1. Used to support the clinical diagnosis of infectious diseases.

2. Only paired acute and convalescent sera drawn 2-4 weeks apart are useful for diagnosing recent infection.  Testing a single convalescent sample may be fruitful for some agents when an acute sample is not available.

Paired sera are usually the diagnostic gold standard.  Documentation of a significant antibody rise is the best serological method of confirming infection.  The laboratory stores acute serum samples until receipt of convalescent sample.  PROVIDE ONSET DATE when ordering test. 

Serological tests often lack sensitivity and specificity in the diagnosis of acute infections.  The frequency of false-positive and false-negative results obtained from testing single acute samples indicates this practice is generally inferior to testing paired sera.  

Only paired acute and convalescent sera drawn 2-4 weeks apart are useful for diagnosing recent infection. Testing a single convalescent sample may be fruitful for some agents when an acute sample is not available.

1. Specimens are forwarded to the North Carolina State laboratory of Public Health (NCSLPH) for testing. The NCSLPH will forward specimens to the Centers for Disease Control (CDC) for some testing. Testing is currently performed at no charge to the patient by the NCSLPH and the CDC. A handling fee is charged by Clinical Microbiology.

2. Review the State Lab Website for details on the acceptable specimen submission and required forms needed to completed when submitting. 

    Virology and Serology Testing: https://slph.dph.ncdhhs.gov/virology-serology/default.asp

    Bacterial STD Testing: https://slph.dph.ncdhhs.gov/virology-serology/bacterial-std.asp

    Rabies Virus Testing: https://slph.dph.ncdhhs.gov/virology-serology/rabies.asp

    Serology Testing: https://slph.dph.ncdhhs.gov/virology-serology/serology.asp

    Special Virology Testing (Zika, West Nile, Dengue and other Encephalitis causing virus's): https://slph.dph.ncdhhs.gov/virology-serology/special-serology.asp

     Virus Culture Testing: https://slph.dph.ncdhhs.gov/virology-serology/virusCulture.asp

     Zika Virus Testing: https://slph.dph.ncdhhs.gov/zika/default.asp

3.  Indicate the INFECTIOUS AGENT SUSPECTED when ordering the test.  Serological tests available include (but are not limited to) arbovirus (EEE, WEE, SLE, LaCrosse, West Nile), Dengue, Hantavirus, Japanese B, E. histolytica, Babesia, Chagas' Disease, cysticercosis, Malaria, Lung Fluke, Bilharzia, Toxocara, Trichinellosis, Strongyloides, Leptospirosis, Leishmaniasis, Schistosomiasis.

4. Refer to BRUCELLA ANTIBODY, TULAREMIA ANTIBODY, and ROCKY MTN SPOTTED FEVER ANTIBODY for additional information.

5. PROVIDE ONSET DATE when ordering test. This will ensure correct application of interpretative criteria. The NCSLPH prefers paired (acute and convalescent) sera for testing but will test a single convalescent sample.


Metholodogies used at the NCSLPH include Indirect Fluorescent Antibody (IFA) or Enzyme ImmunoAssay (EIA).

NC State Lab of Public Health Special Serology Information Page: https://slph.dph.ncdhhs.gov/virology-serology/special-serology.asp 

Forms and Misc Documents Required for Sample Submission: https://slph.dph.ncdhhs.gov/forms.asp

Special Serology State Lab Requisition Required for submission with required signatures of Ordering Physician: https://slph.dph.ncdhhs.gov/Forms/SpecialSerologyForm-3445.pdf

Zika Virus Testing Guidance: https://www.cdc.gov/zika/hc-providers/testing-guidance.html

Zika and Dengue Virus Testing Guidance: https://www.cdc.gov/mmwr/volumes/68/rr/pdfs/rr6801a1-H.pdf