Virology / Serology
General Information
Location: Telephone Extension:
4th Floor, Basic Science Building (BSB), Room 4-128 1837, 2660
Director:
Anna Plourde, MPH MD
Office: Extension: 8295
Supervisor:
Marly Islam
Office: BSB-4-128C Extension: 2660, 1837
Laboratories: Office: BSB-4-128 Extension: 1837, 2660
The virology laboratory uses several methodologies, including culture, antigen and
nucleic acid assays, and serology to aid in the diagnosis of viral and chlamydial
infections. Many variables determine the choice of methods, including the suspected
etiologic agent and the nature and stage of the infection.
Operation Schedule and Staffing:
The laboratory is located in the Basic Science Building, Room 4-128 and is open Monday thru Friday from 9:00 a.m. until 5:00 p.m. Call the laboratory for additional information regarding collection and submission of specimens or interpretation of results.
Ordering:
All requests must be ordered in the LIS and labeled with the preprinted barcode label.
A brief history of symptoms should be provided. This can be entered as an order comment in the LIS when ordering the request.
Viral Culture:
Cell culture systems in routine use for viral culture permit the isolation of adenoviruses (excluding enteric types 40/41), Coxsackie A viruses (not all types), Coxsackie B viruses, cytomegalovirus, echoviruses, herpes simplex viruses, influenza A and B, measles, mumps, polio viruses, reoviruses, respiratory syncytial virus, rhinoviruses, and varicella-zoster virus.
Chlamydial Culture:
Culture is performed primarily for the isolation of Chlamydia trachomatis but C. pneumoniae may be recovered in the same cell culture system, particularly with specimens containing high titers of this organism.
Chhlamydial cultures are limited to special circumstances, i.e. test of cure, sexual abuse, pediatric respiratory infections, ocular infections, and are not performed for routine diagnostic purposes. For routine screening purposes a nonculture assay is performed (see below).
Specimen Collection & Transport:
Viral Culture:
The choice of specimen for viral culture depends on the organ system involved (respiratory, central nervous system, etc.). The following suggestions are based on clinical symptoms and are meant only to serve as a general guide.
Respiratory infections: nasopharyngeal aspirate, nasopharyngeal swab, throat swab, bronchoalveolar lavage.
Exanthems/enanthems: vesicle fluid (aspirate preferred to swab), nasopharyngeal swab, throat swab, stool.
CNS: CSF, stool, nasopharyngeal swab, throat swab.
Enteric: nasopharyngeal swab, throat swab, stool.
Urogenital: urine (adenovirus, cytomegalovirus), urethral swab, cervical swab; urine specimens are useful for detecting congenital cytomegalovirus or rubella virus infections.
Ocular: conjunctival swab.
Disseminated: blood, tissues
Note: With the exception of suspected arboviral infections, blood is not usually collected from immunocompetent individuals for viral culture; anticoagulated blood is generally collected for the detection of cytomegalovirus viremia in immunocompromised individuals and may be useful for the diagnosis of congenital infections (e.g. cytomegalovirus, rubella).
Anticoagulated Blood: Hold at room temperature prior to delivery to the laboratory. Do not refrigerate
or freeze.
Attempt to schedule collection of blood for viral culture so that the maximum time
between collection and delivery to the laboratory is 18 hrs.
Deliver to the laboratory by 1:00 p.m.
Chlamydial Culture
Urogenital: urethral swab, cervical swab, vaginal swab (prepubescent/anestrogenic), rectal swab.
Respiratory (neonatal): nasopharyngeal aspirate, nasopharyngeal swab.
Occular: conjunctival swab
Viral and Chlamydial Culture
Transport Medium and Swabs
M4 Universal Transport Medium suitable for viruses and chlamydia is available from the laboratory. Store at 2-8oC.
Use dacron or rayon swabs with plastic or aluminum shafts; avoid calcium alginate, cotton, and wooden-shafted swabs.
