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Tuberculosis
The laboratory takes pride in offering rapid, accurate and quality TB testing. The majority of testing for TB specimens in Westchester County is performed in this laboratory. First line drug susceptibilities for M. tuberculosis using radiometric procedures, identification of all clinical Mycobacterium species and 24 hour turn-around time for smears, are all key functions of this laboratory. With the increase in immunocompromised individuals and their risk of acquiring TB, the vigilance for TB monitoring has increased considerably. Drug resistant TB has a potential of causing a great harm to public health. Early detection and follow up has enabled the County to regain control of this disease and reverse the increase in incidence. The TB laboratory testing service is provided free to all Westchester County residents. For additional information or questions, contact (914) 231-1757.

HIV
HIV infection remains a great public health threat in the United States. Although newer anti HIV drugs are becoming available, the need for testing for HIV remains very high. This laboratory performs HIV screening (ELISA) and confirmatory (Western Blot) tests with a quick turn-around time. Patient confidentiality is maintained to conform to New York State laws and guidelines. Specimens may be submitted for confidential testing. Specimens will be accepted only through physician’s referral and after proper counseling. The new HIV viral load tests to monitor the effect of drug therapy and disease progression will be available soon.  For additional information or questions, contact (914) 231-1760.

Syphilis
The laboratory serves as the reference center for diagnosing syphilis in Westchester County. Syphilis testing is performed using RPR/VDRL methods for screening and TPPA/FTA-ABS for confirmation. These tests are performed either on serum or CSF specimens. All patient results and demographic data are stored in the LIMS and statistical reports are generated for Westchester County Health Department to help control this disease in the County. For additional information or questions, contact (914) 231-1758.

Gonorrhea
Gonorrhea remains one of the leading sexually transmitted diseases. This infection is symptomatic in both male and females. Gonorrhea tests are performed by culture and DNA probe procedures. Slides are also accepted for the identification of gram negative diplococci for symptomatic males. The laboratory serves as the reference center for the diagnosis of gonorrhea in Westchester County. The laboratory also helps Westchester County Health Department in tracking this disease for implementing control measures.  For additional information or questions, contact (914) 231-1759.

Chlamydia
Chlamydia trachmatis is one of the most common organisms associated with sexually transmitted diseases. Most infected individuals carry the organism asymptomatically and spread it unintentionally by sexual contact. The laboratory performs Chlamydia DNA probe screening and culture isolation tests. Statistical reports are generated for monitoring the incidence in the population at risk. The data is shared with Westchester County Health Department for disease tracking among individuals at risk.   For additional information or questions please contact (914) 231-1759.

Herpes
Herpes Simplex virus is the most common virus isolated in the laboratory.  Most people have latent infection of HSV.   It is usually acquired as a primary infection during childhood or adolescent stage. It is often transmitted by sexual contact. Both Herpes Simplex type 1 and type 2 are detected by smear test from a lesion or by culture isolation and shell vial tests. Generally the results are reported within 24-48 hours. Pregnant women with active genital Herpes can pass the infection to the new-borne causing life threatening complications. Herpes Simplex viruses are also associated with non genital infections. For additional information or questions please contact (914) 231-1760.

Giardia
Giardia duodenalis is a flagellate that inhabits the intestinal tract. Giardiasis is acquired by ingestion of the parasite most commonly through a contaminated water supply. The incubation period varies from a few days to a few weeks. Diagnosis is generally established by submission of a stool specimen to the laboratory for microscopic testing. Results are provided within a few hours. Three specimens over a five day period are necessary to rule out Giardiasis. For additional information or questions please contact (914) 231-1759.

Cyclospora
Cyclospora is a newly discovered coccidia that has received much public attention through media reports in the past. Epidemiologic investigations have implicated imported raspberries as the vehicle for its transmission in certain parts of the U.S. This organism still has an unknown lifecyle. It causes severe watery diarrhea. Specimens submitted for detection of Cyclospora are tested by microsopic examination using a direct wet mount, concentrated wet mount and modified acid fast stain. We serve as the reference laboratory for area hospitals in the diagnosis of this parasite and collaborate with CDC in the investigation of outbreaks. For additional information or questions please contact (914) 231-1759.

Cryptosporidium
Waterborne outbreaks of Cryptosporidium have become an increasing public health problem. Untreated surface water, some public water supplies and contaminated wells have been associated with this parasite. Farm animals have also been associated with large outbreaks. This parasite is acquired by ingestion of the oocysts. Laboratory detection is accomplished from stool examination by wet mounts, modified acid fast stain, immunofluorescense, and ELISA methodologies. All stool specimens submitted for parasitology in our laboratory are tested for this organism by wet mount as well as the more sensitive direct immunofluorescent procedure. Most often, Cryptosporidiosis is self-limiting. In the very young, old or immunocompromised, the disease could be more serious. For additional information or questions please contact (914) 231-1759.

