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Beaumont Laboratory

Varicella Zoster Virus by PCR

Herpes Zoster PCR, Chickenpox PCR, VZ PCR, VZV PCR, Varicella Zoster Virus (VZV) by PCR, VZV Detection By PCR, EPIC: LAB6408, SOFT: IVZVG

Specimen Collection Criteria

Collect: ONE of the following specimen types:

  • Amniotic Fluid: 1.0 mL fluid in a sterile collection container or syringe with the needle removed. (Min: 0.5 mL) 
  • Cerebrospinal Fluid (CSF): 1.0 mL CSF in a sterile collection container. (Min: 0.5 mL)
  • Skin/Mucous Membranes: Swab the lesion and place in viral transport medium.
  • Ocular (Aqueous or Vitreous) Fluids: Submit 1.0 mL vitreous fluid (not the dilute fluid in the cassette) in a sterile collection container. (Min: 0.2 mL)
  • Vesicles: Puncture the vesicle and collect the vesicle fluid with a swab. Place the swab in viral transport medium.
  • Serum: Submit a Gold-top SST tube (Min: 1.0 mL); Pediatric: submit 2 Microtainers®
  • Plasma: Submit a Lavender-top EDTA tube (Min: 1.0 mL) ; Pediatric: submit 2 Microtainers®
  • Bronchoalveolar Lavage (BAL): Submit in a sterile collection container. (Min: 0.5 mL)
  • Sputum (Expectorated, Tracheal, Trans-Tracheal, Nasotracheal, Endotracheal): Submit in a sterile collection container. (Min: 0.5 mL)
  • Tissue: Place in a sterile collection container or in Universal Transport Media (UTM, UVT)

Other specimen types require approval of the Medical Director of Molecular Pathology or Microbiology.

Physician Office/Drawsite Specimen Preparation

Do not freeze specimens. Maintain all specimen types refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: All specimen types, at room temperature (20-25°C or 68-77°F) or refrigerated (2-8°C or 36-46°F).

Rejection Criteria

  • Frozen specimens.
  • Heparinized specimens.
  • Specimens with gross bacterial contamination. 

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): 30 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Clinical Molecular Pathology Laboratory.

Performed

Sunday - Saturday.
Results available within 24 hours for CSF, ocular, or pediatric specimens. Results for all other specimen types available in 2-3 days.

Reference Range

Negative.

Test Methodology

Real-Time Polymerase Chain Reaction (PCR), followed by Melting Curve Analysis.

Interpretation

A negative result does not rule out VZV infection.

Clinical Utility

This assay provides a highly sensitive and specific test for the diagnosis of VZV infection, VZV encephalitis, and intraocular infections. This method can also be used to detect VZV in fetal tissue and amniotic cells.

Clinical Disease

  • Varicella-zoster virus causes two distinct diseases- varicella (chickenpox) and herpes zoster (shingles).
  • Chickenpox is a seasonal childhood disease characterized by low grade fever, malaise, and a generalized vesicular rash. Chickenpox may occur after exposure to either chickenpox or shingles and is a manifestation of primary VZV infection. VZV infection during pregnancy causes birth defects in rare cases. When infection occurs at term, life threatening infections can occur in the neonate.
  • Shingles exhibits no seasonality and it usually occurs in immunocompromised patients and in older adults. Evidence suggests that shingles results from a reactivation of virus that remains latent in the sensory spinal ganglia after the primary infection rather than a reintroduction of the virus into the host. It is characterized by painful vesicular eruptions of the skin along the distribution of the involved nerves.

Epidemiology

Most varicella cases occur in winter and early spring with peak incidence in March and April. Epidemics occur at irregular 5 year intervals.

Incubation Period

11-21 days with a mean of 13-17 days.

Transmission

VZV is highly contagious and transmission is via direct contact and through droplets. Patients are infectious 1-2 days before the rash appears and for 3-5 days thereafter.

CPT Code

87798.

Test Codes

EPIC: LAB6408, SOFT: IVZVG

Last Updated

06/20/2017

Microtainer® and Vacutainer® are registered trademarks of Becton, Dickinson and Company.
UroVysion® is a registered trademark of Abbott Laboratories. ThinPrep® is a registered trademark of Hologic, Incorporated.

This directory currently reflects information only for specimens collected and/or processed at the Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.