Collection
Refer to Table 1 for instructions.
Do not allow swab specimens to dry. Place swabs into transport medium immediately and keep swab tip immersed during transport to the laboratory.
The specimen tube label must include the patient’s name and medical record number and should also include the type of specimen and the date and time of collection.
Note: Storage at warm temperatures for extended periods may reduce the sensitivity of viral or chlamydial cultures.
Specimens other than anticoagulated blood
Place specimens at 2-8oC (refrigerator temperature) prior to delivery to the laboratory. Do not freeze specimens.
Viral and Chlamydial Non Culture (Direct) Assays:
Respiratory syncytial virus, Influenza virus type A and B:
Test (immunofluorescence).
Specimen: nasopharyngeal aspirate (NPA) or NP swab collected in transport medium as described above for viral and chlamydial culture (see Table 1). The specimen tube label must include the patient’s name and medical record number.
Immediate transport and cold storage are not critical unless viral culture is to be performed on the same sample.
Assay is performed daily. Results are available on the day of receipt for samples received by 2:30 p.m.
CMV Antigenemia:
Indirect Immunofluorescence of cytospin prepared peripheral blood leukocytes.
Collect a minimum of 5ml of EDTA anticoagulated blood (lavender top). Transport at ambient temperature (Do Not Refrigerate) and deliver to laboratory by 1:00 PM, Mon-Thur., and by 10:00 am on Fridays.
Test is performed Monday-Friday. Turn around time is 24hrs for specimens received Monday through Friday up to 10:00 am. Specimens received after 10:00 am. on Fridays will be completed by the following Monday.
Chlamydia trachomatis and N. Gonnorrhea DNA by PCR
Female cervical swab, male urethral swab.
Use M4-RT Viral Transport media.
Follow collection protocol as detailed on collection kit.
Transport at ambient temperature.
Limited to adult cervical and male urethral testing only. See Chlamydia Culture for all other testing.
Turn around time. Within 4 days of receipt of specimen.
Viral Antibody Assays (Serology)
Test Availability and Scheduling:
ELISA assays for mumps, measles, varicella-zoster, and HIV-1 are performed weekly.
Passive agglutination assays for rubella and cytomegalovirus are Performed bi-weekly.
Syphilis screening (RPR) is performed daily.
Heterophile antibodies (Monospot) performed daily, Mon.-Fri.
HIV
Specimen Submission:
Requests for testing other than for HIV-1
All requests are ordered through the laboratory information system (Cerner) and labeled with the printed bar code label. (See Policy and Procedure- Procedure for Handling Laboratory Orders and Results). (Lab-1)
If the specimen is collected for other than immune status determination for Rubella or CMV (i.e. illness or exposure), provide a brief clinical summary, the onset date of symptoms and other relevant information (e.g. recent immunization, exposures, pregnancy status). This can be entered as a order comment in the L.I.S).
Requests for HIV-1 Diagnostic
Order in the LIS - HIV Antibody Screen ELISA.
NYS Health Code requires Informed Written Consent to be obtained from all patients consenting for HIV testing. Consult the Department of Epidemiology/HIV Counseling Service for more details.
The laboratory must have on file an attestation from the clinician that informed written consent has been obtained from the patient. Complete and submit with the labeled specimen tube the form - HIV INFORMED WRITTEN CONSENT CERTIFICATION.
Western blot testing is performed on all samples repeatedly reactive by ELISA.
Specimen Collection:
Collect blood without anticoagulants and transport at ambient temperature.
Turn around Time:
Comprehensive viral cultures are kept in test for 14 days except for cytomegalo virus tube cultures which are observed for 4 to 6 weeks; herpes cultures are kept in test for 10 days. Most isolates are detected during the first 5 days of culture, with the majority of positive herpes simplex cultures detected within 24 to 48 hrs.
Chlamydial cultures are tested and reported within 7 days of receipt.
Test results are retrievable through the Laboratory Information System (Cerner).