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i. Which virology test? Identify the correct test, sample and indication

For all virology testing requiring an EDTA blood sample please use a 9ml tube (e.g. VACUETTE® TUBE 9 ml K3E K3EDTA - lavender cap).

For all NHSGGC sites please order the 9ml EDTA bottles from the PECOS internet procurement manager, search for Item No./Mfr No. 455036.

Viral PCR Sample Solution (VPSS)

Abbott multi-collect specimen collection kit

BAL:  Bronchoalveolar lavage in a universal container

Clotted blood: 9ml yellow biochemistry bottle

CSF:   Cerebrospinal fluid in a universal container

EDTA blood:  9mL purple cross matching/FBC bottle

Gargle: 5-10mL of gargled tap water in a universal container

NPA:  Nasopharyngeal aspirate in a universal container

VPSS:  Virus PCR Sample Solution

Suspected diagnosis / screen / test

  

Aciclovir Theraputic Drug Monitoring

Clotted blood for aciclovir (including valaciclovir) TDM

Please see the Antimicrobial Reference Laboratory for their 'Antibiotic Assay Guidelines for Users' and 'Antibiotic Assay Guideline Ranges'

TrakCare item: Aciclovir therapeutic drug monitoring

GP electronic request (ICE / EMIS / Vision) item: Other virology requests 

Adenovirus  

Respiratory

If a lower respiratory tract infection is present the best sample (1.) for sensitivity to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Faeces - Sterile (universal) container

Rectal swab in VPSS

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal

Please note: Multiplex PCR test for rotavirus, astrovirus, adenovirus and saporovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

Related items:

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Vomit

EDTA Blood (for quantitation in immunocompromised patients)

TrakCare item: Blood - CMV EBV adenovirus PCR (this item tests for cytomegalovirus, Epstein-Barr virus and adenovirus)

GP electronic request (ICE / EMIS / Vision) items: Other virology requests

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Related items

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Various specimen types

TrakCare item: Non-blood - CMV EBV adenovirus PCR (this item tests for cytomegalovirus, Epstein-Barr virus and adenovirus)

GP electronic request (ICE / EMIS / Vision) items: Other virology requests

Anti-streptolysin O (ASO)

Clotted blood

Antibodies against streptolysin O (ASO) are detected by latex agglutination at the WoSSVC. Streptolysin O is produced by some group A/C/G Streptococcus bacteria and the presence of antibody indicates recent infection.

ASO starts to rise two weeks after acute infection, peaking at 4-6 weeks, therefore testing during the acute stage is not recommended.

ASO does not rise after skin and/or soft tissue infections and post-streptococcal complications are rare in patients over 40years.

Anti-streptolysin O titre should only be used to support the diagnosis of post-streptococcal infection complications (e.g. glomerulonephritis and rheumatic fever).

TrakCare item: Anti - Streptolysin O titre

GP electronic request (ICE / EMIS / Vision) items: Anti-Streptolysin O (ASO)

Astrovirus

Faeces - Sterile (universal) container

Rectal swab in VPSS

Please note: The multiplex PCR test for rotavirus, astrovirus, adenovirus and sapovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal

Related items:

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

Bacillus anthracis (anthrax)

EDTA Blood AND clotted blood plus tissue biopsy, eschar, lesion washings, post mortem tissue - Sterile (universal) container

Health Protection Scotland: Anthrax

Public Health England: Anthrax: guidance, data and analysis

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Bartonella henseale / B.quintana (Cat Scratch Disease)

Cat Scratch Disease and endocarditis 

PLEASE NOTE: Testing for Bartonella on clotted blood is not currently available, however testing is available on tissue samples.

The Bartonella serology service at PHE Colindale has been suspended, effective from the 1st of July 2015 due to quality considerations. Samples received after this date will not be tested.

Tissue samples may still be sent for 16S rRNA gene sequencing for the diagnosis of Bartonella. Work continues in PHE to develop other options for Bartonella serodiagnosis.

PHE Microbiology Services Colindale Bacteriology Reference Department - Respiratory and Vaccine Preventable Bacteria Reference Unit (RVPBRU)

User manual Page 36

Respiratory and Vaccine Preventable Bacteria Reference Unit (RVPBRU) Request form

BK polyomavirus

EDTA Blood

Please do NOT send urine without prior agreement with virology clinical staff (ext. 38721). Urine is a risk to the laboratory in the form of contamination. EDTA blood is normally the most appropriate sample type.

TrakCare item: BK virus PCR

Bordetella pertussis (whooping cough)

The recent Scottish Microbiology Virology Nework (SMVN) review on pertussis testing states that throat swabs are the recommended sample for ages >1 yrs, these should be submitted in Viral PCR Sample Solution (VPSS). Nasopharyngeal aspirates (submitted in the sample compartment) and nasopharyngeal swabs (submitted in Viral PCR Sample Solution (VPSS)) are the recommended samples for children <1 yrs.
PCR testing should be considered useful up to 3 weeks post the onset of illness. However, PCR should not be carried out if a patient has received 5 days of antibiotic therapy.
These samples have the benefit of being of use for viral and mycoplasma infections also. Gargles and nasal swabs are also likely to be of use for the detection of all upper respiratory tract pathogens but data comparing this sample type with others is lacking. Please avoid submitting two sample types for testing (one for virology and one for pertussis) as this will lead to unnecessary costs and workload.

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR (submitted in Viral PCR Sample Solution (VPSS) or a universal container)

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum (submitted in a universal container)

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab (submitted in Viral PCR Sample Solution (VPSS))

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle (submitted in a universal container)

Test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Borrelia burgdorferi (Lyme disease/ Lyme borreliosis)

Please note, the WoSSVC no longer deal with Lyme disease testing requests. Please forward all and samples and direct any questions to your local microbiology department (NHS GG&C Microbiology).

Please note: 'Tick bite’ alone is not an indication for Lyme serology testing (BIA position statement: Journal of Infection (2011) 62, 329-338). Please include the clinical symptoms of Lyme borreliosis, date of on-set of symptoms, date of known a tick bite (if applicable) or risk factor are required prior to testing for Lyme borreliosis.

BEFORE sending a sample to Microbiology please see: 18. Lyme borreliosis BIA position statement

Bronchiolitis

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Brucella   

Please note, the WoSSVC no longer deal with Brucella testing requests. Please forward all and samples and direct any questions to your local microbiology department (NHS GG&C Microbiology).

