Testing for a coxsakie and enterovirus

Hip

Senior Member
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18,109
As the first port of call on the roadmap it is a bit of a roadblock, since the options for this test for Europeans are almost non-existent - unless everyone is just using the exorbitantly priced america tests (is that what everyone is doing?)

It is very difficult to get enterovirus testing done. There was an excellent lab in the Netherlands which did a coxsackievirus B neutralisation test for just over €100, and accepted blood samples from abroad, but they discontinued their neutralisation test some years back, replacing with a complement fixation test, which is insensitive for chronic infections.

Neutralisation tests involve a lot of work for the lab, which is why most labs prefer to offer CFT or ELISA, which are easier to perform.


I believe for those in the US, if you get your ARUP tests through Any Lab Test Now, it's cheaper, something like $200, if I remember correctly (@sometexan84 will know). But I don't think there is any way to go via ALTN from the UK.

Other options to explore are Fleury Lab in Sau Paulo, Brazil, who offer a coxsackievirus B antibody neutralisation test for around $100. It would be straightforward to get a 3 day international courier to send blood serum samples to Brazil. But you would have to contact them and see if they accept samples from abroad.

And the Torlak Institute of Virology, Vaccines and Sera in Serbia have a neutralisation test for coxsackievirus B1 to B5 costing €200. Again you would have to contact them to check if they accept samples from abroad.


I once contacted the lab director of RedLabs in Belgium, who specialise in ME/CFS tests, to see if they were interested in offering an enterovirus neutralisation test, explaining that this is important for ME/CFS patients. But they showed little interest. If enough patients contacted them, perhaps they could be persuaded to offer an enterovirus test.
 
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Guwop2

Senior Member
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269
I believe for those in the US, if you get your ARUP tests through Any Lab Test Now, it's cheaper, something like $200, if I remember correctly (@sometexan84 will know). But I don't think there is any way to go via ALTN from the UK.

Other options to explore are Fleury Lab in Sau Paulo, Brazil, who offer a coxsackievirus B antibody neutralisation test for around $100. It would be straightforward to get a 3 day international courier to send blood serum samples to Brazil. But you would have to contact them and see if they accept samples from abroad.

And the Torlak Institute of Virology, Vaccines and Sera in Serbia have a neutralisation test for coxsackievirus B1 to B5 costing €200. Again you would have to contact them to check if they accept samples from abroad.

I will look into those options, though a trip to athens isnt out of the question.
I presume you had these tests done, though perhaps some time ago, may I ask where you went for them?
 

Hip

Senior Member
Messages
18,109
I presume you had these tests done, though perhaps some time ago, may I ask where you went for them?

I got my coxsackievirus B test done at a great lab in the Netherlands (UMC Utrecht) which offered a CVB neutralisation test for just over €100. Shipped my blood serum to them from the UK. But they unfortunately stopped doing that neutralisation test, replacing it with a CVB complement fixation test, which is easier for the lab to do, but is not sensitive for chronic infections.
 

Cipher

Administrator
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1,186
I live in the UK and have been looking into getting the Coxackievirus B & Echovirus tests done as per the treatment roadmap and have discovered that IMD Berlin doesnt do the neutralisation tests anymore and the Institute of Medical Virology doesnt offer this service to people not referred to them by a doctor

While they've told that patient that they need a doctor's order, in practice they don't check if the sender is a doctor, nor is it a written requirement on the request form. I've sent a serum sample to them for testing, and I know two others who have also had success. As long as the request form is correctly filled out there hopefully shouldn't be any issues. If you write your e-mail address on the request form they can send the test results via e-mail. The invoice came via post if I recall correctly.

You'll need to find a local lab that's willing to draw the blood and separate the serum for you. There are special shipping rules when it comes to blood samples which you can read more about here. I've sent packages labeled as "Exempt human specimen" successfully using FedEx. You can get a 40% discount on all shipments if you register a FedEx account.

Including a HS code in the customs declaration is preferable when sending packages internationally. You can find the destination country's specific HS codes using this tool.
 

Lolinda

J'aime nager dans le froid style Wim Hof.. 🏊‍♀️🙃
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432
While they've told that patient that they need a doctor's order, in practice they don't check if the sender is a doctor, nor is it a written requirement on the request form.

Hello everybody who has sent in samples for the enterovirus neutralization test in Frankfurt:
There are two fields for names in the German request form:
-- the name of the doctor ("Einsender-Adresse")
-- the name of the patient ("Patient-Identifikation").
Did you write both times your own name? or did you leave one empty? or did you invent a doctor's name or a patient's name and wrote your own into the other field?
thanks a lot for experiences! :)

@Canned @green_echo @Markus83

and does anyone have experiences with antivirus neutralization testing at the Czech national lab (https://szu.cz/en/expert-centres-and-departments/centre-for-epidemiology-and-microbiology/) as per Hip's roadmap? (https://mecfsroadmap.altervista.org/)

