Chikungunya laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2], Alonso Alvarado, M.D. [3]
Laboratory Findings
- Clinical laboratory findings can include lymphopenia, thrombocytopenia, elevated creatinine, and elevated hepatic transaminases.
- Laboratory diagnosis is generally accomplished by testing serum or plasma to detect virus, viral nucleic acid, or virus-specific immunoglobulin (Ig) M and neutralizing antibodies.
- Viral culture may detect virus in the first 3 days of illness; however, chikungunya virus should be handled under biosafety level (BSL) 3 conditions.
- During the first 8 days of illness, chikungunya viral RNA can often be identified in serum.
- Chikungunya virus antibodies normally develop toward the end of the first week of illness. Therefore, to definitively rule out the diagnosis, convalescent-phase samples should be obtained from patients whose acute-phase samples test negative.
- Chikungunya virus testing is performed at CDC, a few state health departments, and one commercial laboratory.
- Test results are normally available 4 to 14 days after specimen receipt.
- Reporting times for test results may be longer during summer months when arbovirus activity increases.
- Receipt of a hard copy of the results will take at least 2 weeks after testing is completed.
- Initial serological testing will be performed using IgM-capture ELISA and IgG ELISA. If the initial results are positive, further confirmatory testing will be performed and it may delay the reporting of final results.