HEPATITIS
Hepatitis refers to an inflammation of the liver. Viral hepatitis refers to an inflammation of the liver caused by a virus.
HEPATITIS A VIRUS (HAV)
- Hepatitis A is a liver disease caused by the Hepatitis A virus
- HAV is found in the stool (feces) of persons with hepatitis A.
- HAV is usually spread from person to person by putting something in the mouth (even though it might look clean) that has been contaminated with the stool of a person with hepatitis A.
- HAV is also a concern in flooded areas where sewer systems contaminate drinking water.
- Persons at risk for infection include:
- Household contacts of infected persons
- Sex contacts of infected persons
- Persons, especially children, living in areas with increased rates of hepatitis A during the baseline period of 1987-1997
- Travelers to countries where hepatitis A is common
- Men who have sex with men
- Users of injection and non-injection drugs
- OLS will perform HAV-IgM testing for
- Out break situations
- Patients involved in high risk behavior.
HEPATITIS B VIRUS (HBV)
- Hepatitis B is a liver disease that is caused by the Hepatitis B virus
- Hepatitis B virus (HBV) can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.
- Transmission occurs when blood from an infected person enters the body of a person who is not infected.
- HBV is spread through having sex with an infected person
- By sharing drugs, needles, or other paraphernalia when injecting drugs
- Through needle sticks or sharps exposures on the job
- From an infected mother to her baby during birth.
- Persons at risk for infection include
- Persons with multiple sex partners
- Persons with a diagnosis of a sexually transmitted disease
- Men who have sex with men
- Sex contacts of infected persons
- Injection-drug users
- Household contacts of chronically infected persons
- Infants born to infected mothers
- Infants or children of immigrants from areas with high HBV infection rates
- Health care or public safety workers with exposure to blood
- Hemodialysis patients
- OLS will perform the following tests:
- Hepatitis B Screen
- This includes the HBsAg and the HBcAb markers which determine if the patient has been exposed to the Hepatitis B Virus.
- Hepatitis Post Vac (HBsAb)
- This is the HBsAb marker which is preformed to determine if the patient has immunity to the HBV virus ( immunity can be acquired by vaccine or from being exposed to the virus through contact with a positive person)
- Draw blood 4-6 weeks after the final vaccine shot
- Patients unsure of their vaccine history may receive both "screen" and "post-vac” testing upon request.
HEPATITIS C (HCV)
- Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV).
- Transmission occurs when blood from an infected person enters the body of a person who is not infected.
- HBV is spread through having sex with an infected person
- By sharing drugs, needles, or other paraphernalia when injecting drugs
- Through needle sticks or sharps exposures on the job
- From an infected mother to her baby during birth.
- Testing for HCV is performed ONLY on high risk patients with following criteria:
- Current or prior history of injecting drug users
- Recipients of clotting factors made before 1987
- Patients with long-term kidney dialysis
- Recipients of blood and/or solid organs before 1992
- Patients with chronic liver disease or other undiagnosed liver problems
- Infants born to infected mothers
- needle sticks/blood splash ( only after a known exposure)
- sexual contact with:
- injecting drug users
- known infected persons
- homosexual/bisexual
- multiple partners
SPECIMEN SUBMISSION
- A link to the Diagnostic Immunology Submission Form can be found Here
§ Specimen Type: Blood/Serum
o Blood should be drawn before heparin therapy.
o Avoid exposure of specimen to extremes of temperature
§ Complete the form, providing all information requested.
o For more information on submitting blood specimens click here.
RESULTS INTERPRETATIONS
For help understanding patient test results click on the link below
Hepatitis Laboratory Interpretations Guidelines
LYME DISEASE
- Lyme disease is caused by the bacterium Borrelia Burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks.
- Symptoms include fever, headache, fatigue and a characteristic skin rash that looks like a ‘bulls- eye” called an erythema migrans
- The Center for Disease Control (CDC) recommends a 2-test approach for serologic diagnosis of Lyme disease.
- Specimens are first screened with an enzyme immunoassay.
- Equivocal or positive serum specimens are then analyzed with a more specific immunoglobulin IgM and IgG Western blot.