MY EXPERIENCES SO FAR WITH THE CZECH LAB FOR ENTEROVIRUS NEUTRALIZATION TESTING:
I exchanged emails with them and from how they answer the questions, they have one person who speaks English but they are not very professional. And really reluctant to give any information at all. That well-known feeling I had in another East European country when interacting with underpaid state employed doctors: demotivation everywhere. (The first answer was essentially just send in the serum to our address and it will be fine :D :D. But then, when I have asked more, it turned out that they actually do have further information, for example that I need to specify the laboratory so the sample arrives at the right place within the big institution. And they seriously told me that I have to send samples frozen. Yes, I do know how to get that done and I have already done it ... but if the Frankfurt lab doesn't require frozen samples then I doubt it is needed in order to measure the exact same thing in Prague... But in the end, it's not the quality of the emails but the lab quality that counts. And that I cannot judge. And if sending frozen samples on dry ice helps with accuracy then I am happy to do it: I find very high accuracy utmost important because I wish to retest after interventions, and small improvements should become visible. On the positive side, the Czechs confirmed the price of 130$ for the entire panel. Even if I add a 100 bucks or so for the courier to be there next day (ordinary post to Prague is really too slow within Europe) it is very tempting compared to the price of 410€ for the entire panel in Frankfurt (the panel contents are not much different. among the viruses that Dr Chia finds in his CFS patients, both have all except that Frankfurt has the EV9 which Prague does not have. Now, back to the email exchange, most frighteningly, my email exchange was not with some secretary (which I would tolerate if she was clueless), but with a lab doctor (Dr R...ová). What I also strongly disliked, that in several occasions, she avoided answering questions. for example, I asked if sending samples frozen is really needed, and I stressed that it would be for me very important to know how others within the Czech Republic send in samples and she didn't answer, just said that well then send non frozen... I mean hello, in a professional lab they simply would do a test to find out what is really needed: let the sample sit in a shelf for some days and repeat the measurements and see if the test still measures the same as initially or not. Such tests need to be done, it's not a matter of negotiation with the client and it's not okay to simply always demand the maximum, to send in everything frozen on dry ice....
-> While I'm very still interested in other's experiences, I ditched the Czech lab for this round of testing and will pay the much higher price in Frankfurt.
 
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Cipher

Administrator
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1,186
Did you write both times your own name? or did you leave one empty? or did you invent a doctor's name or a patient's name and wrote your own into the other field?
thanks a lot for experiences! :)
Since "Einsender-Adresse" just translates to "sender address" I just put my own name/adress, and it worked.
 
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Lolinda

J'aime nager dans le froid style Wim Hof.. 🏊‍♀️🙃
Messages
432
Since "Einsender-Adresse" just translates to "sender address" I just put my own name, and it worked.
so you put both times the same name + same street address, right?
(PS: I do speak German. But having quite some experience with German labs, for example IMD and Ganzimmun, I almost can't believe it that the guys in Frankfurt would be so easy going. That's why I double ask for double security ("Doppelt gemoppelt hält besser!" :D). Ganzimmun accepts me on special permission from one of the lab heads.. I talked science to her until she succumbed :D. IMD does not accept, though I didn't try hard)
 
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Messages
99
There are two fields for names in the German request form:
-- the name of the doctor ("Einsender-Adresse")
-- the name of the patient ("Patient-Identifikation").
Did you write both times your own name? or did you leave one empty? or did you invent a doctor's name or a patient's name and wrote your own into the other field?

I did put the name of my doctor in the form. But i didn’t send it. I did it together with my doctor. A nurse came to my home took blood, centrifuged it in my doctors lab. Then a family member drove to Frankfurt to deliver the serum to the lab. Quite an act..

I would just write your name in both if you do it alone.
 

Lolinda

J'aime nager dans le froid style Wim Hof.. 🏊‍♀️🙃
Messages
432
@Canned and @Cipher and everybody else:

Did you get a biopsy tested for enterovirus? if so, where? and using which testing method? I would love to take a test available in Europe for an immunoperoxidase staining for enterovirus VP1 like the one performed in Dr Chia's landmark study.

And thank you guys for the advice on filling in the form! I have sent serum to Frankfurt.
Canned: cool name!! - it pretty much expresses my own feeling with being sick... like being a fish, canned half-alive, not able to break out of my invisible can...

As for biopsies, if anyone interested, Redlabs in Belgium does test for all kinds of viruses in biopsies using PCR, including for enterovirus. But that test is less valid compared to VP1 immunoperoxidase staining, as shown by the study cited above (PCR found enterovirus
in 37%, while VP1 staining found it in 82%). Also, I did have that test in the wrong specimen: a biopsy of the duodenum. As Chia found that the enteroviruses persist in the parietal cells, testing the duodenum is not so useful as there are not many parietal cells :D (having said that, enterovirus has been found in individual patients in various places, such as the end of the ileum or the bone marrow in this study)

1000000048.jpg
 
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Messages
99
Did you get a biopsy tested for enterovirus? if so, where? and using which testing method? I would love to take a test available in Europe for an immunoperoxidase staining for enterovirus VP1 like the one performed in Dr Chia's landmark study.

And thank you guys for the advice on filling in the form! I have sent serum to Frankfurt.
Canned: cool name!! - it pretty much expresses my own feeling with being sick... like being a fish, canned half-alive, not able to break out of my invisible can...
Thank you :) ! Good luck with the testing!

Yes i tried to get a biopsy tested last year. I had a gastroscopy because of stomach problems. The doctor was a family friend and I told him about my EV titers, showed him the Chia study and ask if these EVs could be responsible for my gastro problems. He took a biopsy and asked the lab to test it for the viruses. They checked for inflammation, didn’t found any and said no inflammation=no EV.

I guess Chias method of testing for VP1 is not a standard method and can’t be done in a normal pathology lab.

But this year I had a colonoscopy and they found inflammation in the biopsies. They even said, it actually looks like it’s caused by a viral infection.

Anyway, I would not recommend a gastroscopy with severe ME and no sedation. It’s quite awful.
 
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Hey @Lolinda . Did you do the Test in Frankfurt? If yes, do you have positive results?

Ich Frage mich, ob sich das Testen von Coxsackie und enteroviren überhaupt lohnt. Liebe Grüße
 
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20
@kalles I may be in the same boat as you. I'm wondering whether testing for coxsackie and enteroviruses would be worth it for me. If it's really around 400 Euro for the entire panel it's a lot of money.
 
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