State health departments are integral to providing guidance on specimen collection, transport, and testing of vaccine-reportable diseases. The CDC is the definitive organization to gather such information.
A number of different tests are used to identify Vaccine-Preventable Diseases. Many are beyond the testing capability of any one clinical lab, which is why they are often sent to state reference labs or the CDC. Table 1 is provided by the CDC and lists the types of tests performed on VPDs.8
Table 1. Confirmatory and Other Tests for VPDs.Disease | Confirmatory Tests | Other Useful Tests |
Diphtheria | Culture Toxigenicity testing | PCR MALDI-TOF |
Haemophilus influenzae | Culture Real-time PCR | Serotyping slide agglutination or PCR (identification of capsular type of encapsulated strains) Antigen detection Molecular typing |
Hepatitis A | IgM anti-HAV (positive) | Total anti-HAV IgG anti-HAV (markers of immunity) PCR for HAV RNA (marker of current infection) |
Hepatitis B | IgM anti-HBc (acute infection) HBsAg (acute or chronic infection)* | Anti-HBs (marker of immunity) Total anti-HBc (marker of past or present infection) PCR for HBV DNA (marker of current infection) |
Influenza | Culture Antigen detection (EIA, IFA, EM) RT-PCR | |
Measles | IgM RT-PCR Virus isolation | IgG IgG for seroconversion or 4-fold titer rise Avidity (case classification) |
Meningococcal disease | Culture | Serogrouping Slide agglutination or PCR (identification of capsular type of encapsulated strains) Antigen detection Molecular typing |
Mumps | Virus isolation RT-PCR | IgG for seroconversion or 4-fold titer rise (not recommended) |
Pertussis | Culture PCR | Serology |
Pneumococcal disease | Culture PCR | WGS-based deduction of all strain features (serotype, antimicrobial resistance, MLST genotype)
- Serotyping
- PCR deduction of serotypes
- Strain identification (MLST, PFGE)
|
Poliomyelitis | Culture from stool, pharynx, or CSF | Intratypic differentiation (wild vs. vaccine type) Paired serology CSF analysis |
Rotavirus |
| RT-PCR/qRT-PCR |
Rubella | Paired sera for IgG IgM | Culture |
Tetanus | There are no lab findings characteristic of tetanus | Serology (for immunity testing) |
Varicella | PCR | DFA Culture Serology Genotyping |
Abbreviations: EIA, enzyme-linked immunosorbent assay; IFA, indirect fluorescent antibody; EM, electron microscopy; PCR, polymerase chain reaction; MLST, multilocus sequence typing; PFGE, pulsed field gel electrophoresis; CSF, cerebral spinal fluid; IgG, immunoglobulin G; IgM, immunoglobulin M; HAV, hepatitis A virus; HBV, hepatitis B virus; anti-HBc, hepatitis B core antibody; HBsAg, hepatitis B surface antigen; qRT-PCR, quantitative reverse transcription polymerase chain reaction
*Confirmation of HBsAg positive results by HBsAg neutralization assay should be performed as specified in the test package insert.