Brucella Reference Unit request form 

Public Health England: Brucella reference unit (BRU)

Cat Scratch Disease (Bartonella henseale / B.quintana)

Cat Scratch Disease and endocarditis 

PLEASE NOTE: Testing for Bartonella on clotted blood is not currently available, however testing is available on tissue samples.

The Bartonella serology service at PHE Colindale has been suspended, effective from the 1st of July 2015 due to quality considerations. Samples received after this date will not be tested.

Tissue samples may still be sent for 16S rRNA gene sequencing for the diagnosis of Bartonella. Work continues in PHE to develop other options for Bartonella serodiagnosis.

PHE Microbiology Services Colindale Bacteriology Reference Department - Respiratory and Vaccine Preventable Bacteria Reference Unit (RVPBRU)

User manual Page 36

Respiratory and Vaccine Preventable Bacteria Reference Unit (RVPBRU) Request form


Chickenpox   

PLEASE NOTE: Varicella zoster virus IgM testing on blood is no longer available at the WoSSVC, please submit a swab for PCR testing.

Vesicle/ulcer swab in VPSS

TrakCare item: Vesicle rash PCR - set (this item includes Herpes simplex / varicella zoster virus PCR and Enterovirus / parechovirus PCR)

TrakCare item: Herpes simplex / varicella zoster virus PCR

GP electronic request (ICE / EMIS / Vision) items: HSV/VZV PCR - Non-genital ulcer/vesicle

Related items

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) items: Eye PCR - HSV VZV adenovirus Chlamydia

Clotted blood for VZV IgG

TrakCare item: Varicella zoster IgG - past infection

PLEASE PHONE THE WoSSVC IF TESTING IS DUE TO A VZV EXPOSURE (ext. 38721 /38722)

Immunity to varicella zoster virus (VZV IgG) is only offered in immunocompromised patients and their household contacts (with no past medical history of chickenpox), pregnant patients (with no past medical history of chickenpox) or health care workers (with no past medical history of chickenpox).

Please provide the gestation for pregnant women or the diagnosis of immunocompromised patients or their household contact. VZV IgG can be tested on an antenatal or any blood sample taken in the last six months stored at the laboratory.

Chikungunya  

EDTA Blood AND clotted blood

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Chlamydia trachomatis

Abbott multi-collect specimen collection kit EXCEPT for eye swabs which must be added to VPSS

Men: Urine (Abbott multi-collect specimen collection kit), urine must be provided in the Abbott Multi-Collect transpost tube.

Female: Vulvovaginal swab (Abbott multi-collect specimen collection kit) 

Rectal swab, pharyngeal swab for either sex as required (Abbott multi-collect specimen collection kit) 

Swabs must be provided in the orange topped Abbott multi-collect tube unless an eye swab.

TrakCare item: Chlamydia / Gonorrhoea PCR

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Urine

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Vulvovaginal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Pharyngeal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Rectal

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Related items

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Chlamydophila pneumoniae / Chlamydophila psittaci serology (Not available/suitable for Chlamydia trachomatis) 

Please note, the WoSSVC no longer deal with Chlamydophila pneumoniae / Chlamydophila psittaci testing requests. Please forward all and samples and direct any questions to your local microbiology department (NHS GG&C Microbiology).

Conjunctivitis

Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Coronavirus (for MERS-CoV please see 'Middle East Respiratory Syndrome Coronavirus - (MERS-CoV)' below)

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Coxiella burnetti (Q-fever) 

EDTA blood, clotted blood, tissue, heart valve

We restrict Q-fever (Coxiella burnetii) testing to specific clinical pictures

Public Health England: Q-fever

IF APPROPRIATE please complete and send the Rare and Imported Pathogens Laboratory request form to the WoSSVC including details of exposure/risk factor and symptoms including the date of onset. The expected turnaround time is approximately seven working days.

Coxsackievirus   

Faeces - Sterile (universal) container or throat swab in VPSS

TrakCare item: Enterovirus / parechovirus PCR

GP electronic request (ICE / EMIS / Vision) items: Other virology requests

Crimean-Congo hemorrhagic fever virus

EDTA blood AND clotted blood, urine, tissue

Please see 4a. Viral Haemorrhagic Fever (VHF) inc. Ebola

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Cytomegalovirus  

Congenital cytomegalovirus <21 days old:

Urine in a sterile (universal) container or a throat swab in VPSS 

TrakCare item: Non-blood - CMV EBV adenovirus PCR

Congenital cytomegalovirus >21 days old:

EDTA Blood for CMV IgG

TrakCare item: CMV IgG - past infection

Guthrie card for PCR, ONLY if CMV IgG positive, send the Guthrie card only after discussion with the WoSSVC.

TrakCare item: Other virology / virus testing requests

Various specimens including throat swab in VPSS 

TrakCare item: Non-blood - CMV EBV adenovirus PCR

All other testing: EDTA Blood

Serology (IgM/IgG) and avidity (confirmation of primary infection during pregnancy only, laboratory instigated, not available to order on TrakCare): EDTA Blood

Please note, CMV IgM testing is limited to patients less than thirty years old, with lymphadenopathy or those with a lymphocytosis. Please list the patients symptoms and signs or this test will not be performed by the laboratory and further clinical details will be requested. Isolated abnormal LFTs in patients greater than 30 years is NOT an indication for CMV IgM testing.

