Transport the specimen to the Microbiology laboratory (6004 BT) immediately on ice or refrigerate. From 2245 to 0700, deliver specimen to Specimen Control (6240 RCP) on ice. If the tube system is used, ensure specimens are in leak-proof containers that are securely closed and double bagged. Do not send traps through the tube system

Collect nasopharyngeal swab in viral transport medium (33595). Alternatively, collect tracheal aspirate, bronchoalveolar lavage, bronchial wash, or nasopharyngeal wash/aspirate in sterile, leak-proof container. Nasopharyngeal swab: Collect specimen using the flexible minitip flocked swab (Hospital Stores #33595). A. Measure the distance from the patient's nostril to the nasopharynx (half the distance from nostril to base of the ear) and hold the swab at that location. Do not advance the swab beyond that point. B. Gently insert the swab along the base of one nostril (straight back, not upwards) and continue along the floor of the nasal passage until reaching the nasopharynx. C. Rotate swab 2-3 times and hold in place for 5 seconds. Place swab in tube containing viral transport medium. Break off the excess length of swab at the score mark to permit capping of the tube. Nasopharyngeal wash/aspirate: A. Assemble equipment: Sterile specimen trap Personal Protective Equipment (gloves, surgical mask, eye protection) Appropriate size suction catheter (8 fr for infants/children, 10/12 fr for adults) Normal saline vial Wall suction Bag or cup of ice for specimen transport to laboratory B. Place patient with the head tilted slightly back. C. With sterile gloved hand, insert suction catheter into the patient's nose to the depth of the nasopharyngeal area (beyond the turbinates). Do not remove catheter until end of procedure. (see diagram) D. With the non-sterile gloved hand, instill approximately 1-2 mL normal saline outside the catheter. E. Apply suction to aspirate nasopharyngeal secretions. F. Above steps may need to be repeated to obtain 1 mL sample in specimen trap. G. Remove catheter from patient. With specimen trap still in-line, rinse catheter with remaining saline to clear secretions. H. Specimens transported by tube system must be transferred from trap to a leak-proof sterile container (be sure the lid is tightly secured).

This PCR assay tests for eight respiratory viruses: Influenza A (including H1N1), influenza B, parainfluenza viruses 1, 2, 3, adenovirus, respiratory syncytial virus (RSV), and human metapneumovirus. Human metapneumovirus is a recently identified (2001) respiratory virus related to RSV. Its clinical manifestations are also similar to that of RSV and ranges from mild upper respiratory infections to bronchiolitis and severe pneumonia.