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Chikungunya RNA Detection by Real Time PCR - Serum

Bacterial/ Viral
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Report in 72Hrs

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No Fasting Required

Details

Detects viral RNA in serum.

₹5,254₹7,506

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Chikungunya RNA Detection by Real Time PCR - Serum

  • Why is it done?
    • This test detects and identifies Chikungunya virus RNA in serum samples using real-time polymerase chain reaction (PCR) technology, which amplifies and detects viral genetic material.
    • Primary indication for acute Chikungunya virus infection in symptomatic patients, particularly those presenting with fever, joint pain (arthralgia), and myalgia.
    • Performed during the acute phase of illness, typically within the first 5-7 days after symptom onset when viral load in serum is highest.
    • Essential for confirming suspected Chikungunya cases in areas with active transmission or in travelers returning from endemic regions.
    • Used for differentiation from other arboviral infections such as dengue fever, Zika virus, and other causes of acute febrile illness.
    • Important for epidemiological surveillance and outbreak investigations.
  • Normal Range
    • Normal (Negative) Result: No Chikungunya RNA detected or Ct (Cycle threshold) value >40 or reported as 'Not Detected'
    • Positive Result: Chikungunya RNA detected with Ct value ≤40 or reported as 'Detected'
    • Ct Value Interpretation: Lower Ct values (15-25) indicate higher viral loads and recent acute infection; higher Ct values (25-40) indicate lower viral loads.
    • Units of Measurement: Cycle threshold (Ct) or quantification cycle (Cq) values; virus copies per milliliter (cp/mL) if quantitative assay
    • Borderline/Equivocal Results: Ct values 38-40 may warrant repeat testing or correlation with clinical presentation and serology
  • Interpretation
    • Positive Result (RNA Detected): Confirms acute Chikungunya virus infection; patient is viremic and infectious; indicates current or recent infection within the past 5-7 days; requires clinical correlation with symptoms including fever, arthralgia, myalgia, rash, and headache.
    • Negative Result (RNA Not Detected): Rules out acute viremia; may indicate infection is beyond the detectable viremic window (after 7-10 days); does not exclude recent infection if serology is positive; consider IgM antibody testing if clinical suspicion remains high.
    • Ct Value Significance: Very low Ct (<20) suggests high viral burden with recent symptom onset; moderate Ct (20-35) indicates detectable infection; high Ct (35-40) suggests lower viral load or late-stage acute infection.
    • Factors Affecting Results: Timing of collection is critical (best within first week of symptom onset); specimen quality and handling affect sensitivity; immunocompromised patients may have prolonged viremia; co-infections may influence viral loads.
    • Clinical Significance of Patterns: Positive PCR combined with typical clinical presentation confirms diagnosis; negative PCR with positive IgM antibodies suggests recent or resolving infection; repeated positive PCR suggests either prolonged viremia or recurrent symptoms.
    • Sensitivity and Specificity: Real-time PCR has high sensitivity (>95%) and specificity (>99%) for Chikungunya RNA detection; significantly more sensitive than viral culture and serology during acute phase.
  • Associated Organs
    • Primary Organ Systems Involved: Musculoskeletal system (joints and muscles); nervous system (CNS involvement in severe cases); cardiovascular system (myocarditis in rare cases); liver (hepatitis possible).
    • Acute Chikungunya Fever: Characterized by sudden onset fever (often >39°C), severe arthralgia and arthritis (particularly hands, wrists, feet), myalgia, headache, rash, and lymphadenopathy.
    • Chronic/Post-Infectious Complications: Chronic arthralgia/arthritis persisting months to years after acute infection; joint pain affecting mobility and quality of life; rare neurological complications including Guillain-Barré syndrome, myelitis, and encephalitis.
    • Severe Manifestations: Hemorrhagic manifestations; myocarditis and cardiac complications; acute kidney injury; meningoencephalitis; particularly severe in neonates, elderly, and immunocompromised individuals.
    • Vertical Transmission: Mother-to-child transmission possible, particularly during pregnancy and childbirth; can result in neonatal Chikungunya with fever, rash, thrombocytopenia, and potential long-term complications.
    • Associated Diseases and Conditions: Co-infection with dengue or Zika virus in endemic regions; secondary bacterial infections from scratching; exacerbation of underlying rheumatologic or cardiovascular conditions.
  • Follow-up Tests
    • Chikungunya IgM and IgG Antibody Testing: Recommended if PCR is negative but clinical suspicion remains high; IgM appears after viremia wanes and persists for 2-3 months; IgG indicates past infection.
    • Dengue and Zika PCR Testing: Indicated in endemic regions to exclude co-infections or alternative diagnoses with similar presentations.
    • Complete Blood Count (CBC): May show lymphocytosis, mild thrombocytopenia, or anemia; helps assess disease severity.
    • Liver Function Tests (LFTs): May reveal elevated liver enzymes; monitors for hepatic involvement in severe cases.
    • Renal Function Tests (Creatinine, BUN): Indicated if severe disease or acute kidney injury suspected.
    • Inflammatory Markers (CRP, ESR): May be elevated during acute infection; useful for monitoring inflammation and chronic complications.
    • Joint Imaging (X-rays, MRI): Recommended if chronic arthralgia persists to assess for joint damage or rule out other rheumatologic conditions.
    • Cerebrospinal Fluid (CSF) Testing: Indicated if neurological complications suspected (meningitis, encephalitis); includes cell counts, protein, glucose, and PCR for Chikungunya.
    • Repeat PCR Testing: May be performed 1-2 weeks later if initial result is negative with high clinical suspicion.
    • Monitoring Frequency: For uncomplicated cases: clinical follow-up at 1-2 weeks; for chronic arthralgia: periodic assessments every 3-6 months; for severe disease: frequent monitoring until resolution.
  • Fasting Required?
    • Fasting Requirement: NO - Fasting is NOT required for Chikungunya RNA PCR testing. This test only requires a serum blood sample and can be collected at any time of day.
    • Specimen Collection Requirements: Blood sample (typically 3-5 mL) collected in a serum separator tube or standard collection tube without anticoagulant.
    • Optimal Timing: Collection should occur during acute phase of illness, ideally within 5-7 days of symptom onset for optimal viral detection.
    • Special Instructions: Inform healthcare provider about recent travel to endemic areas; clearly indicate symptom onset date on test requisition.
    • Medications to Avoid: None - No specific medications need to be held or avoided before this test; all routine medications may be continued.
    • Specimen Handling: Allow blood to clot for 30 minutes at room temperature; centrifuge to separate serum; refrigerate or freeze if testing will be delayed; proper storage maintains specimen integrity.
    • Biohazard Precautions: Healthcare workers should follow standard blood-borne pathogen precautions; patients with confirmed Chikungunya should use insect repellent and protective measures to prevent mosquito transmission.

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