Mumps Testing Guidance

(as of 4/4/14 at 12:35 pm)

 

Mumps cases have been laboratory-confirmed in Wisconsin. Therefore, health care providers in Wisconsin should be alert and consider mumps in individuals presenting with symptoms such as parotitis.

The information below from the Wisconsin State Laboratory of Hygiene (WSLH) and Wisconsin Division of Public Health (WDPH) addresses specimen collection and mumps testing questions. For general information about mumps, please visit the CDC website (http://www.cdc.gov/mumps/).

 

For healthcare providers, clinical laboratories, infection preventionists, local and tribal health departments:

 

The WDPH requests that all DIAGNOSTIC specimens for mumps, measles and rubella testing be sent to the WSLH or the City of Milwaukee Health Department Laboratory.

When a request for testing is received for a patient suspected of having a vaccine preventable disease such as measles, mumps, or rubella, notify local (http://www.dhs.wisconsin.gov/localhealth/counties/countyalphalist.htm) or state public health of the suspect case immediately. DO NOT wait for the test results before notifying public health.  Immediate notification allows public health to quickly initiate an investigation of the suspect case.

 

PCR is the PREFERRED diagnostic test for mumps. Please submit buccal swab specimens for PCR testing.

 

What specimens should be collected for testing?

 

PREFFERED — Buccal Swabs for PCR: Buccal swabs in viral transport medium are the preferred specimen for PCR testing for mumps and should be collected as soon as mumps is suspected (preferably within 3 days of parotitis onset and not after 9 days of parotitis onset) for the best chance of detection of virus. Massage the parotid gland area for 30 seconds and then swab the area around Stensen’s duct. For specific instructions and illustrations of specimen collection, go to: http://www.cdc.gov/mumps/lab/detection-mumps.html.

 

ALTERNATE — Acute Serum: Collect the first (acute-phase) serum as soon as mumps disease is suspected. A second serum for repeat IgM testing (collected 5-7 days after onset of parotitis) may be useful if the first serum is negative for IgM antibody to mumps and was collected within 3 days of parotitis onset in an unvaccinated person.

Convalescent Serum: A second (convalescent-phase) serum specimen should be collected 2-3 weeks after the first serum.

Urine: Not recommended.

 

Which tests should be ordered from the WSLH?

 

PCR is the preferred diagnostic test for mumps.

PCR Testing (WSLH test # VR01714): PCR is the preferred test for the diagnosis of mumps. It is used to detect the presence of mumps virus and can also be used for the molecular characterization of the virus. Requires collection of a buccal swab specimen.

Mumps IgM and IgG Antibody (WSLH Test #SS02130): Antibody test for mumps. Requires collection of a serum specimen.

For more information on these tests, please see the WSLH Clinical Test Search at http://www.slh.wisc.edu/wslhApps/RefMan/wslhSearch.php.  Type “mumps” in the search box and the click the button labeled Search. All mumps tests available at the WSLH will come up in the search results. Click test link for information on that specific test. If you have additional questions, please call WSLH Customer Service at 800-862-1013 between 8:00 am – 4:30 pm, Monday-Friday. The WSLH after-hours emergency pager is 608-263-3280.

NOTE: Unless requested by a local health department, serum specimens collected for immune status testing only should be sent to a commercial laboratory and only the IgG serology test should be ordered.

 

How do I order tests from the WSLH?

 

If you do not already have WSLH test requisition forms, please contact WSLH Customer Service at 800-862-1013 between 8:00 am – 4:30 pm, Monday-Friday to request forms.

 

How do I ship specimens to the WSLH?

 

If your laboratory is using Dunham Express for transport of the specimen, please indicate that the specimen transport is to be billed to the “outbreak” account 7271.  Providing that you are not calling late in the day, Dunham should pick up the specimens the same day you call and deliver them to the WSLH the following morning. NOTE: If specimens are sent on a Friday, be sure to specify “Saturday delivery”, or the specimens will not be received at the WSLH until Monday. If you are having any trouble arranging transport of the specimens, please let us know and we will assist you in finding a solution.

PLEASE NOTIFY the WSLH that specimens are being sent to the WSLH for testing. Your advance telephone call allows us to prepare for testing and provide a more timely result, which in turn allows for more rapid public health intervention to prevent the spread of disease.

You can notify the WSLH by calling WSLH Customer Service at 800-862-1013 between 8:00 am – 4:30 pm, Monday-Friday or after-hours by calling the WSLH after-hours emergency pager at 608-263-3280.

 

Will mumps testing at the WSLH be fee-exempt?

 

Healthcare providers and clinical laboratories must receive approval from local or state public health for testing to be performed fee-exempt at the WSLH. Please contact your local health department for information on fee-exempt testing. (http://www.dhs.wisconsin.gov/localhealth/counties/countyalphalist.htm)

 

About negative mumps test results

 

Negative results do not rule out mumps infection due to the following:

  • The amount of virus shed at the time of sample collection may have been too low to be detected.
  • Inadequate specimen collection, processing, shipping or storage can significantly reduce the likelihood of detecting mumps virus or mumps RNA.
  • Mumps IgM antibody may be transient or undetectable in previously vaccinated individuals.
  • The full clinical and epidemiologic picture must be taken into consideration when interpreting test results.