Virology Studies

I.GENERAL COMMENTS

Obtain specimens as early in the patient's illness as possible. In immunocompetent hosts, viruses are usually recoverable only for a few days after onset of illness.

Specimen Recovery Time

Most specimens should be collected in a sterile container and/or appropriate transport media.   Store and transport most specimens for viral studies at 2-8°C (on ice or Viral Transport Boxes). Blood specimens should be sent at room temperature (18-25°C). See appropriate instructions for individual specimen types.

  1. Respiratory Specimens:
  1. Nasopharyngeal aspirates or washings:
    1. Introduce 1-3 mL nonbacteriostatic physiological saline into one or both nostrils.   Reaspirate the saline and nasal secretions using a suction catheter/trap.   Add a tube of UTM to the specimen. (Use a suction catheter size 6 or 8.)
    2. Store and transport to the laboratory at 2-8° C.
  2. Nasopharyngeal Swabs (use swab packaged with UTM or minitip swab [pediatric])
    1. Swab the posterior nasopharynx and any visible lesions with a plastic-shafted minitip swab. Immediately place swab into UTM.
    2. Store and transport to the laboratory at 2-8°C.     
  1. Throat Swab: Use swab packaged with UTM or plastic-shafted swab. Swab posterior pharynx and any visible lesions vigorously with a plastic-shafted swab. Immediately place the swab into UTM.  Store and transport to the laboratory at 2-8°C.

  2. Sputum: May be substituted for throat specimen in patients with lower respiratory disease, but it is considered an inferior specimen. Collect deep coughed or aspirated specimen as for bacteriological culture and add a tube of UTM. Discard swab packaged with UTM. Store and transport to the laboratory at 2-8°C.

  3. Tracheal or transtracheal aspirates/bronchial washes or brushes: Collect as for bacteriological culture and add or place in a tube of UTM. Discard swab packaged with UTM. Store and transport to the laboratory at 2-8°C.

B.       Gastrointestinal specimens:

  1. Stool: 5-10 g in sterile container (preferred specimen because of small number of viral particles present). Store and transport to the laboratory at 2-8°C.

  2. Rectal swab (use swab packagd with UTM): Collect with a plastic-shafted swab moistened with sterile saline and inserted into the anus until the cotton tip is no longer visible. Rotate 3-4 times. Immediately place swab into UTM. Store and transport to the laboratory at 2-8°C.

C.       Skin Specimens (Dermal or Genital):

  1. Vesicles or pox: Rupture lesion with a plastic-shafted swab (use swab packaged with UTM) scraping the base of the underlying ulcer to obtain both cells and fluid. Immediately place swab into UTM. Store and transport to the laboratory at 2-8°C.

    Alternate method: Aspirate fluid from the vesicle with a tuberculin syringe and eject into an equal amount of UTM.  Discard swab packaged with UTM. Store and transport to the laboratory at 2-8°C.

D.    Eye Specimens

  1. Conjunctival secretions: Use swab packaged with UTM to collect secretions from palpebral conjunctiva. Immediately place swab into UTM.   Store and transport to the laboratory at 2-8°C.

  2. Scrapings: This procedure may be performed by the Eye Department.  Place scrapings in UTM. Discard swab packaged with UTM. Store and transport to the laboratory at 2-8°C.
E.   Body Fluid Specimens:
CSF, pleural, peritoneal, synovial fluids or pericardial effusions: Collect specimen in sterile tubes according to established procedures; 1-2 ml should be obtained.  Add an equal volume of UTM.  Discard swab packaged with UTM. Store and transport to the laboratory at 2-8°C.

NOTE:  CSF for Herpes PCR - Collect a minimum of 1 ml in a sterile tube according to established procedures.  Store and transport to the laboratory at 2-8°C. Do not add UTM for this testing.
 
F.  Urine Specimens
Clean catch/catheterized/suprapubic:  Collect 10-50 ml fresh urine (preferably first catch morning specimen) in a sterile container as for bacteriological culture (5-10 mL is sufficient for pediatric patients). Store and transport to the laboratory at 2-8°C.
 
G. Tissue Specimens:
Autopsy, biopsy, or clotted bone marrow specimens: Collect approximately 1 cm3 piece of tissue when possible using sterile technique and place in a sterile container with UTM added.  Specimens: Respiratory (lung, trachea), CNS (brain, spinal cord), myocarditis (heart, pericardium), disseminated disease (liver, spleen, kidney, lung). Collect as soon as possible post mortem.  Smaller samples can be placed directly into UTM. Discard swab packaged with UTM. Store and transport to the laboratory at 2-8°C.
 
H. Blood Specimens for Cytomegalovirus (CMV Antigenemia):
Collect blood in EDTA. Collect two 2 mL tubes for neonates and two 6 mL tubes for other patients. Store and transport to the laboratory at room temperature.
 
I. Blood Specimens for Viral Culture (Herpes simplex,  adenovirus, enterovirus, measles)
Collect blood in EDTA tubes.  Collect two 2 mL tubes for neonates and two 6 mL tubes for other patients. Store and transport to the laboratory at room temperature.