Specimen Submission:
§ OLS does not provide collection supplies or mailing containers for Lyme testing.
§ If interested in submitting a sample to OLS for testing, a link to the Lyme Submission Form can be found Here
§ Specimen Type: Blood/Serum
o Avoid exposure of specimen to extremes of temperature
§ Complete the form, providing all information requested.
o For more information on submitting Lyme specimens click here.
§ RESULTS INTERPRETATION
SYPHILIS
Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. Syphilis is passed from person to person through direct contact with a syphilis sore. Pregnant women with the disease can pass it to the babies they are carrying. Syphilis can not be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing or eating utensils.
OLS tests for syphilis using the RPR (Rapid Plasma Reagin) test. Positives if found, are quantitated. Reactivity with the antigen used in the RPR Circle Card Test diminishes over time or with treatment.
OLS also uses the TP-PA Treponema pallidum Particle Agglutination test as the confirmatory test for syphilis. This test is performed on all new positives. Once this test is positive, it remains positive for the life of the patient and does not need to be repeated.
Serological procedures for syphilis are performed in the support of:
- The state pre-natal law (for indigent persons only)
- The Sexually Transmitted Disease (STD) Control Division of the Bureau of Health;
- The Family Planning program;
- The private medical community (for which the OLS would serve as a Reference Laboratory for diagnostic problem cases only.)
SPECIMEN SUBMISSION
Complete the DI Specimen Submission Form, providing all information requested. Check appropriate box below patient address. Print so that information is clearly legible on all copies of the form. TP-PA secondary testing will be performed on all new positive RPR's.
For information on collecting and submitting Syphilis samples see Blood Collection Instructions.
RUBELLA
Rubella virus causes two clinical conditions:
- a benign, self-limiting illness acquired postnatally;
- severe illness sometimes inflicting long-life disability, resulting from in-utero infection.
Serological tests for rubella antibodies are performed for the following reasons:
- diagnosis of CONGENITAL rubella;
- diagnosis of POSTNATAL rubella;
- determination of the IMMUNE STATUS of women during their child-bearing period.
At OLS only Rubella immunity screening is available to support the Family Planning program to determine immune status of women.
SPECIMEN SUBMISSION
Complete the DI Specimen Submission Form, giving all information requested. Print so that information is clearly legible on all copies of the form.
For information on collecting and submitting Rubella samples see Blood Collection Instructions.
CHLAMYDIA AND GONORRHEA
Infection with Chlamydia can result in a serious and often asymptomatic disease. The most common infections are cervicitis and pelvic inflammatory disease (PID) in females, nongonococcal urethritis and epididymitis in males, and conjunctivitis and pneumonia in newborns.
Infection with Gonorrhea usually results in anterior urethritis with purulent exudates in men, a few days after exposure. Female infections are frequently asymptomatic, yet severe complications and sterility may occur if the disease remains untreated.
The Diagnostic Immunology section screens for Chlamydia and Gonorrhea using the following method:
NAAT TESTING USING URINE SAMPLES
The Diagnostic Immunology section screens for both of these organisms from submitted urine specimens from approved Family Planning and STD sites. Family Planning patients must NOT EXCEED 29 years of age at time of collection, except if the patient exhibits symptoms of STD or is a known/suspected contact. For additional information go to Urine Collection Instructions.
SPECIMEN SUBMISSION
Complete the DI Specimen Submission Form, providing all information requested. Federal CLIA regulations require that the name on the form AND tube match before testing can be done. To ensure a speedy return of results complete the date of collection and date of birth.
RESOURCE LINKS
Center for Disease Control STD - Definitions, signs, symptoms of STD's.
CDC Disease Listings - Provides an alphabetical list of diseases with both technical and general information.
CONTACT INFORMATION
Serology Section
Ph. 304-558-3530 x2405
Ph. 304-558-3530 x2401
Dondeena McGraw, Supervisor
Microbiologist III
304-558-3530 x2405
RELATED CONTACT INFORMATION
Family Planning
Ph. 304-558-5358
familyplanning@wvdhhr.org
www.wvdhhr.org/mcfh/wvfp
STD Control
Ph. 304-558-5358
