Non-CDC Options for Molecular and Serologic Testing for Parasitic Diseases

This list of resources should not be considered as any endorsement by ASTMH, CDC/Division of Parasitic Disease and Malaria, CLIA, any accrediting body, nor should it be considered comprehensive.

Outside of the CDC’s clinical laboratory, almost all testing for parasitic diseases in the United States is done by these five laboratories (with some additional labs as mentioned in listing below) on a fee-for-service basis:

• ARUP:  https://www.aruplab.com/testing
• Kephera Diagnostics: https://kephera.com 
• Mayo Clinic Laboratories:  https://www.mayocliniclabs.com/test-catalog
• Mt Sinai: email MMLdirectors@mountsinai.org
• Quest:  https://testdirectory.questdiagnostics.com/test/home
• National Reference Centre for Parasitology (NRCP): http://www.nrcp.ca *please contact prior to sending

When the CDC’s parasitic lab testing is unavailable, their experts are still available to provide advice on diagnosis or management of suspected cases of parasitic diseases; they can be contacted via the CDC’s Parasitic Diseases Hotline at (404) 718-4745 or e-mail parasites@cdc.gov.

SEROLOGY

Amebiasis (Entamoeba histolytica) serology

• Commercial Lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, and Quest
• Public Health/NIH Lab available: No
• Comment: Useful for extraintestinal, invasive disease only. Sensitivity is low for non-invasive disease, including amebic dysentery.
• International Lab: Yes (NRCP)

Chagas disease (Trypanosoma cruzi) serology

• Commercial Lab: Yes, all
• Public Health/NIH Lab available: Yes, TX DSHS (for patients living in Texas only)
• Comment: Commercial labs offering Chagas disease serologic tests include (In alphabetical order): ARUP, Labcorp, Kephera Diagnostics, Mayo Clinic Laboratories, and Quest Diagnostics.
  • Currently, Kephera Diagnostics, Mayo Clinic Laboratories, Mt Sinai, and Quest Diagnostics offer multi-step testing with different serological assays. All other reference labs perform only one immunoassay at this time (a positive result by at least two distinct immunoassays is needed to confirm a diagnosis of Chagas disease).
• International Lab: Yes (NRCP) 

Echinococcosis serology

• Commercial lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, and Quest
• Public Health/NIH lab available:  No
• International lab: Yes (Switzerland, NRCP)
  • University of Bern performs serologic and molecular testing for E. granulosus and E. multilocularis.  They also have a quadruplex real-time PCR that differentiates E. granulosus sensu lato, E. multilocularis and Taenia spp.  See IFIK Request Form for Diagnostic Parasitological Analyses

Fascioliasis serology

• Commercial lab: No
• Public Health/NIH lab available: None
• International Lab: Yes (NRCP)

Paragonimiasis serology

• Commercial lab: No
• Public Health/NIH lab available: No
• International Lab: Yes (NRCP)

Strongyloidiasis serology

• Commercial lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, and Quest
• Public Health/NIH lab available:  Yes, at some state public health labs
• International Lab: Yes (NRCP)

Schistosomiasis serology

• Commercial lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, Quest, University of Washington, but lower sensitivity for non-S. mansoni species. Immunoblot for species identification not available.
• Public Health/NIH lab available: Yes, at some state public health labs
• International: Yes (NRCP)

Babesiosis (microti) serology

• Commercial lab: Yes, ARUP, LabCorp, Mayo Clinic Laboratories, and Quest.
• Public Health/NIH lab available: Yes, at some state public health labs
• International Lab: Yes (NRCP)

Filariasis serology

• Commercial lab: Yes, Quest
• Public Health/NIH lab available: Yes. Contact CDC for instructions on sending specimens to NIH. NIH Laboratory of Parasitic Diseases (Fax: 301-480-5338) is CLIA approved for filaria serology.
• International Lab: Yes (NRCP)

Toxocariasis serology

• Commercial lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, and Quest
• Public Health/NIH lab available: No
• International Lab: Yes (NRCP)

