Laboratory Influenza Information
On this page:
When To Send a Specimen
Specimen Submission
Specimen Collection
Specimen Transport
Specimen Submission Forms
Shipping to MDH-PHL
Additional Influenza Surveillance Programs
Reporting Influenza
Other Influenza Information
Questions?
When To Send a Specimen
Hospitalized surveillance – submit specimens from persons who are hospitalized with influenza-like illness (ILI)* or hospitalized with clinical suspicion of influenza or deceased following ILI or deceased with clinical suspicion of influenza.
- If no influenza testing is performed, submit a nasopharyngeal swab or other specimen as appropriate, see Specimen Submission below.
- If a rapid influenza test was performed, regardless of the result, send a specimen.
- If your laboratory is performing onsite influenza testing by PCR and/or viral culture (or if you are using a reference laboratory for PCR and/or viral culture), MDH is still requesting that specimens positive for influenza from these patients be submitted to MDH-PHL for further characterization.
*ILI is defined as fever > 100° F and cough or sore throat in the absence of a known disease other than influenza.
Cluster investigation or other unusual circumstance for which MDH Epidemiology has requested a specimen(s) be sent to MDH-PHL. Testing in atypical situations (e.g. for a suspected influenza cluster) will be considered after consultation with MDH epidemiology at 651-201-5414 or 1-877-676-5414.
Laboratory surveillance - To further characterize this season's influenza strains, MDH-PHL is requesting that laboratories performing rapid and other testing methods (EIA, IFA, DFA, PCR, etc.) continue to submit up to two patient specimens (non-hospitalized) that are positive for influenza A or B each week for surveillance purposes. In addition, virology laboratories should continue to submit all viral culture isolates that are positive for influenza so that MDH-PHL can sub-type the isolates and compare them to the current vaccine configuration.
Specimen Submission
Non-Hospitalized Patients
For non-hospitalized patients and surveillance specimens, submit ONE UPPER RESPIRATORY specimen per patient.
- Nasopharyngeal swab is the preferred specimen.
- Other acceptable specimens include; nasal swab, nasal wash/aspirate, or combined nasal swab with an oropharyngeal swab, and viral culture.
Hospitalized Patients
For patients admitted with influenza-like illness (ILI) or suspect influenza without evidence of pneumonia or other lower respiratory disease – submit ONE UPPER RESPIRATORY specimen per patient.
- Nasopharyngeal swab is the preferred specimen.
- Other acceptable specimens include; nasal swab, nasal wash/aspirate, or combined nasal swab with an oropharyngeal swab, and viral culture.
For patients admitted with ILI or suspect influenza with evidence of pneumonia or other lower respiratory disease – submit an UPPER RESPIRATORY specimen AND a LOWER RESPIRATORY specimen (DO NOT perform a procedure such as bronchoscopy solely to collect a specimen for MDH)
- Lower Respiratory Specimen;
- Bronchial alveolar lavage (BAL)
- Tracheal aspirate (if intubated)
- Bronchial wash
Specimen Collection
Nasopharyngeal Specimen Collection for Viral Respiratory Pathogens (NYC Dept. of Health and Human Hygiene)
Collection of Nasopharyngeal Specimens with the Swab Technique. (Video-New England Journal of Medicine)
Specimen Transport
- Place swab in Viral Transport Media (VTM; e.g. M4, M5, Hanks) for transport to MDH. If VTM is not available, then sterile saline or phosphate buffered saline (PBS) is acceptable.
- Specimens transported in VTM must reach MDH within 7 days of collection
- Specimens not transported in VTM must reach MDH within 5 days of collection
- If sending leftover saline solution (no other chemicals, preservatives) from rapid testing, you must send at least 500 µl.
- Swabs collected and/or transported in non-sterile containers, baggies, or without transport media (dry) will not be accepted.
- Ship at refrigeration temperature.
Specimen Submission Forms
MDH is NO longer requiring the separate Clinical Screening Form used in the 2009-2010 influenza season. Only a single Clinical Testing and Submission Form is required, however, you must use the correct version of the form, which is dependant on whether the patient is hospitalized or not.
NOTE: There is NO fee sticker required for influenza testing.
