Francisella tularensis Antibodies (IgG, IgM)

Test Code
FTABQ or 18516


CPT Codes
86668 x2

Preferred Specimen
0.6 mL serum


Minimum Volume
0.5 mL


Instructions
Centrifuge and aliquot serum into a plastic vial.


Transport Temperature
Room temperature


Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis; grossly lipemic; grossly icteric


Methodology
Immunoassay, Enzyme Linked Immunosorbent Assay

Setup Schedule
Tues, Thurs, Sat


Report Available
3-5 days 


Reference Range
F. tularensis Ab (IgG): Negative
F. tularensis Ab (IgM): Negative
 


Clinical Significance
This immunoassay is for the qualitative detection of antibodies (IgG, IgM) against Francisella tularensis, the causative agent of Tularemia disease. Antibodies can be detected starting 2-3 weeks after the onset of symptoms. Paired sera 2-3 weeks apart to observe seroconversion is recommended to confirm infection in patients with high clinical suspicion.

This assay is intended for patients with signs and symptoms consistent with acute Tularemia and not useful for patients with resolved infection. Tularemia can cause a wide spectrum of symptoms depending on exposure. People rarely can be infected through tick and deer fly bites, contact with infected animals, drinking contaminated water, or inhalation.

Antibodies against other bacteria, including Brucella, can cross-react with assays targeting Francisella. Therefore, positive serologic results should be interpreted in the context of clinical illness and exposure consistent with Tularemia infection. Antibodies can persist for years and IgM in a single sample is not a reliable indicator of recent infection. Positive IgG and IgM results can represent current, recent, or past infection since they can be detected for several years post infection. A negative result can occur early during acute infection, before the development of antibodies.

References:
1. Clinical Testing and Diagnosis for Tularemia, Centers for Disease Control and Prevention. https://www.cdc.gov/tularemia/hcp/diagnosis-testing/index.html Last updated May 15, 2024.
2. Jeannine M Petersen, and Elizabeth A Dietrich, 2023. 13.4 Detection of Francisella tularensis Antibodies, Leber AL, Burnham CD Clinical Microbiology Procedures Handbook, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781683670438.CMPH.ch13.4.
3. Maurin, Max. Francisella tularensis, Tularemia and Serological Diagnosis. Front Cell Infect Microbiol. 2020; 10: 512090.


Performing Laboratory
Quest Diagnostics



The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.