Avian influenza infects wild and domestic birds over the world. Zoonotic transmission can occur between humans who are in close contact with infected birds. A/H5N1 and A/H7N9 have been associated with severe human disease and high fatality rates. Consider testing for avian influenza in a returning traveller who visited South East Asia, Egypt or Turkey 10 days prior to symptom onset and where close contact with live, ill or dead birds, for example in a bird market has occurred.
Further information and clinical algorithms can be found at: https://www.hps.scot.nhs.uk/a-to-z-of-topics/avian-influenza/ and https://www.gov.uk/government/collections/avian-influenza-guidance-data-and-analysis
The West of Scotland Specialist Virology Centre has both a real-time PCR assay for H5 viruses and H7 viruses. Please contact the West of Scotland Specialist Virology Centre BEFORE the samples are sent to ensure no risk to laboratory staff accidently opening a respiratory sample suspected of carrying avian influenza. It is important to discuss a possible case of avian influenza with the virologist on clinical for a decision to be made on the urgency of the sample.
Middle Eastern Respiratory Syndrome - coronavirus (MERS-CoV)
MERS-CoV is a respiratory virus which first emerged in 2012. A wide range of symptoms can occur with MERS-CoV ranging from asymptomatic to pneumonia or acute respiratory distress syndrome (ARDS). Fatality rate has been reported at 30%. There have been sporadic cases in returning travellers and nosocomial outbreaks.
Cases have mainly been seen in the Saudi peninsula, therefore MERS-CoV should be considered in any returning traveller with pneumonia or ARDS who has travelled to the following regions:
Bahrain, Jordan, Iraq, Iran, Kingdom of Saudi Arabia, Kuwait, Oman, Qatar, United Arab Emirates and Yemen
Further information can be found at:
Health Protection Scotland (for primary care and secondary care algorithms): https://www.hps.scot.nhs.uk/a-to-z-of-topics/middle-east-respiratory-syndrome-coronavirus/
If a patient has travelled to any of the regions above within the last 14 days and is exhibiting respiratory symptoms, please discuss with ID prior to calling the virology laboratory.
The West of Scotland Specialist Virology Centre has a specific MERS-CoV real-time PCR assay.
Please contact the West of Scotland Specialist Virology Centre BEFORE the samples are sent to ensure no risk to laboratory staff accidently opening a respiratory sample from a suspected MersCoV patient. It is important to discuss a possible case of Mers-CoV with the virologist on clinical for a decision to be made on the urgency of the sample. No Mers-CoV test will be performed at the laboratory without prior agreement.
Specimen Type Required
Transport of Sample
Specimens transported to the West of Scotland Specialist Virology Laboratory in a UN3373 Category B container (these boxes are distributed by ward 5C, QEUH and A+E Departments).
Delivery details: https://www.nhsggc.org.uk/about-us/professional-support-sites/laboratory-medicine/laboratory-disciplines/microbiology-and-virology/west-of-scotland-specialist-virology-centre/urgent-testing/