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COVID-19, Influenza A/B, and RSV by PCR (Southeast and Southeast Michigan Only)

Flu A, Flu B, Influenza A, Influenza B Virus, RSV, Respiratory Syncytial Virus, URI, ILI, Wuhan, PCR, RT-PCR, Coronavirus, 2019-nCoV, COVID-19, SARS, Novel coronavirus

Test Codes

Influenza and RSV by PCR: EPIC: LAB1231142
Influenza A/B by PCR: EPIC: LAB3255 (West and Southeast Michigan Only)
Respiratory Syncytial Virus (RSV) by PCR: EPIC: LAB1231053 (Southeast Michigan Only)
COVID-19 by PCR: EPIC: LAB1230607

Department

Microbiology

Instructions

• RVP, Flu, RSV, and Covid swabbing should be performed at physician office.
• Please see instructions for Nasopharyngeal (NP) Swab Collection.

Specimen Collection Criteria

Collect: Nasopharyngeal (NP) Swab in viral transport medium (UVT, UTM).

• NP swabs should be held in the nasopharynx for 30 seconds and rotated.
• Transport specimen to the Laboratory immediately after collection.

Physician Office/Draw Specimen Preparation

Arrange for transport to the Laboratory immediately. Maintain NP Swab in viral transport medium (UVT, UTM) refrigerated (2-8°C or 36-46°F) for transport.

Preparation for Courier Transport

Transport: NP Swab in viral transport medium (UVT, UTM) refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Bloody specimens.
• Specimens submitted on dry swabs.
• Specimens submitted on cotton or calcium alginate swabs, or on wooden shaft swabs.
• Contaminated media (e.g. yellow in color or contain black particles).

Inpatient Specimen Preparation

Transport specimens to the Laboratory immediately after collection.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 8 Hours
Refrigerated (2-8°C or 36-46°F): 7 Days
Frozen (-20°C/-4°F or below): 30 days

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Dearborn Microbiology Laboratory
Farmington Hills Microbiology Laboratory
Grosse Pointe Microbiology Laboratory
Lenox Main Laboratory
Livonia Main Laboratory
Royal Oak Clinical Microbiology Laboratory
Taylor Microbiology Laboratory
Trenton Microbiology Laboratory
Troy Microbiology Laboratory
Wayne Microbiology Laboratory

Performed

Sunday – Saturday, 24 hours a day.
Batch tested once per day.
Routine results available within 24-48 hours.

Reference Range

Negative.

Test Methodology

Nucleic Acid Amplification (FDA Approved).

Interpretation

These assays determine the presence of influenza A, influenza B, Respiratory Syncytial Virus (RSV), and Covid-19 in a respiratory specimen. Nucleic acid amplification testing is the optimal diagnostic modality for detection of respiratory viruses. The sensitivity of this test is greater than 97% as compared to culture.

Clinical Disease

• Influenza moves rapidly throughout the population each winter, causing more than 20,000 excess deaths, principally in the elderly, the immunocompromised, and in patients with chronic lung or kidney conditions (1). In these populations, influenza can also cause polyneuritis, encephalopathy, and inflammation of cardiac and skeletal muscles. Reye's syndrome may also occur after influenza infections.
• Influenza virus causes acute respiratory tract disease characterized by an abrupt onset of fever, chills, headache, and myalgia. Coryza, sore throat, and cough are typical of the disease and these symptoms are often severe and prolonged. In healthy adults, the disease is usually self-limiting and typically resolves within a week.
• RSV infection is more prevalent in infants and toddlers and is a leading cause of hospitalization in this age group, but RSV also causes disease that can be severe in certain populations. In infants and young children, RSV disease can range from cold-like illness, bronchitis, or croup to lower respiratory infections such as bronchiolitis and pneumonia. In adults, symptomatic infection usually presents as an upper respiratory tract illness with runny nose (rhinorrhea), sore throat (pharyngitis), and cough, with some patients also complaining of headache, fatigue, and fever. High-risk adults, such as those with certain chronic illnesses or immunosuppression, may have more severe disease, such as pneumonia.
• Symptoms of SARS-CoV-2 (CoVID-19) infection are similar to those of other respiratory viruses that occur seasonally in the winter and include:

-  Fever
-  Dry cough
-  Fatigue
-  Shortness of breath
-  Sore throat
-  Chills
-  Pneumonia

Epidemiology

Influenza generally spreads through a population in an epidemic fashion and at least 10 global pandemics have occurred during the past 200 years. Most cases of influenza occur in the winter and early spring (January through April) with peak incidence in January and February. Influenza A causes major epidemics at 2-3-year intervals (1). RSV is present yearly, showing up in the early fall and causing morbidity until late spring.

The 2019 novel Coronavirus SARS-CoV-2 was identified as the cause of an outbreak of respiratory illness first detected in December 2019 near Wuhan City, Hubei Province, China. As this is an emerging pathogen, the incidence and distribution of the virus in the US and world-wide is constantly evolving. Currently, SARS-CoV-2 cases in the US include those that are associated with travel, cases among close contacts of known cases and community-acquired cases where the source of the infection is unknown.

Incubation Period

The incubation period for Influenza A/B and RSV is 18-70 hours. Patients are infectious one day before the onset of symptoms and for 3-4 days thereafter. Infants may shed virus for longer periods of time (1).

According to estimates from the World Health Organization (WHO), the incubation period for SARS-CoV-2 ranges from 2 – 14 days with a median incubation period of 5 days.

Transmission

These viruses are very contagious and are transmitted through inhalation of virus-laden aerosols or by autoinoculation after handling fomites contaminated with nasal or throat secretions (1).

Reference

1. Mufson, M.A., 2000. Respiratory Viruses. Clinical Virology Manual, 3rd Edition. S. Specter, R.L. Hodinka, S.A. Young, (eds.), ASM Press. Washington, D.C., pp. 235-251.

CPT Codes

87631
Influenza A 85477-8, Influenza B 40682-1, 85478-6, Flu A 80382-5, Flu B 80383-3, RSV Type A & B 40988-8

COVID-19 U0003
LOINC: 94306-8, 94500-6, 95209-3, 94309-2, 94500-6

Contacts

Last Updated

11/18/2024