Influenza
Rapid tests are performed to diagnose Influenza A and Influenza B viruses to control the spread of influenza in the community. Culture tests are performed to confirm the presence of Influenza and other respiratory viruses. Influenza virus identifications are conducted in collaboration with CDC and WHO for the prevalence of new strains in the area. The testing for 2009 pandemic H1N1 (swine flu) was immediately implemented using PCR and culture to manage the H1N1 pandemic. The data is shared with the county, state and federal agencies for epidemiologic investigations; and for the formulation of vaccines in the following years. Culture tests are also performed for the isolation of Influenza A, B and C viruses. For additional information or questions please contact (914) 231-1760.

Food-borne Illnesses
Salmonella, Shigella, Listeria, Camplylobacter, Vibrio, Cycoclospora, E. coli 0157:H7 are a few of the pathogens tested in food-borne outbreaks. The illnesses these organisms cause are seen sporadically throughout the year. Most of these organisms are passed to individuals by improper food handling or poor hygiene. As a result food becomes contaminated and are ingested resulting in food-borne illness. When food-borne outbreaks are suspected, specimens are submitted for testing. In collaboration with Westchester County Health Department, an investigation will occur to find the cause and extent of outbreak. Often stool specimens from those infected or suspected carriers are submitted to help determine the initial index case and source of contamination. This laboratory has the expertise and provides a leading role in identifying Cyclospora and work in conjunction with NYSDOH and CDC in investigating recent outbreaks. Food samples are also tested for agencies outside the County of Westchester. A list of pathogens tested are available by calling the laboratory. For additional information or questions please contact (914) 231-1610.

Other Bacteria
The laboratory provides comprehensive diagnostic services for all pathogenic bacteria, including bacteria not routinely cultured or isolated in most hospital laboratories. Examples are: Legionella, Mycoplasma, Ureaplasma, Brucella, Bordetella, Haemophilus ducreyii etc. Thus this laboratory serves as the reference laboratory for area hospitals and physicians. For further information and specimen submission, refer to the Laboratory Handbook. For additional information or questions, contact (914) 231-1759.

Other Viruses
The laboratory performs rapid direct detection tests for HSV, RSV, Adeno 40/41, Rota and Influenza A and B viruses and culture isolation tests for other viruses such as: Adenoviruses, Respiratory viruses (Influenza, Parainfluenza, RSV, Rhinoviruses), Enteroviruses (Polio, Coxsackie, Echo), Measles, Mumps, Rubella, CMV, VZV etc. All tests are performed by highly skilled technologists with state-of-the-art techniques. For further detail and specimen requirements, refer to the Laboratory Handbook. For additional information or questions please contact (914) 231-1760.

Other Parasites
A variety of other parasites in addition to Giardia, Cyclospora and Cryptosporidium are diagnosed in our laboratory. These parasites are detected using current laboratory methods of wet mounts and permanent stains. They are seen most often in immigrants and travelers but can also be seen in the general population. Some of these parasites include: Ascaris lumbricoides(roundworm), Trichuris trichiura (whipworm), Necatur americanus (hookworm), Taenia sp. (beef tapeworm), Diphyllobothrium latum (fish tapeworm), Hymenolepsis nana (tapeworm), Entaemoeba histolytica (amebiasis) and Enterobius vermicularis (pinworm). For additional information or questions please contact (914) 231-1759.

Fungi (yeasts and molds)
There are thousands of known species of fungi however, only a few cause human disease. Most are limited by human defense mechanisms but could become more serious if they invade the skin and subcutaneous tissue. Immunocompromised individuals are at a higher risk of acquiring fungal infections. Some species are inhaled or become systemic causing serious disease. Identification of fungi are based upon colonial and microscopic morphology. Additionally, nutritional requirements, fermentation, assimilation and some biochemical tests assist in identification. Most commonly, yeast infections are seen followed by dermatophytes (infection of the skin, hair and nails). The laboratory is equipped to identify most clinical isolates. For additional information or questions please contact (914) 231-1610.

Water Pathogens
The laboratory performs testing for bacterial pathogens such as Legionella, Salmonella, Campylobacter and Mycobacterium avium that may be present in water. Such organisms in water have the potential of causing major outbreaks of public health significance. The laboratory provides this service to hospitals, industries and public health agencies in the area. For submission of appropriate water samples please call the Microbiology Laboratory at 914-231-1610.

Diagnostic Immunology
Diagnostic assays such as ELISA and IFA are performed for detection of antibodies ( IgG & IgM ) to various infectious agents. The presence of antibodies generally indicate, recent or past exposure to infection, or response to vaccination. The assays are performed for CMV, Chlamydia, EBV, HSV, Legionella, Measles, Mumps, Mycoplasma, Rubella, Toxoploasma, Parvovirus and Varicella (chicken pox). ELISA and Western Blot assays are performed for detection of antibodies to HIV.  RPR/VDRL and FTA - ABS tests are performed for detection of syphilis.  Heterophile antibodies are detected by hemagglutination test. For additional information or questions, contact (914) 231-1760.