Influenza, Influenza-Associated Mortality, and Novel Influenza A

Laboratory testing at the MSPHL is limited to sentinel sites and outbreak investigations. Routine laboratory testing is not provided.

If an outbreak is reported at a school, hospital, nursing home, or other group setting, contact the District Communicable Disease Coordinator or the District Senior Epidemiology Specialist to arrange for respiratory specimen collection kits to be sent to the facility from the MSPHL. Instruct the facility to properly collect specimens from symptomatic patients, residents or staff, and send the specimens back to the MSPHL for testing.  Specimen types acceptable for RT-PCR testing include nasopharyngeal swabs, nasal swabs, throat swabs, nasal aspirates, nasal washes, dual nasopharyngeal/throat swabs, bronchoalveolar lavage, bronchial wash, tracheal aspirate, sputum, lung tissue, and specimens from viral culture.

Specimens should be collected in the acute stage of the illness, kept in viral transport media only, and refrigerated immediately. Specimens should be stored at refrigerator temperature (2-8°C) pending shipment and should be shipped on refrigerant packs to the MSPHL as soon as possible. Whenever possible, specimens should be shipped so they will not arrive in the laboratory over the weekend or on a holiday. Specimens that are not received within three days of collection will not be tested unless stored at -70°C and shipped on dry ice.  Postage-paid mailers are provided to sentinel sites and facilities experiencing outbreaks, and the state laboratory courier service is provided free-of charge. Be sure to label the specimen with the date of collection and the patient’s name.  Any specimens that are received by the laboratory without patient names will be discarded without testing.

All specimens are tested by both polymerase chain reaction (PCR) and viral culture. Regardless of the PCR result, viral isolation will still be performed on the specimen since an isolate is still needed to do further antigenic typing. Viral culture testing may take up to 3 weeks for strain identification; therefore it is not suitable for diagnosis in determining treatment options. PCR results will be reported within a week from when the specimen is received. PCR testing is used to quickly identify influenza outbreaks or novel strains of influenza that may be circulating. 

Questions regarding seasonal influenza testing or avian influenza testing  may be directed to the MSPHL at 573-751-3334.