TrakCare item: CMV IgM - acute infection

TrakCare item: CMV IgG - past infection

TrakCare item: Blood - CMV EBV adenovirus PCR

GP electronic request (ICE / EMIS / Vision) items: Cytomegalovirus IgM - acute CMV

Related tests

TrakCare item: EBV IgM - acute infection

GP electronic request (ICE / EMIS / Vision) items: Epstein Barr virus IgM - acute EBV

Cytomegalovirus drug resistance: EDTA Blood

TrakCare item: Other virology / virus testing requests

Ganciclovir / valganciclovir therapeutic drug monitoring: Clotted blood 

Please see the Antimicrobial Reference Laboratory for their 'Antibiotic Assay Guidelines for Users' and 'Antibiotic Assay Guideline Ranges'

TrakCare item: Ganciclovir / valganciclovir therapeutic drug monitoring

Dengue virus  

EDTA Blood AND clotted blood

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Diarrhoea   

Faeces - Sterile (universal) container

Rectal swab in VPSS

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

Please note: The multiplex PCR test below for rotavirus, astrovirus, adenovirus and sapovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

Eastern equine encephalitis virus (EEEV), Western equine encephalitis virus (WEEV), Venezuelan equine encephalitis virus (VEEV) 

EDTA blood AND Clotted blood AND CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Ebola virus   

EDTA blood, Clotted blood, tissue

Please see 4a. Viral Haemorrhagic Fever (VHF) inc. Ebola

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Echovirus  

Faeces - Sterile (universal) container, throat swab in VPSS

TrakCare item: Enterovirus / parechovirus PCR

GP electronic request (ICE / EMIS / Vision) items: Other virology requests

Enterovirus  

Faeces - Sterile (universal) container, throat swab in VPSS

TrakCare item: Enterovirus / parechovirus PCR

GP electronic request (ICE / EMIS / Vision) items: Other virology requests

Epstein–Barr virus

EDTA Blood

TrakCare item: EBV IgM - acute infection

GP electronic request (ICE / EMIS / Vision) items: Epstein Barr virus IgM - acute EBV

Please note: EBV IgM testing is limited to patients less than thirty years old, with lymphadenopathy or those with a lymphocytosis. Please list the patients symptoms and signs or this test will not be performed by the laboratory and further clinical details will be requested. Isolated abnormal LFTs in patients greater than 30 years is NOT an indication for EBV IgM testing.

TrakCare item: EBV VCA IgG - past infection (Epstein-Barr virus viral capsid antigen IgG)

TrakCare item: Blood - CMV EBV adenovirus PCR (this item provides a viral load in IU/mL)

Various specimens including throat swab in VPSS 

TrakCare item: Non-blood - CMV EBV adenovirus PCR

Eye samples

Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Francisella tularensis

EDTA blood AND clotted blood, tissue, wound swab

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Ganciclovir Theraputic Drug Monitoring

Clotted blood ganciclovir (including valganciclovir) TDM

Please see the Antimicrobial Reference Laboratory for their 'Antibiotic Assay Guidelines for Users' and 'Antibiotic Assay Guideline Ranges'

TrakCare item: Ganciclovir / valganciclovir therapeutic drug monitoring

Gastroenteritis/Diarrhoea

Faeces - Sterile (universal) container

Rectal swab in VPSS

Vomit - Sterile (universal) container

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Vomit

Please note: The multiplex PCR test below for rotavirus, astrovirus, adenovirus and sapovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

Gonorrhoea

Abbott multi-collect specimen collection kit EXCEPT for eye swabs which must be added to VPSS

Men: Urine (Abbott multi-collect specimen collection kit), urine must be provided in the Abbott Multi-Collect transpost tube.

Female: Vulvovaginal swab (Abbott multi-collect specimen collection kit) 

Rectal swab, pharyngeal swab for either sex as required (Abbott multi-collect specimen collection kit) 

Swabs must be provided in the orange topped Abbott multi-collect tube unless an eye swab.

TrakCare item: Chlamydia / Gonorrhoea PCR

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Urine

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Vulvovaginal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Pharyngeal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Rectal

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Related items

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Hantavirus   

EDTA Blood AND clotted blood, urine - Sterile (universal) container

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Hantavirus serology / PCR


Hendra virus  

EDTA blood AND clotted blood, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Henipavirus   

EDTA Blood AND clotted blood, CSF - Sterile (universal) container

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Hepatitis A virus (HAV)

EDTA Blood

Please note: HAV is now very rare in Scotland. Please include the details of the hepatitis (inc maximum ALT), travel history (with dates), food risk history and clinical features if HAV testing is required or the request will be rejected. HAV IgM is only offered in jaundiced patients or those with an ALT greater than 100 U/L.

TrakCare item: Hep A IgM - acute infection request

GP electronic request (ICE / EMIS / Vision) items: Acute Hepatitis testing

Please note if HAV IgM is appropriate then HEV IgM and HEV IgG should also be requested along with HBsAg and HCV antibody and HCV antigen. All of which are available in:

TrakCare item: Acute Hepatitis Screen - Set

and

GP electronic request (ICE / EMIS / Vision) items: Acute Hepatitis testing

Post HAV vaccine antibody (IgG) checks are not recommended. Test is for natural immunity (very high levels) and not normally sensitive enough for vaccine induced immunity. Suggest that you follow manafacturer's guidelines for duration of immunity and timing of booster doses.

TrakCare item: Hep A IgG - past infection

GP electronic request (ICE / EMIS / Vision) items: Hepatitis A virus IgG - past HAV

Hepatitis B virus (HBV) & hepatitis delta virus (HDV)

EDTA Blood

For screening use TrakCare item: Hep B screen - HBsAg - current infection

or TrakCare item: HIV, Hep B, Hep C screen - Set

For screening use GP electronic request (ICE / EMIS / Vision) items: Chronic Hepatitis testing

  • TrakCare item: Hep B - anti-HBs - post vaccine
  • GP electronic request (ICE / EMIS / Vision) item: Anti-HBs-post HBV immunisation

TrakCare item: Hep B - anti-HBc IgM - acute HBV request

GP electronic request (ICE / EMIS / Vision) item: Acute Hepatitis testing

  • TrakCare item: Hep B - anti-HBc IgG request
  • GP electronic request (ICE / EMIS / Vision) item: Anti-HBc IgG-past natural HBV infection

Related item

TrakCare item: Acute Hepatitis Screen - Set

Available for request to specialist services only:

TrakCare item: Hep B - anti-HBe request

TrakCare item: Hep B - HBeAg request

TrakCare item: Hep B anti-viral resistance

TrakCare item: Hep B - Quantitative HBsAg

TrakCare item: Hep B viral load ( PCR )

TrakCare item: Hep D viral load ( PCR )

Hepatitis C virus (HCV)

EDTA Blood

For screening use TrakCare item: Hep C antibody screen

or TrakCare item: HIV, Hep B, Hep C screen - Set

For screening use GP electronic request (ICE / EMIS / Vision) item: Chronic Hepatitis testing

TrakCare item: Hep C - HCV antigen request

TrakCare item: Acute Hepatitis Screen - Set

GP electronic request (ICE / EMIS / Vision) item: Acute Hepatitis testing

Available for request to specialist services only:

TrakCare item: Hep C anti-viral resistance

TrakCare item: Hep C genotyping

TrakCare item: Hep C - IL28B genotyping

TrakCare item: Hep C viral load ( PCR )

Hepatitis delta virus (HDV)

EDTA Blood

Available for request to specialist services only:

TrakCare item: Hep D viral load ( PCR )

Hepatitis E virus (HEV)

EDTA Blood

Please include the details of the hepatitis (inc maximum ALT), travel history (with dates and destination if genotype 1 is suspected), food risk history and clinical features if HEV testing is required or the request will be rejected. HEV testing is only offered in jaundiced patients or those with an ALT greater than 100 U/L. Please note if HEV IgM is appropriate then HAV IgM should also be requested along with HBsAg and HCV antigen.

