Keep specimen at 4C
Respiratory specimen of choice is a NASOPHARYNGEAL ASPIRATE. Collect the aspirate in a leukens trap and immediately transport to Clinical Virology Laboratory. Refer to the Nursing Procedure Manual, Section VII, Respiratory Care, 7:14:a for complete instructions on the collection of a nasopharyngeal aspirate using a leukens trap. Nasal washings, tracheal aspirates, and bronchoalveolar lavage specimens may be submitted. Collection of COMBINED THROAT AND NASOPHARYNGEAL SWABS is recommended for patients in which aspirates or washings cannot be readily obtained. For collection of nasopharyngeal swab specimen: 1. Insert swab into one nostril. 2. Press swab tip on the mucosal surface of the mid-inferior portion of the inferior turbinate, and rub the swab tip several times across the mucosal surface to loosen and collect cellular material. 3. Withdrawal the swab; place swab into tube of Viral Transport Medium. For collection of oropharyngeal swab specimen: 1. Ask patient to open mouth widely and phonate an 'ah'. 2. Gently depress the tongue with a tongue blade. 3. Guide a swab over the tongue into the posterior oropharynx. 4. Using a gentle back-and-forth sweeping motion, swab the area behind the uvula and between the tonsillar pillars. 5. Withdrawal the swab; place swab into the same tube of Viral Transport Medium that contains the nasoparyngeal swab. Immediately transport to the Clinical Virology Laboratory.
Swab specimens not received in viral transport medium or received in bacteriological transport medium are discouraged. DO NOT USE CALCIUM ALGINATE OR WOODEN SHAFT SWABS FOR COLLECTION OF SPECIMENS; ONLY USE DACRON OR RAYON TIPPED SWABS ON PLASTIC OR METAL SHAFTS.
Amplification and detection of enterovirus RNA 5'-untranslated region using TaqMan real-time PCR technology. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
If positive, results are reported as enterovirus RNA detected.
Negative or no enterovirus RNA detected
Recovery of enteroviruses may be enhanced by collecting specimens from multiple different body sites. These may include CSF, urine, blood (serum or plasma), respiratory, stool, tissue (e.g., liver, myocardium), and sterile body fluids (e.g., pericardial fluid, pleural fluid). Cerebrospinal fluid (CSF) is the specimen of choice for detecting enteroviruses in patients with aseptic meningitis or other central nervous system (CNS) diseases. It is also recommended that urine and serum specimens be sent on all patients with CNS disease to increase the likelihood of finding an enterovirus. A positive result from any one of these specimens is diagnostic for enteroviral disease. Both urine and serum should be sent on neonates and other children that present with sepsis or acute nonfocal febrile illness. Please Note: positive results from respiratory and stool specimens do not always correlate with disease because of prolonged viral shedding. Positive results from these specimens should be interpreted accordingly. Please call the Clinical Virology Laboratory at extension 42050 for more information on requirements for specimen collection and handling.