Rare or Imported Diseases

Test information: The presentation of most imported diseases is very similar, and it can be difficult to distinguish between them clinically. Co-infections with more than one agent are also relatively common. For this reason, panels of tests are performed based upon the patient's symptoms and travel history that include the commonest differential diagnoses. Unless you have a specific reason for testing for a single agent, or are very familiar with current disease prevalence, we suggest that you provide as many clinical and travel details as possible to permit appropriate test selection.

Availability: Referred to Rare and Imported Pathogens Laboratory (RIPL): Monday - Friday during routine hours: 08:45 - 17:15.

Turnaround Time: Up to 10 Days upon receipt at Rare and Imported Pathogens Laboratory (RIPL)

Specimen Type(s)

• Cerebrospinal fluid;
• Clotted blood;
• EDTA Whole Blood;
• Joint fluids;
• Post-Mortem Specimens;
• Pus;
• Pus Exudate;
• Semen;
• Swab;
• Throat swab;
• Tissue;
• Tissue Biopsies;
• Urine;
• Vesicle Fluid;
• Vesicle Swabs;

Other Acceptable Specimen Type(s)

N/A

Specimen Container - Adult

• Gold Top SST BD;
• Purple Top BD;
• Sterile CE-marked Universal Container;

Specimen Container - Paediatric

• Plain Top Sarstedt;
• Purple Top Microtainer BD;
• Sterile CE-marked Universal Container;

Analytes

• Anaplasma phagocytophilum antibodies / DNA;
• Bacillus anthracis (anthrax) DNA;
• Borrelia burgdorferi antibodies;
• Brucella species DNA;
• Burkholderia mallei DNA;
• Burkholderia pseudomallei (melioidosis) DNA;
• Chikungunya antibodies / RNA;
• Coxiella burnetii (Q-fever) antibodies / DNA;
• Crimean-Congo haemorrhagic fever (CCHF) RNA;
• Dengue virus antibodies;
• Dengue virus RNA;
• Eastern equine encephalitis antibodies / RNA;
• Ebola group virus RNA;
• Francisella tularensis spp. antibodies / DNA;
• Hantaviruses antibodies / RNA;
• Hendra virus RNA;
• Japanese encephalitis virus antibodies / RNA;
• Lassa virus RNA;
• Leptospira antibodies / DNA;
• Marburg virus RNA;
• Murray Valley encephalitis virus antibodies;
• Nipah virus RNA;
• Orientia tsutsugamushi (scrub typhus) antibodies / DNA;
• Orthopoxviruses DNA;
• Pan Borrelia DNA;
• Parapoxviruses DNA;
• Rickettsia (spotted fever and epidemic typhus groups) antibodies / DNA;
• Rift Valley fever virus antibodies / RNA;
• Ross River virus antibodies;
• Sandfly fever viruses (including Toscana virus) antibodies;
• Sindbis virus antibodies;
• Tick-borne encephalitis group virus antibodies / RNA;
• Venezuelan equine encephalitis antibodies / RNA;
• West Nile virus antibodies / RNA;
• Western equine encephalitis antibodies / RNA;
• Yellow fever virus antibodies / RNA;
• Yersinia pestis (plague) DNA;
• Zika virus antibodies / RNA;

Part of a test profile?

No

Volume (min) of sample to be sent to laboratory

5-10mL Blood
1mL Urine
500uL CSF

Patient Preparation, Sample Handling and Transport

• Minimum-clotting time 30 minutes.
• Specimens should be transported to the laboratory as soon as possible.
• Outside of normal hours samples should be refrigerated (2 °C to 8 °C).

Maximum add on time

N/A

Units and Reference Ranges / Interpretation

Negative / Positive, Not Detected / Detected

UKAS number

9304

UKAS accredited test?

Yes

Comments

• Panels include both serology and PCR as required, with PCR tests being offered as well as serological tests for acute cases. PCR tests are not normally performed for long-term conditions except Q fever, as they are highly unlikely to be positive and diagnosis relies on serology.
• Arboviruses and rickettsiae are causes of febrile illness in travellers returning to the UK from many areas. Less frequently, illness caused by viral haemorrhagic fevers may have to be considered. Although not common, leptospirosis, Q fever, anthrax, plague and other bacterial infections, derived either from within the UK or abroad, may also be considered as part of the differential diagnosis.
• Common conditions such as malaria or enteric fever (typhoid) must not be forgotten and should be screened for, alongside more exotic diseases, as prompt treatment may be life-saving.
• Some assays are developmental.
• Some assay require contact with the imported fever service in advance.

If you have any queries about a test or results interpretation please contact us.