TrakCare item: Hep E IgM screen - acute infection

TrakCare item: Acute Hepatitis Screen - Set

GP electronic request (ICE / EMIS / Vision) item: Acute Hepatitis testing

 

TrakCare item: Hep E viral load ( PCR ) (this item is restricted to use in immunocompromised patients)

Herpes simplex virus-1/2 (HSV-1/2)

PCR tests are HSV combined with either Treponema pallidum (Syphilis) or varicella zoster virus

Vesicle/ulcer swab in VPSS

TrakCare item: Herpes simplex / varicella zoster virus PCR

or TrakCare item: Herpes simplex - Syphilis PCR ( GUM ) (this item tests for herpes simplex virus-1/2 (HSV-1/2) and Treponema pallidum)

or TrakCare item: Vesicle rash PCR - Set (this set includes tests for herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus and enterovirus / parechovirus)

GP electronic request (ICE / EMIS / Vision) item: HSV/VZV PCR - Non-genital ulcer/vesicle

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Related items

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

CSF

TrakCare item: CSF viral PCR screen (this item tests for herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and enterovirus / parechovirus)

Neonates

Skin lesion, vesicle/ulcer, nose and throat, rectal and eye swab, EDTA Blood +/- CSF

TrakCare item: Herpes simplex / varicella zoster virus PCR

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Herpes simplex virus antiviral resistance

Swab in Viral Transport Medium – please contact the laboratory for VTM

TrakCare item: Other virology / virus testing requests

Herpes simplex virus past infection

EDTA Blood

TrakCare item: Herpes simplex IgG - past infection

Human herpesvirus-6/7 (HHV-6 / HHV-7)

Throat swab in VPSS for acute rash diagnosis in children under 5 years

TrakCare item: Paediatric maculopapular rash - virus PCR - Set

or

TrakCare item: Human herpesvirus-6/7 PCR

GP electronic request (ICE / EMIS / Vision) item: Maculopapular rash PCR-current infection

EDTA Blood in immunocompromised patients

TrakCare item: Human herpesvirus-6/7 PCR

Human herpesvirus-8

EDTA Blood

If required please complete the Seromolecular Services Unit (SSU) request form, Virus Reference Department, PHE Microbiology Services Colindale

TrakCare item: Other virology / virus testing requests

Human immunodeficiency virus (HIV) 

EDTA Blood

For screening use TrakCare item: HIV antibody / antigen screen

or TrakCare item: HIV, Hep B, Hep C screen - Set

For screening use GP electronic request (ICE / EMIS / Vision) item: HIV antibody/antigen (Ab/Ag) screen

Available for request to specialist services only:

TrakCare item: HIV anti-retroviral drug resistance

TrakCare item: HIV anti-retroviral therapeutic drug monitoring

Please see Lab21 Therapeutic Drug Monitoring Tests for the currently available anti-retroviral TDM assays

TrakCare item: HIV avidity

TrakCare item: HIV integrase drug resistance

TrakCare item: HIV tropism

TrakCare item: HIV viral load ( PCR )

Human papillomavirus

Please see the Scottish Human Papilloma Virus Reference Laboratory (SHPVRL) user manual 

If testing is required please complete the appropriate form below:

HPV Gynaecology request form: Human Papillomavirus (HPV) Test Request Form (for GYNAE) Scottish Human Papillomavirus Reference Laboratory

HPV non-gynaecology sample type request form: Human Papillomavirus (HPV) Test Request Form (for Non-GYNAE) Scottish Human Papillomavirus Reference Laboratory

TrakCare item: Other virology / virus testing requests

Human T-lymphotropic virus Type I and II (HTLV-1/-2) 

EDTA Blood

Please provide the indication for the test (e.g. suspected Adult T-cell leukaemia / lymphoma or HTLV-I-associated myelopathy, also known as tropical spastic paraparesis) along with ethnicity, risk factors and clinical signs or symptoms. If the test is for organ donation or is required prior to a specific therapy please specify. Please provide the full clinical details or this test will not be performed by the laboratory and further clinical details will be requested.

TrakCare item: HTLV-1/2 antibody screen

Influenza A and B virus

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B
  • Respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Japanese encephalitis virus 

EDTA blood AND clotted blood, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

JC polyomavirus  

CSF

TrakCare item: Immunocompromised CSF virus PCR - Set

or

TrakCare item: JC virus PCR

Clotted blood

TrakCare item: JC virus antibody

TrakCare item: Other virology / virus testing requests

Junin virus - Argentine hemorrhagic fever (AHF) 

EDTA blood AND clotted blood

Please see 4a. Viral Haemorrhagic Fever (VHF) inc. Ebola

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Kunjin virus  

EDTA blood AND clotted blood, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Lassa fever virus

EDTA blood AND clotted blood, urine, throat swab, tissue

Please see 4a. Viral Haemorrhagic Fever (VHF) inc. Ebola

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Leptospira interogans (Leptospirosis)

Clotted blood

Please complete and send the Leptospira Reference Unit request form including details of exposure/risk factor and symptoms including the date of onset.

Lymphocytic choriomeningitis virus (LCMV) 

CSF

Please telephone the WoSSVC (ext. 38721 / 38722) to discuss any request for LCMV testing. Testing is performed by the High Containment Microbiology Department, PHE Colindale) Tel: 0208 327 6222.

