April 2009

Information Bulletin 09-09
NH-139
BC-48

Collecting Influenza Specimens In Long-Term Care Facilities

Purpose:

In response to recent activity of swine influenza in the United States and Mexico, the Minnesota Department of Health (MDH) is requesting that long-term care facilities collect specimens on residents and staff exhibiting influenza-like illness (ILI) and send them to MDH for testing. ILI is defined as the following: fever ( >100°F ), cough, and/or sore throat.

The MDH offers influenza testing to long-term care facilities free of charge during suspected influenza outbreaks.

Contact:

Call MDH at 651-201-5414 or 1-877-676-5414 if you have suspected or confirmed influenza in your facility. Please be on the lookout for ILI during the summer months. Although seasonal influenza is winding down, we may be seeing just the beginning of swine influenza activity.

When to Collect Influenza Specimens:

• When a resident or staff member develops ILI.
• Within three days of symptom onset, preferably as soon as possible after onset.

How to Collect Influenza Specimens:

Collect one N/P or nasal specimen and one throat specimen from each patient or staff member exhibiting ILI. Swabs from the same person can be placed in the same vial. Use the following collection methods:

N/P Swab
• Perform a nasopharyngeal swab in both nares, using a viral culturette (included in MDH kits).
• Gently insert the swab through the nostril to the posterior nasopharynx.
• Leave swab in place for 15-30 seconds, rotate, and remove.
• Place the swab directly into the viral transport media.

Nasal Swab
• Insert a dry swab past the nares until the tip reaches the area below the inferior turbinate.
• Allow swab to remain there for 15 seconds to absorb secretions.
• Rotate the swab gently 2-3 times and withdraw.
• Place the swab directly into the viral transport media.

Throat Swab
• Depress the tongue with a tongue blade, and gently swab the posterior pharynx in an up-and-down motion several times.
• Place the swab directly into the viral transport media.

How to Submit Specimens to the MDH Public Health Laboratory:

Specimens must be accompanied by a completed specimen request form; otherwise, they will not be tested. Please click the link below to print the form:

/divs/phl/clin/specimensubmission.pdf (expired link)

Complete one specimen request form for all specimens. MDH requires all of the information highlighted in blue including, but not limited to, patient name, date of birth, name and address of requesting facility, specimen source and date of collection, and test requested. Please denote that the specimen is from a long-term care facility.

• Ship to the laboratory by an overnight delivery service.
• Use a cold pack to keep specimens at 4o C.
• Mail to:
  
  

  U.S. Mail	Federal Express
  Minnesota Department of Health	Minnesota Department of Health
  Public Health Laboratory	Public Health Laboratory
  Attn: Specimen Handling, 1st Floor	Attn: Specimen Handling, 1st Floor
  601 Robert Street North	601 Robert Street North
  P.O. Box 64899	St. Paul, MN 55155-2531
  St. Paul, MN 55164-0899

   
• For specimen handling questions call 651-201-4953
• MDH may not be able to provide individual results, depending on the type of laboratory test used.
• If swine influenza is suspected, you will be notified immediately and provided additional infection control guidance.
• There is no cost to long-term care facilities for influenza testing.
• Questions? Please call the MDH Public Health Laboratory at 651-201-4953, Susan Fuller at 651-201-5255, or Karen Martin at 651-201-5537

For up to date swine influenza information:
Please visit the MDH website at Influenza (Flu)