Florida Bureau of Public Health laboratories
Influenza A H5 rt-pcr
BPHL has verified the FDA-approved Influenza A/H5 which is a qualitative real time reverse transcription polymerase chain reaction (rRT-PCR) test utilizing the CDC protocol to detect influenza A/H5 virus.
Analyte(s)
Influenza A/H5, highly pathogenic avian influenza (HPAI)
Test Code
9190
Testing Location
Testing Department
Virology
Pre-approval Required?
Yes. Requires prior approval from regional epidemiology and notification to the testing lab.
Contact the local county health department (CHD) to start the process for approval.
Required Forms
BPHL Test Requisition, DH1847
Include all required fields, who authorized the testing, onset date, collection date, travel history, and symptoms.
Turn around Time
48 business hours after receipt at the laboratory.
Unsatisfactory specimen
1) Swab with calcium alginate or cotton tips or with wooden shafts was used
2) Quantity not sufficient (QNS)
3) Specimen was not labeled with at least 2 unique patient identifiers
4) Information on specimen does not match requisition/test order
5) Specimen leaked in transit
6) Specimen was received out of the acceptable temperature range
Minimum Volume
At least 300 𝜇𝐿 (0.3 mL), but at least 1 mL is preferred
The collection swab should be placed into 1-3 mL of media at the time of collection.
Collection Media
Viral transport medium (VTM) or universal transport media (UTM) tubes using a synthetic tip, such as nylon or Dacron®, and an aluminum or plastic shaft.
Sterile leak-proof container
Special SPecimen Preparation
None
Specimen Labeling
Specimen must be labeled with at least two unique patient identifiers, e.g., name and DOB, and the date of collection.
Information on the specimen must match the requisition and/or test order.
Specimen Sources
Individuals with respiratory symptoms:
• Nasopharyngeal swab (NP) in viral transport media (VTM) or universal transport media (UTM) tubes
• Combined nasal swab (NS) and oropharyngeal swab (OP) (e.g., two swabs in one VTM or UTM tube)
Individuals with Conjunctivitis (with or without symptoms):
• Conjunctival swabs (please collect two swabs, each in separate VTM or UTM tubes) *This must be collected with paired NP swab
• Nasopharyngeal swab (NP) in VTM or UTM tube
Individuals with severe respiratory disease (also collect lower respiratory tract specimens):
• Endotracheal aspirate (in sterile leak-proof container)
• Bronchoalveolar lavage fluid (in sterile leak-proof container)
Storage Conditions
Store specimens at 2-8° C until shipment
If specimens will not be shipped same day and longer storage is needed, specimens can be stored at ≤-20° C
Packaging and Shipping
Specimens must be shipped overnight at 2-8° C. You must select “Saturday delivery” on packages shipped on Friday.
Separate multiple specimens into different biohazard bags (preferred). Paperwork should be placed in the outer pocket of the biohazard bag in case of leaks.
If a specimen is frozen at ≤-20° C, ship overnight on dry ice (do not let the specimen thaw)
Couriered samples must be transported in a cooler with frozen ice packs to arrive at the laboratory between 2-8° C. Laboratory staff will check the temperature of the cooler upon arrival before accepting specimens.
Interferences and Limitations
Swabs with calcium alginate or cotton tips or with wooden shafts, can result in inactivation of some viruses and inhibit some molecular assays.
Conjunctival swabs are not verified at BPHL as an acceptable specimen type at this time, therefore results will be reported with a disclaimer indicating results CANNOT be reported to the patient and CANNOT be used for diagnosis. The results are ONLY for public health purposes. When the verification is completed, the disclaimer will be removed.
Reference Range
Not detected for Influenza A/H5
Result Indicator
Presumptive Positive for Influenza A/H5
Inconclusive for Influenza A/H5
Not detected for Influenza A/H5
Reference Lab
CDC, if needed
Reflex Testing
None