TrakCare item: Other virology / virus testing requests

Lymphogranuloma venereum (LGV)  

Rectal swab in Abbott multi-collect specimen transport tube previously diagnosed as Chlamydia trachomatis positive

Rectal swab, pharyngeal swab for either sex as required (Abbott multi-collect specimen collection kit) 

TrakCare item: Chlamydia / Gonorrhoea PCR 

Marburg virus  

EDTA blood AND clotted blood +/- CSF

Please see 4a. Viral Haemorrhagic Fever (VHF) inc. Ebola

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Mayaro virus  

EDTA blood AND clotted blood, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Measles virus
PLEASE NOTE: Measles IgM is no longer available at the WoSSVC

Throat swab in VPSS

TrakCare item: Measles / rubella virus PCR - current infection

or

TrakCare item: Adult maculopapular rash - virus PCR - Set

Contains:

  • Measles / rubella virus PCR - current infection
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

TrakCare item: Paediatric maculopapular rash - virus PCR - Set 

Contains:

  • Measles / rubella virus PCR - current infection
  • Human herpesvirus-6/7 PCR
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

GP electronic request (ICE / EMIS / Vision) item: Maculopapular rash PCR-current infection

or

GP electronic request (ICE / EMIS / Vision) items: Measles / rubella PCR -current infection

EDTA blood

Immunity to measles (IgG) is only offered in immunocompromised or pregnant patients who have been exposed/possibly exposed to a case and would be eligible for administration of human normal immunoglobulin, all other individuals should be offered two doses of MMR if they do not have documented evidence of two previous doses. Please provide the full clinical details or this test will not be performed by the laboratory and further clinical details will be requested.

TrakCare item: Measles IgG - past natural infection

GP electronic request (ICE / EMIS / Vision) items: Measles IgG - past natural infection

Middle East Respiratory Syndrome Coronavirus - (MERS-CoV)

  • Sputum

AND

  • Nose and throat swab (expressed in same VPSS container)

AND

  • EDTA Blood

AND

  • Clotted blood

PLEASE SEE 4b. MERS coronavirus & avian influenza

TrakCare item: MERS-CoV - Middle East Respiratory Syndrome Coronavirus

Mumps virus  

PLEASE NOTE: Mumps IgM is no longer available at the WoSSVC

Buccal (inner cheek) mouth swab in VPSS

TrakCare item: Mumps PCR - current infection

GP electronic request (ICE / EMIS / Vision) item: Mumps PCR - current infection

Murray Valley encephalitis virus 

Clotted blood, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Mycoplasma pneumoniae

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Neisseria gonorrhoeae

Abbott multi-collect specimen collection kit EXCEPT for eye swabs which must be added to VPSS

Men: Urine (must be provided in the Abbott multi-collect transpost tube)

Female: Vulvovaginal swab (Abbott multi-collect specimen collection kit) 

Rectal swab, pharyngeal swab for either sex as required (Abbott multi-collect specimen collection kit) 

TrakCare item: Chlamydia / Gonorrhoea PCR (Abbott multi-collect specimen collection kit)

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Urine

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Vulvovaginal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Pharyngeal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Rectal

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Related items

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Nipah virus  

EDTA blood AND clotted blood, CSF  

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Norovirus  

Faeces - Sterile (universal) container

Rectal swab in VPSS

Vomit - Sterile (universal) container

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Vomit

Related items

Please note: The multiplex PCR test below for rotavirus, astrovirus, adenovirus and sapovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

Orientia tsutsugamushi (Scrub typhus)

EDTA blood, Clotted blood, eschar biopsy, CSF  

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Parainfluenza-1/2/3/4

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Parvovirus B19  

Throat swab in VPSS

TrakCare item: Parvovirus B19 PCR

or

TrakCare item: Adult maculopapular rash - virus PCR - Set

Contains:

  • Measles / rubella virus PCR - current infection
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

TrakCare item: Paediatric maculopapular rash - virus PCR - Set 

Contains:

  • Measles / rubella virus PCR - current infection
  • Human herpesvirus-6/7 PCR
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

GP electronic request (ICE / EMIS / Vision) item: Maculopapular rash PCR-current infection

EDTA Blood

      TrakCare item: Parvovirus B19 IgG - past infection
GP electronic request (ICE / EMIS / Vision) item: Parvovirus B19 IgG - past infection

Parvovirus B19 IgG testing is limited to pregnant patients who are exposed to a maculopapular rash illness, when the blood sample is taken less than five days after the rash exposure. Parvovirus B19 IgG is a test for immunity to parvovirus B19. If the patient has had an antenatal blood sample taken please call the WoSSVC to request testing on that specimen. Please state the date of rash contact and current gestation. Please provide the full clinical details or this test will not be performed by the laboratory and further clinical detailswill be requested.

TrakCare item: Parvovirus B19 IgM - acute infection

GP electronic request (ICE / EMIS / Vision) item: Parvovirus B19 IgM - acute infection

Parvovirus B19 IgM testing is limited to symptomatic patients with a maculopapular rash, acute onset arthralgia or acute anaemia and asymptomatic pregnant patients three weeks after exposure to a rash illness. Please state the rash onset date or the date of rash contact in pregnant women along with the current gestation. Please provide the full clinical details or this test will not be performed by the laboratory and further clinical details will be requested.

Pertussis (Whooping cough / Bordetella pertussis) 

The recent Scottish Microbiology Virology Nework (SMVN) review on pertussis testing states that throat swabs are the recommended sample for ages >1 yrs, these should be submitted in Viral PCR Sample Solution (VPSS). Nasopharyngeal aspirates (submitted in the sample compartment) and nasopharyngeal swabs (submitted in Viral PCR Sample Solution (VPSS)) are the recommended samples for children <1 yrs.

PCR testing should be considered useful up to 3 weeks post the onset of illness. However, PCR should not be carried out if a patient has received 5 days of antibiotic therapy.
These samples have the benefit of being of use for viral and mycoplasma infections also. Gargles and nasal swabs are also likely to be of use for the detection of all upper respiratory tract pathogens but data comparing this sample type with others is lacking. Please avoid submitting two sample types for testing (one for virology and one for pertussis) as this will lead to unnecessary costs and workload.

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR (submitted in Viral PCR Sample Solution (VPSS) or a universal container)

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum (submitted in a universal container)

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab (submitted in Viral PCR Sample Solution (VPSS))

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle (submitted in a universal container)

Test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Pneumocystis jirovecii

If Pneumocystis jirovecii is suspected the best sample for sensitivity to the worst are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:
  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Rabies virus   

Serology post vaccination: Clotted blood

Please consult UK immunisation guidance (the ‘Green Book’ Chapter 27: Rabies) for the requirements of post-rabies vaccination testing. IF INDICATED please complete and send the VLARAB1 request form 'Request for determination of antibodies against rabies' to us including the indication for testing.