Hospitalized Patients Only - Influenza Testing - Clinical Testing and Submission Form (Project #1492)
Use this form for all specimens submitted from persons hospitalized with ILI or clinical suspicion of influenza. In order to allow for prompt testing of submitted specimens for project #1492, please be sure to fill out the form completely, especially information regarding hospitalization (date of admission, hospital of admission, and outcome) found on the lower right hand corner of the form.
Use one of the following forms: Hospitalized Patients Only – Influenza Testing
- Printable Hospitalized Influenza Form (PDF:107KB/1 page) Print and fill out manually.
- Fillable Hospitalized Influenza Form (PDF:793KB/1 page) Fill out on your computer, then print.
Non-Hospitalized Influenza Testing - Clinical Testing and Submission Form
Use this form for submitting specimens for influenza testing from non-hospitalized patients. This would include submissions by clinical laboratories of positive influenza isolates that are being sent to MDH-PHL for surveillance subtyping or for any specimen specifically requested by MDH staff related to cluster investigation or other unusual circumstance.
- Printable Form (PDF:84KB/1 page) Print and fill out manually.
- Fillable Form (PDF: 578KB/1 page) Fill out on your computer, then print.
If applicable, please include the following under “Submitting Laboratory's Comments” at bottom of form.
- Influenza testing result
- Method used (DFA, rapid EIA, PCR, etc.)
- Name of test kit
- Please write 493 in the project box on the top of the form
Shipping to MDH-PHL
- Ship specimens to MDH-PHL by an overnight delivery service.
- Use cold packs to keep specimens at 4 degrees C.
- Ship to:
- Minnesota Department of Health
Public Health Laboratory
Attn: Biological Accessioning
601 Robert St. N
St. Paul, Minnesota 55155-2531
Additional Influenza Surveillance Programs
MLS Laboratory Influenza Surveillance Program
MDH Weekly Influenza Activity - Statistics
The MN Lab System (MLS) Laboratory Influenza Surveillance Program is made up of more than 100 clinic- and hospital-based laboratories, voluntarily submitting testing data on a weekly basis. These laboratories perform rapid testing (DFA, rapid EIA) for Influenza and Respiratory Syncytial Virus (RSV). Significantly fewer labs, perform confirmatory culture testing for Influenza and RSV, and even fewer perform PCR.
Tracking the laboratory results assists healthcare providers with patient diagnosis of influenza-like illness and provides an indicator as to the progression of the influenza season as well as prevalence of disease in the community.
If your laboratory is interested in participating in this program, please call: 651-201-5580
MLS Virology Laboratory Isolate Surveillance
Viral isolates are subtyped to monitor for the introduction of new influenza virus strains for comparison to the current vaccine subtypes. MDH-PHL performs hemagglutinin subtyping on isolates submitted from virology laboratories serving MN patients. Selected influenza isolates are forwarded to CDC for neuraminidase subtyping.
Influenza Sentinel Surveillance Program
Physicians and healthcare providers across the state help to monitor
influenza throughout the flu season. Sentinel providers fill out a weekly
report detailing the number of patients they've seen with influenza-like
illness. They also submit additional influenza specimens to the MDH Public
Health Lab according to the Sentinel Surveillance program guidelines.
More on the
Influenza Sentinel Surveillance Program
Avian Influenza Surveillance
Specimen Collection and Laboratory Testing for Avian H5N1 Influenza
Call MDH at 651-201-5414 or 1-877-676-5414 if you have a suspect
avian H5N1 case. Do not attempt to perform viral culture. Culture
for H5N1 should only be done at a BSL3+ or BSL4 facility.
Reporting Influenza
Reporting Influenza - information on what to report, how to report, and who is required to report.
Other Influenza Information
Links to other MDH and CDC Laboratory Specific Influenza Information
MDH Weekly Influenza Activity: Statistics / Surveillance Maps and Graphs
Questions?
- For specimen handling questions, call 651-201-4953.
- For the Virology Supervisor at 651-201-5257, or the MDH Public Health Virology Laboratory, call 651-201-5247.
- For an MDH epidemiologist, call 651-201-5414 or 1-877-676-5414.