Test Catalog

Test Id : QFP

Not Orderable

Q Fever IgM and IgG, Titer, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of Coxiella burnetii, the causative agent of Q fever

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Method Name
A short description of the method used to perform the test

Only orderable as a reflex. For more information see QFEVR / Q Fever Antibody Screen with Titer Reflex, Serum.

 

Indirect Immunofluorescence

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Q Fever IgM/IgG, Titer, S

Aliases
Lists additional common names for a test, as an aid in searching

Coxiella burnetii

Coxiella Titer

Febrile Agglutinins

OX-19 (Proteus OX-19 - Weil-Felix)

OX-2 (Proteus OX-2 - Weil-Felix)

OX-K (Proteus OX-K - Weil-Felix)

Proteus (Weil-Felix)

Rickettsial Antibody

Typhus

Weil-Felix

QFP

Q-Fever

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Only orderable as a reflex. For more information see QFEVR / Q Fever Antibody Screen with Titer Reflex, Serum.

 

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.25 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
Frozen 7 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of Coxiella burnetii, the causative agent of Q fever

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Q fever, a rickettsial infection caused by Coxiella burnetii, has been recognized as a widely distributed zoonosis with the potential for causing both sporadic and epidemic disease. The resistance of C burnetii to heat, chemical agents, and desiccation allows the agent to survive for extended periods outside the host.

 

C burnetii is spread by the inhalation of infected material, largely from dried sheep and goat reproductive material; the organism is also shed in feces, milk, nasal discharge, placental tissue, and amniotic fluid from ruminant animals.

 

The clinical spectrum of disease ranges from unapparent to fatal. Respiratory manifestations usually predominate; endocarditis and hepatitis can be complications.

 

During the course of the infection, the outer membrane of the organism undergoes changes in its lipopolysaccharide structure, called phase variation. Differences in the host antibody response between phase I and phase II antigens can help classify infections as either acute or chronic:

-In acute Q fever, the phase II antibody is generally higher than the phase I titer, often by 4-fold, even in early specimens. Although a rise in phase I as well as phase II titers may occur in later specimens, the phase II titer remains higher.

-In chronic Q fever, the reverse situation is generally seen. Serum specimens collected late in the illness from chronic Q fever patients demonstrate significantly higher phase I titers, sometimes much greater than 4-fold.

-In the case of chronic granulomatous hepatitis, IgG and IgM titers to phase I and phase II antigens are quite elevated, with phase II titers generally equal to or greater than phase I titers.

-Titers seen in Q fever endocarditis are similar in magnitude, although the phase I titers are quite often higher than the phase II titers.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Only orderable as a reflex. For more information see QFEVR / Q Fever Antibody Screen with Titer Reflex, Serum.

 

Q fever phase I antibody, IgG

<1:16

 

Q fever phase II antibody, IgG

<1:16

 

Q fever phase I antibody, IgM

<1:16

 

Q fever phase II antibody, IgM

<1:16

 

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

A negative result argues against Coxiella burnetii infection. If early acute Q fever infection is suspected, collect a second specimen 2 to 3 weeks later and retest.

 

A negative result following a reactive C burnetii enzyme immunoassay screen suggests a falsely reactive screen. In cases of suspected acute C burnetii infection, repeat testing in 2 to 3 weeks is recommended.

 

Phase I antibody titers greater than or equal to phase II antibody titers are consistent with chronic infection or convalescent phase Q fever.

 

Phase II antibody titers greater than or equal to phase I antibody titers are consistent with acute/active infection.

 

In Q fever sera, it is common to see IgG titers of 1:128 or greater to both phase I and phase II antibody titers. IgG class antibody titers appear very early in the disease, reaching maximum phase II titers by week 8 and persisting at elevated titers for longer than a year. Phase I titers follow the same pattern, although at much lower levels, and may not be initially detected until convalescence.

 

In Q fever sera, it is common to see IgM titers of 1:64 or greater.

 

IgM class antibody titers appear very early in the disease, reaching maximum phase II titers by week 3 and declining to very low levels by week 14. Phase I titers follow the same pattern, although at much lower levels, and may not be initially detected until convalescence.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Serologic responses are time dependent. Specimens collected too early in the disease may not have detectable antibody levels. A second specimen collected 2 to 3 weeks may be necessary to detect antibody.

 

Low level positive titers (ie, <1:256) may remain for prolonged periods of time following resolution of disease.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Hartzell JD, Marrie TJ, Raoult D. Coxiella burnetii (Q fever). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2360-2367

2. Anderson A, Bijlmer H, Fournier PE, et al. Diagnosis and management of Q fever--United States, 2013: recommendations from CDC and the Q Fever Working Group [published correction appears in MMWR Recomm Rep. 2013 Sep 6;62(35):730]. MMWR Recomm Rep. 2013;62(RR-03):1-30

Method Description
Describes how the test is performed and provides a method-specific reference

An indirect immunofluorescence test is used for the measurement of IgM and IgG antibodies to Coxiella burnetii. Specific antibodies present in the serum of the patient react with rickettsial cells that have been previously fixed on a glass microscope slide. Fluorescein-labeled antihuman IgG or IgM conjugate is used to stain specific antibody bound to the substrate cells. The slides are examined with a fluorescence microscope for characteristic, apple-green fluorescence of the infected cell.(Edligner B. Immunofluorescence serology. A tool for prognosis of Q fever. Diagn Microbiol Infect Dis. 1985;3[4]:343-351; package inserts: Q fever IFA IgG. Focus Diagnostics, Inc; 12/2022; Q fever IFA IgM. Focus Diagnostics, Inc; 12/2022)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86638 x 4

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
QFP Q Fever IgM/IgG, Titer, S 77175-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
80965 Q Fever Phase I Ab, IgG 34716-1
24011 Q Fever Phase II Ab, IgG In Process
81115 Q Fever Phase I Ab, IgM 9710-5
24009 Q Fever Phase II Ab, IgM 9711-3
24010 Interpretation 69048-7

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
Obsolete Test 2023-08-17