Suspected current infection

Please contact the laboratory for urgent clinical virology advice

  • EDTA blood

AND

  • Clotted blood

+/-

  • Skin biopsy - Sterile (universal) container
  • CSF
  • Mouth swab in VPSS

TrakCare item: Other virology / virus testing requests

Rash Screen

Please note that rubella IgM is no longer available at the WoSSVC.

Throat swab in VPSS

TrakCare item: Adult maculopapular rash - virus PCR - Set

Contains:

  • Measles / rubella virus PCR - current infection
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

TrakCare item: Paediatric maculopapular rash - virus PCR - Set 

Contains:

  • Measles / rubella virus PCR - current infection
  • Human herpesvirus-6/7 PCR
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

GP electronic request (ICE / EMIS / Vision) item: Maculopapular rash PCR-current infection

EDTA Blood

  • TrakCare item: HIV antibody / antigen screen
  • GP electronic request (ICE / EMIS / Vision) item: HIV antibody/antigen (Ab/Ag) screen

  • TrakCare item: Parvovirus B19 IgM - acute infection
  • GP electronic request (ICE / EMIS / Vision) item: Parvovirus B19 IgM - acute infection

  • TrakCare item: Syphilis Serology Screen
  • GP electronic request (ICE / EMIS / Vision) item: Syphilis serology screen - blood

Rash contact in immunocompromised 
Please contact the laboratory for clinical virology advice

As appropriate:

EDTA Blood

      TrakCare item: Parvovirus B19 IgG - past infection
GP electronic request (ICE / EMIS / Vision) item: Parvovirus B19 IgG - past infection

Clotted blood

TrakCare item: Varicella zoster IgG - past infection

GP electronic request (ICE / EMIS / Vision) item: Varicella zoster virus IgG - past VZV

Rash contact during pregnancy 
Please contact the laboratory for clinical virology advice

As appropriate:

EDTA Blood

      TrakCare item: Parvovirus B19 IgG - past infection
GP electronic request (ICE / EMIS / Vision) item: Parvovirus B19 IgG - past infection

Clotted blood

TrakCare item: Varicella zoster IgG - past infection

GP electronic request (ICE / EMIS / Vision) item: Varicella zoster virus IgG - past VZV


Respiratory

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

TrakCare order set: Paediatric Respiratory Point of Care contains:

TrakCare item: Respiratory POCT (Paeds Microbiology) (NPA in VTM)
for Respiratory syncytial virus (RSV) testing

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae
TrakCare item: Respiratory - Chlamydia trachomatis PCR

Respiratory syncytial virus (RSV) 

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

TrakCare order set: Paediatric Respiratory Point of Care contains:

TrakCare item: Respiratory POCT (Paeds Microbiology) (NPA in VTM)
for Respiratory syncytial virus (RSV) testing

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Retinitis

Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Related items:

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Rhinovirus  

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Rickettsia  

EDTA Blood AND clotted blood, eschar biopsy, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Rickettsia serology / PCR

Rift Valley fever virus

EDTA blood AND clotted blood, CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Ross river virus

EDTA blood AND clotted blood

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Rotavirus  

Faeces - Sterile (universal) container

Rectal swab in VPSS

Please note: The multiplex PCR test for rotavirus, astrovirus, adenovirus and sapovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal

Related items:

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

Rubella   

Please note that rubella IgM and IgG is no longer routinely available.

Throat swab in VPSS

TrakCare item: Adult maculopapular rash - virus PCR - Set

Contains:

  • Measles / rubella virus PCR - current infection
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

TrakCare item: Paediatric maculopapular rash - virus PCR - Set 

Contains:

  • Measles / rubella virus PCR - current infection
  • Human herpesvirus-6/7 PCR
  • Enterovirus / parechovirus PCR
  • Parvovirus B19 PCR

or

TrakCare item: Measles / rubella virus PCR - current infection

GP electronic request (ICE / EMIS / Vision) item: Maculopapular rash PCR-current infection

Please note rubella is rare in Scotland and limited to imported cases and their unvaccinated contacts.

           Laboratory confirmed cases in Scotland

2009                     0

2010                     1

2011                     0

2012                     5

2013                     1

2014                     0

2015                     0

Clinical diagnosis requires acute onset of generalised maculopapular rash AND fever (>37.2 °C) AND cervical, suboccipital or postauricular adenopathy or arthralgia/arthritis. Cases in Scotland are imported. Please provide the patient's rubella/MMR vaccination history, recent international travel and contact date with similar illness.


Sandfly fever virus

EDTA blood AND clotted blood +/- CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Sapovirus  

Faeces - Sterile (universal) container

Rectal swab in VPSS

Please note: The multiplex PCR test for rotavirus, astrovirus, adenovirus and sapovirus is restricted to immunocompromised patients and children under ten years old. Virology testing in all other individuals with diarrhoea is limited to norovirus.

TrakCare item: Faeces viral PCR screen (this item tests for adenovirus, sapovirus, astrovirus and rotavirus, it does NOT include norovirus, which must be requested separately)

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Faeces

GP electronic request (ICE / EMIS / Vision) item: Viral Diarrhoea PCR (not noro)-Rectal

Related items:

TrakCare item: Norovirus PCR

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Faeces

GP electronic request (ICE / EMIS / Vision) item: Norovirus PCR - Rectal Swab

Sexual Health

EDTA blood

  • TrakCare item: HIV antibody / antigen screen
  • GP electronic request (ICE / EMIS / Vision) item: HIV antibody/antigen (Ab/Ag) screen

  • TrakCare item: Hep B screen - HBsAg - current infection

or TrakCare item: HIV, Hep B, Hep C screen - Set

  • GP electronic request (ICE / EMIS / Vision) items: Chronic Hepatitis testing

  • TrakCare item: Syphilis Serology Screen
  • GP electronic request (ICE / EMIS / Vision) item: Syphilis serology screen - blood

Vesicle/ulcer swab in VPSS

TrakCare item: Herpes simplex - Syphilis PCR ( GUM ) (this item tests for herpes simplex virus-1/2 (HSV-1/2) and Treponema pallidum)

GP electronic request (ICE / EMIS / Vision) item: HSV / syphilis PCR - Genital ulcer

Chlamydia/Gonorrhoea

Abbott multi-collect specimen collection kit EXCEPT for eye swabs which must be added to VPSS

Men: Urine (Abbott multi-collect specimen collection kit), urine must be provided in the Abbott Multi-Collect transpost tube.

