MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS (MERS-CoV)
Memo from the DHMH Laboratory Director to Medical Laboratory Directors, Local Health Officers and Health Care Providers, June 25, 2013
Suspect MERS-CoV Specimen Submission Guidelines (June 25, 2013)
I. ACCEPTABLE SPECIMENS
1. Lower Respiratory Specimens: sputum, broncheoalveolar lavage, tracheal aspirate
2. Upper Respiratory Specimens: nasopharyngeal and oropharyngeal swabs in viral transport media
II. SPECIMEN COLLECTION KIT INSTRUCTIONS
III. SPECIMEN COLLECTION
1. Lower Respiratory Specimens
Have the patient rinse the mouth with water and then expectorate deep cough sputum directly into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.
b. Lower respiratory tract aspirates/washes (Broncheoalveolar lavage, tracheal aspirate)
Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.
2. Upper Respiratory Samples: Nasopharyngeal (NPS) and Oropharyngeal swabs (OPS) in viral transport media (VTM).
Use only synthetic fiber swabs with plastic shafts. Do not use calcium alginate swabs or swabs with wooden shafts, as they may contain substances that inactivate some viruses and inhibit PCR testing. Place swabs immediately into sterile tubes containing 2-3 ml of viral transport media.
Nasopharyngeal swabs: Insert a swab into the nostril parallel to the palate. Leave the swab in place for a few seconds to absorb secretions. Swab both nostrils.
Oropharyngeal swabs: Swab the posterior pharynx, avoiding the tonsils and tongue.
Collect 2-5 grams of stool specimen (formed or liquid) in sterile, leak-proof, screw-cap.
Serum specimens should be collected during the acute stage of the disease, preferably during the first week after onset of illness, and again during convalescence, ≥ 3 weeks later.
Children and adults: Collect 1 tube (5-10 mL) of whole blood in a serum separator tube. Allow the blood to clot, centrifuge briefly, and separate sera into sterile tube container.
Infants: A minimum of 1 cc of whole blood is needed for testing of pediatric patients. If possible, collect 1 cc in an EDTA tube and in a serum separator tube. If only 1cc can be obtained, use a serum separator tube
III. LABORATORY TEST REQUEST SLIP (INFECTIOUS AGENTS: CULTURE/DETECTION) INSTRUCTIONS
IV. PACKAGING AND SHIPPING
If you suspect a MERS CoV infection, please contact your Local Health Department for a review of the case. If testing is indicated the Local Health Department will make arrangements with the DHMH Laboratory for courier pick-up of specimens and expedited MERS CoV testing.
For questions or concerns, please contact the Division of Molecular Biology Laboratory at (410) 767-5819 during normal business hours from 8:00AM - 4:30PM Monday through Friday.
For urgent inquiries after normal business hours, please contact the DHMH Lab emergency contact number at (410) 925-3121.