDC for confirmation by serum neutralization testing.

  7. For any patient who has a positive or suspect positive test for WNV, the IZDP will notify the local health officer and local mosquito control program providing service in the patient's municipality of residence. Together with the local health department, the IZDP will administer a risk factor surveillance form to the patient or patient's family. This form will be developed in conjunction with the CDC and regional states to ensure comparability of the data collected.

Physicians will be advised of modifications to this protocol through regular notices sent to local health officers and the Chief Executive Officers, Emergency Room Directors, and Infection Control Practitioners of all New Jersey acute care hospitals. This information will also be posted on the NJDOH web site.

5-30-00


NJ Home Page DOH Home Page NJ Home Search NJ NJ Departments NJ Services NJ Directories NJ Legislature NJ Judiciary