Female: Vulvovaginal swab (Abbott multi-collect specimen collection kit) 

Rectal swab, pharyngeal swab for either sex as required (Abbott multi-collect specimen collection kit) 

TrakCare item: Chlamydia / Gonorrhoea PCR

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Urine

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Vulvovaginal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Pharyngeal

GP electronic request (ICE / EMIS / Vision) items: Chlamydia/Gonorrhoea PCR - Rectal

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Sinbis virus  

EDTA blood AND clotted blood

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Shingles  

Please note, varicella zoster virus IgM is no longer available at the WoSSVC

Vesicle/ulcer swab in VPSS

TrakCare item: Vesicle rash PCR - Set (this set includes tests for herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus and enterovirus / parechovirus)

or TrakCare item: Herpes simplex / varicella zoster virus PCR

GP electronic request (ICE / EMIS / Vision) items: HSV/VZV PCR - Non-genital ulcer/vesicle

Related items

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) items: Eye PCR - HSV VZV adenovirus Chlamydia

Syphilis 

EDTA Blood for serology

TrakCare item: Syphilis Serology Screen

GP electronic request (ICE / EMIS / Vision) item: Syphilis serology screen - blood

Vesicle/ulcer swab in VPSS

TrakCare item: Herpes simplex - Syphilis PCR ( GUM ) (this item tests for herpes simplex virus-1/2 (HSV-1/2) and Treponema pallidum)

GP electronic request (ICE / EMIS / Vision) item: HSV / syphilis PCR - Genital ulcer

Tickborne encephalitis virus (TBEV)  

EDTA blood AND clotted blood +/- CSF

Including European/Western tick-borne encephalitis virus, Siberian tick-borne encephalitis virus, Far eastern Tick-borne encephalitis virus (formerly known as Russian Spring Summer encephalitis virus)

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Theraputic Drug Monitoring (TDM) 

Clotted blood for aciclovir (including valaciclovir) and ganciclovir (including valganciclovir).

Please see the Antimicrobial Reference Laboratory for their 'Antibiotic Assay Guidelines for Users' and 'Antibiotic Assay Guideline Ranges'

TrakCare item: Aciclovir therapeutic drug monitoring

TrakCare item: Ganciclovir / valganciclovir therapeutic drug monitoring

EDTA blood for HIV Theraputic Drug monitoring

Please see Lab21 Therapeutic Drug Monitoring Tests for the currently available anti-retroviral drug assays

TrakCare item: HIV anti-retroviral therapeutic drug monitoring


TORCH Screen

It is never appropriate to request a ‘TORCH screen’. ‘TORCH’ screening as a single test was recommended to be abolished in 1993 in the UK, due to poor clinical utility and low diagnostic yield. (Public Health Laboratory Service Working Party on congenital infections. TORCH screening reassessed. 2nd edn. Public Health Laboratory Service, London; 1993.)

Maternal risk factors, symptoms and vaccination history (if appropriate) should be included on the request form along with all foetal/neonatal signs and findings.

Foetal/neonatal gestation at birth, current adjusted gestational age along with all clinical and radiological signs should be communicated to the laboratory

Congenital cytomegalovirus is the most common intrauterine infection and should be considered. In suspected congenital and neonatal infections other pathogens include herpes simplex virus, varicella zoster virus, syphilis, toxoplasma and rubella virus should be considered within the differential diagnosis.

See the individual pathogens for TrakCare item names.

Toxoplasma gondii

Clotted blood for serology

TrakCare item: Toxoplasma IgG - past infection

GP electronic request (ICE / EMIS / Vision) item: Toxoplasma IgG screen

Toxoplasma IgG testing for acute infection is only offered in immunocompromised, pregnant patients or those with lymphadenopathy who are EBV and CMV IgM negative. Please specify the reason for this test along with the patient’s symptoms, signs and imaging results or the request will be rejected.

The WoSSVC sends Toxoplasma samples for further testing the Scottish Toxoplasma Reference Laboratory: 
 
Clinical enquiries 09:00 - 17:00 Monday to Friday, Tel: 01463 704206
Samples for Scottish Toxoplasma Reference Laboratory
• Serology: Clotted blood (10ml)/ serum (500µl). Results from plasma samples may be unreliable.
• PCR:
- Whole blood (EDTA) (1ml). Serum/plasma is not suitable. IT IS VITAL THAT THE WoSSVC IS TELEPHONED BEFORE SENDING BLOOD FOR TOXOPLASMA PCR (38721 / 38722). THIS IS TO PREVENT THE BLOOD FROM BEING SPUN, WHICH AUTOMATICALLY OCCURS FOR ALL OTHER BLOOD SPECIMENS.
- CSF and amniotic fluid (>200µl). Samples should not be centrifuged prior to referral.
- Aqueous/vitreous fluid (200µl)
- Tissue
- PCR samples must be accompanied by a serum sample for serology.

TrakCare item: Other virology / virus testing requests

Treponema pallidum (Syphilis) 

EDTA Blood for serology

TrakCare item: Syphilis Serology Screen

GP electronic request (ICE / EMIS / Vision) item: Syphilis serology screen - blood

Vesicle/ulcer swab in VPSS

TrakCare item: Herpes simplex - Syphilis PCR ( GUM ) (this item tests for herpes simplex virus-1/2 (HSV-1/2) and Treponema pallidum)

GP electronic request (ICE / EMIS / Vision) item: HSV / syphilis PCR - Genital ulcer

Ulcer   

Vesicle/ulcer swab in VPSS

TrakCare item: Vesicle rash PCR - Set (this set includes tests for herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus and enterovirus / parechovirus)

or

TrakCare item: Herpes simplex / varicella zoster virus PCR

GP electronic request (ICE / EMIS / Vision) item: HSV/VZV PCR - Non-genital ulcer/vesicle

and / or

TrakCare item: Herpes simplex - Syphilis PCR ( GUM ) (this item tests for herpes simplex virus-1/2 (HSV-1/2) and Treponema pallidum)

