California Department of Public Health – Viral and Rickettsial Disease Laboratory Enterovirus Enhanced Surveillance Submittal Form




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California Department of Public Health – Viral and Rickettsial Disease Laboratory

Enterovirus Enhanced Surveillance Submittal Form


The California Viral and Rickettsial Disease Laboratory (VRDL) is interested in obtaining samples from patients with suspected enterovirus infections, especially unusual presentations of “hand, foot and mouth” disease; patients hospitalized with neurological symptoms where enterovirus is the suspected causative agent and especially any outbreak for which enterovirus is the suspected causative agent. Instructions for Submitting Samples

When to Collect Samples


The sooner after onset the sample is collected, the greater the probability of obtaining a viral isolate. Ideally specimens should be obtained during the acute phase of illness (within 48-72 hours of onset - when viral excretion is at its peak). Contact your local Public Health laboratory to discuss the utility of viral diagnosis and interpretation of the test results before collecting samples more than one (1) week after onset of symptoms.

What Samples to Collect


Overall, throat swabs are the single most useful specimen to detect enteroviruses. When lesions are present, collection of vesicle swabs significantly increases the ability to detect Enteroviruses. We are not recommending collecting stools from acute cases.

How to Collect Samples

Throat swabs should be taken with the aid of a tongue depressor, by carefully swabbing the lateral and posterior pharynx without touching the tongue or buccal mucosa.

For vesicle swabs, the skin was cleaned gently with 0.9% sterile normal saline, but not with alcohol, which kills viruses. A sterile 24-gauge needle was used to rupture the vesicle, and a swab was used to absorb the fluid. Alternatively, the swab was gently rolled over the vesicle to squeeze out fluid. Mouth ulcers were sampled by rolling the swab over the floor of the ulcer.



Storage and Transportation

Throat swabs and vesicle swabs should be placed in 1-2 ml of Viral Transport Medium (VTM). Samples should be kept at 40C and transported to the local Public Health Laboratory within 48 – 72 hours.



Where to Send

INSERT LOCAL PUBLIC HEALTH LAB INFO, or
Viral and Rickettsial Disease Laboratory
Specimen Receiving- Enterovirus Surveillance
850 Marina Bay Parkway
Richmond, CA 94804



Send with

For each patient, complete the Specimen Submittal Form below and attach either the Hospitalized Enterovirus Case Report or Outpatient HFMD Case Report




Patient’s last name, first name

Patient’s Local Health Jurisdiction: __________________________


Reason for submitting sample:
[ ] Suspected Enterovirus infection

[ ] Patient hospitalized with suspected Enterovirus infection

[ ] From a suspected Enterovirus outbreak





DOB

Age (with units)

Sex (circle):

M F





HFMD/ ENTEROVIRUS SURVEILLANCE


Onset Date:

This section for Laboratory use only.

Date received and Accession Number



1st



Specimen type and/or specimen source



Date Collected

1st





2nd



Specimen type and/or specimen source

Date Collected

2nd








Viral and Rickettsial Disease Laboratory

California Department of Public Health

850 Marina Bay Parkway

Richmond, CA 94804

phone (510) 307-8585 fax (510) 307-8578



Type or print submitter’s complete mailing address above Enhanced Enterovirus Surveillance 02/17/2012

If this is an isolate (rather than an original clinical sample), please fill in below:


Submitted as cell culture isolate using passage # ____ of ________________ cells. [ ] Submitted as Nucleic Acid extract.

Source of original clinical sample: _______________________ [ ] Outbreak ID (if any) ____________________________



Identified (or tentatively identified as) _______________________________ by___________________________________
Contact Name: _____________________________ Phone # (______) ______________ Fax # (______) _______________
Questions? Call LOCAL PUBLIC HEALTH LAB or VRDL Medical Records Unit (510) 307-8585


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