Baylisascariasis serology

• Commercial lab: No
• Public Health/NIH lab available: No
• International Lab: Yes (NRCP)

Cysticercosis serology

• Commercial Lab: Yes (Quest offers an immunoblot assay, Kephera offers Triplex ELISA, ARUP offers ELISA only, Mayo Clinic Laboratories offers ELISA on serum only)
• Public Health/NIH lab available: No
• International Lab: Yes (NRCP)

Leishmaniasis serology (for visceral leishmaniasis)

• Commercial Lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, and Quest
• Public Health/NIH lab available:  No
• International Lab: Yes (NRCP)

Trichinellosis serology

• Commercial Lab: Yes, ARUP, Labcorp, Mayo Clinic Laboratories, and Quest
• Public Health/NIH lab available: No
• International Lab: Yes (NRCP)

Clonorchiasis serology

• Commercial Lab: Kephera Diagnostics
• International lab: Yes (Thailand)

Gnathostomiasis serology

• International Lab: Yes (NRCP, Swiss TPH, Mahidol)
  • Swiss TPH is at Diagnostic Centre at Swiss TPH | Expertise in Parasitic Diseases
  • Mahidol contact info: https://www.tm.mahidol.ac.th/helminth/services/

MOLECULAR/Culture/Other

Taenia solium Ag assay/qPCR of plasma and CSF

• Commercial Lab: No
• Public Health/NIH lab available: Yes. Contact CDC for instructions on sending specimens to NIH. NIH Laboratory of Parasitic Diseases (Fax: 301-480-5338) is CLIA approved for cysticercosis molecular testing.
• International Lab: Yes (NRCP)

Leishmania species identification (for cutaneous leishmaniasis)

• Commercial Lab: Yes, University of Washington-be sure to request species-specific PCR
• Public Health/NIH lab available: No
• International Lab: Yes (NRCP)

Chagas disease molecular detection

• Commercial Lab: Eurofins
• Public Health/NIH lab available: Yes (NY SPHL)
  • Comments: NY SPHL requires pre-approval from CDC. Contact Sue Montgomery.
• International Lab: Yes (NRCP)

Babesia molecular detection

• Commercial Lab: Yes, ARUP, Mayo, Lab Corp, and Quest.
• Public Health/NIH lab available: Yes, at some state public health labs
• International Lab: Yes (NRCP)

Filariasis – Knott’s concentration

• Commercial Lab: Yes, ARUP and Mayo

Strongyloidiasis – Agar Plate Culture

• Commercial Lab: Yes, ARUP (University of Utah and surrounding region only), Mayo (Mayo Clinic Minnesota and Wisconsin region only)

Malaria molecular identification

• Commercial Lab: Yes, ARUP, Labcorp, Mayo, and Quest
• Public Health/NIH lab available: Yes, at some state public health labs
• International Lab: Yes (NRCP)

Microsporidia molecular identification

• Commercial Lab: Yes, ARUP and Mayo
• Public Health/NIH lab available: Yes, at some state public health labs

Angiostrongylus cantonensis molecular detection

• Commercial Lab: Karius test, UCSF NGS (CSF)
• Public Health/NIH lab available: Hawaii SPHL
• Comments: NIH offers a research-use only assay for CSF

Trichomonas susceptibility testing

• Commercial Lab: No
• Public Health/NIH lab available: No
• Comments: University of Alabama Birmingham (UAB) is CLIA certified and can accept samples for testing.

Free-living Ameba molecular detection

• Commercial Lab: Yes
  • Culture: ARUP, Quest
  • Molecular: Mayo, University of Washington (Acanthamoeba and Balamuthia, only)
• Public Health/NIH Lab available: No

Toxoplasma molecular detection

• Commercial Lab: Yes (University of Washington), Mayo Clinic

Entamoeba histolytica molecular detection

• Commercial Lab: Yes, ARUP, Labcorp, and Mayo (as part of a multiplex GI pathogens panel)
• Public Health/NIH Lab available: No
• International Lab: Yes (NRCP)