GP electronic request (ICE / EMIS / Vision) item: HSV / syphilis PCR - Genital ulcer

Varicella-zoster virus

Please note, varicella zoster virus IgM is no longer available at the WoSSVC

Vesicle/ulcer swab in VPSS

TrakCare item: Vesicle rash PCR - Set (this set includes tests for herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus and enterovirus / parechovirus)

or TrakCare item: Herpes simplex / varicella zoster virus PCR

GP electronic request (ICE / EMIS / Vision) item: HSV/VZV PCR - Non-genital ulcer/vesicle

Eye specimens including Conjunctival Swab in VPSS, vitreous humor in VPSS and aqueous humor in VPSS

TrakCare item: Eye PCR screen - viral / chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - HSV VZV adenovirus Chlamydia (this item tests for adenovirus, herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus (VZV) and Chlamydia trachomatis)

Related items

TrakCare item: Eye PCR - Neisseria gonorrhoeae

GP electronic request (ICE / EMIS / Vision) item: Eye PCR - Neisseria gonorrhoeae

Clotted blood

TrakCare item: Varicella zoster IgG - past infection

GP electronic request (ICE / EMIS / Vision) item: Varicella zoster virus IgG - past VZV

PLEASE PHONE THE WoSSVC IF TESTING IS DUE TO A VZV EXPOSURE (ext. 38722)

Immunity to varicella zoster virus (VZV IgG) is only offered in immunocompromised patients and their household contacts (with no past medical history of chickenpox), pregnant patients (with no past medical history of chickenpox) or health care workers (with no past medical history of chickenpox).

Please provide the gestation for pregnant women or the diagnosis of immunocompromised patients or their household contact.

Venezuelan equine encephalitis virus (VEEV), WEEV, EEEV

EDTA blood AND Clotted blood +/- CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Vesicle  

Vesicle/ulcer swab in VPSS

TrakCare item: Vesicle rash PCR - Set (this set includes tests for herpes simplex virus-1/2 (HSV-1/2), varicella zoster virus and enterovirus / parechovirus)

or

TrakCare item: Herpes simplex / varicella zoster virus PCR

GP electronic request (ICE / EMIS / Vision) item: HSV/VZV PCR - Non-genital ulcer/vesicle

and / or

TrakCare item: Herpes simplex - Syphilis PCR ( GUM ) (this item tests for herpes simplex virus-1/2 (HSV-1/2) and Treponema pallidum)

GP electronic request (ICE / EMIS / Vision) item: HSV / syphilis PCR - Genital ulcer

Viral haemorrhagic fever 

EDTA Blood AND clotted blood

If suspected Lassa +/- Urine

If suspected Marburg +/- CSF

Please see 4a. Viral Haemorrhagic Fever (VHF) inc. Ebola

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests


Viral respiratory screen

If a lower respiratory tract infection is present the best sample for sensitivity (1.) to the worst (8.) are as follows:

  1. Bronchoalveolar lavage (BAL) in a sterile universal container
  2. Induced sputum in a sterile universal container
  3. Sputum in a sterile universal container
  4. NPA in a sterile universal container
  5. Gargle in a sterile universal container
  6. Nose and throat swab both expressed in same VPSS container
  7. Throat swab in a VPSS container 
  8. Nose swab in a VPSS container 

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle

Each of the above items test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

Western equine encephalitis virus (WEEV), EEEV, VEEV

EDTA blood AND clotted blood +/- CSF

If testing is required please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

West Nile virus 

EDTA blood AND clotted blood +/- CSF

Please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Whooping cough (Bordetella pertussis) 

The recent Scottish Microbiology Virology Nework (SMVN) review on pertussis testing states that throat swabs are the recommended sample for ages >1 yrs, these should be submitted in Viral PCR Sample Solution (VPSS). Nasopharyngeal aspirates (submitted in the sample compartment) and nasopharyngeal swabs (submitted in Viral PCR Sample Solution (VPSS)) are the recommended samples for children <1 yrs.

PCR testing should be considered useful up to 3 weeks post the onset of illness. However, PCR should not be carried out if a patient has received 5 days of antibiotic therapy.
These samples have the benefit of being of use for viral and mycoplasma infections also. Gargles and nasal swabs are also likely to be of use for the detection of all upper respiratory tract pathogens but data comparing this sample type with others is lacking. Please avoid submitting two sample types for testing (one for virology and one for pertussis) as this will lead to unnecessary costs and workload.

TrakCare item: Resp virus / Mycoplasma / Pertussis PCR (submitted in Viral PCR Sample Solution (VPSS) or a universal container)

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Sputum (submitted in a universal container)

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Throat swab (submitted in Viral PCR Sample Solution (VPSS))

GP electronic request (ICE / EMIS / Vision) item: Viruses+Mycoplasma+Pertussis Gargle (submitted in a universal container)

Test for:

  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae

TrakCare item: BAL screen ( Resp virus / PCP / CMV / Pertussis ) tests for:

  • Pneumocystis jirovecii
  • Cytomegalovirus (CMV)
  • Bordetella pertussis
  • Influenza A (including the H275Y oseltamivir resistance mutation)
  • Influenza B, respiratory syncitial virus (RSV)
  • Human metapneumovirus (HuMP)
  • Parainfluenza-1/2/3/4
  • Coronavirus
  • Rhinovirus / enterovirus
  • Adenovirus
  • Mycoplasma pneumoniae


Yellow fever virus

EDTA blood AND clotted blood

Please complete the Rare and Imported Pathogens Laboratory (RIPL) request form

TrakCare item: Other virology / virus testing requests

Yersinia pestis 

Clotted blood

Tested by the Gastrointestinal infections reference service (GIRS) section of the Gastrointestinal Bacteria Reference Unit (GBRU) ( User manual ) of PHE Microbiology Services Colindale Bacteriology Reference Department

Please complete the L2 ‘E. coli, Shigella, Yersinia, Vibrio’ Referral Form

Please see the full details regarding the Abbott multi-collect specimen collection kit at the website below, images are used to assist staff with identifying which collection tube to submit different sample types: https://www.abbottmolecular.com/products/infectious-diseases/realtime-pcr/multi-collect-specimen-kit.html

Abbott website images used as permitted under the terms of use 'INTELECTUAL PROPERTY' paragraph found on www.abbottmolecular.com/terms-of-use.html