Hepatitis A and B Specimen Submission
Find out what hepatitis A and acute hepatitis B specimens should be submitted to the MDH Public Health Laboratory as a part of a genomic sequencing project between MDH and the CDC.
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Specimen storage and handling
Specimen submission to MDH
Packaging for private or contract couriers
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The Minnesota Department of Health (MDH) requests that specimens from all cases of hepatitis A (HAV) and acute hepatitis B (HBV) infection be submitted to the MDH Public Health Laboratory (MDH-PHL). MDH is working with the U.S. Centers for Disease Control and Prevention (CDC) on genomic sequencing of HAV and HBV to help guide and enhance prevention and control activities; testing of specimens will occur at both the CDC Hepatitis Reference Laboratory and MDH-PHL. This project begins in August 2006, and continues indefinitely pending ongoing funding.
Serum and stool specimens from all confirmed cases of HAV, and only serum specimens from acute cases of HBV, are needed. MDH hepatitis surveillance staff will contact laboratories to request stored serum specimen upon confirming the diagnosis with the healthcare provider, and will contact HAV cases directly to coordinate stool specimen submission. Healthcare providers will be asked to authorize forwarding the specimen to MDH-PHL.
- Laboratories are asked to store serum specimens in accordance with the following criteria:
- Hepatitis A IgM positive
- Hepatitis B core IgM antibody (IgM anti-HBc) positive
- MDH does not require serum from persons with chronic HBV infection or from HBV immune status testing.
- Stool specimens will be requested from the patient, through the physician, by MDH hepatitis surveillance staff when a case of HAV is confirmed.
- Serum is the optimal specimen. EDTA or citrate plasma are acceptable but not optimal.
- Blood should be collected in a redtop tube, spun, and separated off of the cells as soon as possible (preferably within 4 hours).
- Ideally, 3 ml serum, but no less than 0.5 ml should be submitted to MDH-PHL.
- Hemolytic specimens are unacceptable.
- Stool must be placed in Cary-Blair transport media (provided by MDH hepatitis surveillance staff).
- Serum specimens should be stored at –20°C to –70°C. Storage at 3-8°C is acceptable for up to one week. Storage above 15°C for more than a few hours should be avoided.
- Stool must be stored and shipped in Cary-Blair transport media and may remain at room temperature.
- Freeze-thaw cycles should be minimized.
- If serum specimen is stored frozen, please ship frozen on dry ice.
- If serum specimen is stored refrigerated, please ship with cold packs.
- Tubes/containers should be labeled with patient name, date of birth, and date specimen was collected.
- The MDH Hepatitis Specimen Submission Form (provided by MDH hepatitis surveillance staff upon requesting a specimen) should be completed and included with each specimen. The MDH Hepatitis Specimen Submission Form includes the Project ID number (“Project 986” for HAV cases, and “Project 987” for acute HBV cases).
- For help with packaging and shipping, call MDH-PHL Biological Accessioning at 651-201-4953.
- Assure a leak proof primary container for liquids by securing with parafilm.
- Place the primary specimen in a secondary leak proof container such as a Ziploc bag and add paper towel or other absorbent material to absorb any leaks.
- Place the package in an insulated outer container (preferably Styrofoam but if Styrofoam is not available, a cardboard box) with dry ice, cold pack, or wet ice. If wet ice is used, assure that it is in a leak proof bag.
- In addition to the steps outlined for triple packaging for private and contract couriers, add a diamond shaped UN3373 label (indicating diagnostic specimen) to the outside of the outer box.
- Place a label, if not already printed on the box, stating: “Diagnostic Specimen” to the outside of the box.
- When using dry ice, place the “dry ice” hazard label on the outer package.
Public Health Laboratory
Attn: Biological Accessioning
601 Robert St. N.
P.O. Box 64899
St. Paul, MN 55164-0899