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

Posted 16 April 2024

Note: Since this information was first posted in April 2022, the CDC Parasitic Lab has completed its resumption phase. The full list of tests available is listed on the CDC Test Directory page.

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.

Almost all testing for parasitic diseases in the United States is done by three commercial laboratories associated with medical schools on a fee for service basis. Almost all smaller private reference labs send their parasite diagnostics onwards to one of these 3 labs.

ARUP: https://www.aruplab.com/testing
Kephera Diagnostics: https://kephera.com
Mayo: https://www.mayocliniclabs.com/test-catalog
Quest: https://testdirectory.questdiagnostics.com/test/home

For assistance with diagnosis or management of suspected cases of parasitic diseases, contact CDC’s Parasitic Diseases Hotline at (404) 718-4745, or e-mail [email protected].

NIH Laboratory of Parasitic Diseases (Fax: 301 480 3757) is CLIA approved for filaria serology and cysticercosis molecular testing.
Canada (National Reference Centre for Parasitology; NRCP) https://www.mcgill.ca/tropmed/services/national-reference-centre-parasitology

States that they have limited capacity to continue to fulfill requests to test U.S. specimens but has performed some testing for individual submitters including:

Serology: Chagas, human African trypanosomiasis, trichinellosis, echinococcosis, fascioliasis, strongyloidiasis, schistosomiasis, filariasis, toxocariasis, baylisascariasis, cysticercosis, trichinellosis;

Molecular detection: echinococcosis, cutaneous leishmania species identification, Chagas disease, human African trypanosomiasis Babesiosis.

Switzerland: Parasitology Laboratory, Institute of Infectious Diseases, University of Bern have multiple antigen, antibody and PCR testing abilities for multiple helminths and protozoa. See IFIK Request Form for Diagnostic Parasitological Analyses

SEROLOGY
Fascioliasis serology

Commercial lab: None
Public Health/NIH lab available: None

Echinococcosis serology

Commercial lab: Yes
Public Health/NIH lab available: No
International lab: Yes (Switzerland)
- 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

Paragonimiasis serology

Commercial lab: None
Public Health/NIH lab available: No

Strongyloidiasis serology

Commercial lab: Yes, all above
Public Health/NIH lab available: No

Schistosomiasis serology

Commercial lab: Yes all, but no western blot for speciation
Public Health/NIH lab available: No

Malaria serology

Commercial lab: None
Public Health/NIH lab available: No

Babesiosis serology

Commercial lab: Yes
Public Health/NIH lab available: No

Filariasis serology

Commercial lab: Yes
Public Health/NIH lab available: NIH is CLIA approved. Request form prior to submission.

Toxocariasis serology

Commercial lab: Yes
Public Health/NIH lab available: no

Baylisascariasis serology

Commercial lab: None
Public Health/NIH lab available: No

Cysticercosis serology

Commercial Lab: Yes
Public Health/NIH lab available: No

Leishmaniasis serology (visceral leish)

Commercial Lab: Yes
Public Health/NIH lab available: WRAIR lab but restricted to recent Afghan evacuees and only until September 30. Unable to test other civilians.

Trichinellosis serology

Commercial Lab: Yes
Public Health/NIH lab available: No

MOLECULAR
Neurocysticercosis Ag assay/qPCR

Commercial Lab – No
Public Health/NIH lab – Yes, NIH has T.solium Ag assay and qPCR testing (both CLIA approved) in plasma and CSF. On CSF, these assays helpful for monitoring the treatment of subarachnoid NCC patients. For NCC consults and qPCR testing, contact Dr. Elise O’Connell.

Leishmania species identification (cutaneous leish)

Commercial Lab: Yes, but not species specific (U Wash)
Public Health/NIH lab available: Yes, (1) NY State PHL (NY residents only) (2 species), (2) WRAIR Research Lab for Afghan evacuees until September 30 (genus Leishmania by PCR and Species Identification for more than 20 species using culture/CAE)

Chagas disease molecular detection

Commercial Lab: No
Public Health/NIH lab available: Yes (NYSPHL)
- Comments: NYSPHL requires pre-approval from CDC. Similar to CDC process.

Babesia molecular detection

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

Malaria molecular identification

Commercial Lab: Yes
Public Health/NIH lab available: Yes. Widely available from commercial labs and select state health departments. Also available in other countries but unknown which specific labs.

Microsporidia molecular identification (not parasitic)

Commercial Lab: No
Public Health/NIH lab available: No

Angyiostrongylus cantonensis molecular detection

Commercial Lab: Karius test
Public Health/NIH lab available: Hawii SPHL (research only)/NIH research only on CSF

Trichomonas susceptibility

Commercial Lab: No
Public Health/NIH lab available: No
Comments: University of Alabama Birmingham (UAB) is working on this but unclear if they are yet CLIA approved (possibly for research only)