The Leeds Teaching Hospitals NHS Trust

Pathology

Virology Samples

Specific test requirements for Virology testing can be found in the user manual

Samples will be tested in some cases based on clinical details. It is essential that full clinical details including travel history and status of immunity/immunosuppression along with patient demographics are provided to allow appropriate tests to be selected.

Types of Specimens:

 Serum Samples

 Serum Samples are required for antibody detection tests IgG/IgM

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Take sample in serum gel tube or serum separator - min 5 mls

Adult: Red top, yellow ring - ensure tube is filled to line. Separate samples should be sent for blood sciences requests. 

Paediatrics: Red top, white ring. Multiple tests may require multiple bottles.

 Do not use tubes with additives.

Plasma Samples

Plasma Samples are required for molecular PCR tests

Lavender Top Plasma tube

 

 

Adults: Lavender top, black ring, ensure tube is filled to line. Multiple tests require additional tubes.

Paediatrics: Lavender top, white ring

Samples for CMV, EBV, Adenovirus PCR tests need to be in the lab by 9:30am (Mon to Sat) for same day testing.

Viral swab sample - Copan flocked swabs

Copan Flocked swab v2

 

Pink top Copan Swabs. Suitable for Skin swabs, eye swabs, throat swabs, nose swabs, vesicle fluid swabs for PCR

 

 

Respiratory Sample

White top universal container

 

 

 

Nasopharyngeal aspirate BAL or Tracheal Aspirate in Sterile Universal. Samples should reach the laboratory by 9:30 am for same day testing (NB: Respiratory testing at weekends is normally only on Sundays except during peak influenza season)

CSF Sample

Send separate sample and request from other investigations in a sterile Universal. Suitable for PCR testing.

Faeces sample

Samples for faecal virology will not be routinely tested in all patients. Indicated for immunocompromised patients and suspected community acquired outbreaks. Suitable for PCR testing

Tissue Sample

If small biopsy or aspirate sample, moisten with sterile saline. Send in sterile universal. Suitable for PCR testing

Urine Sample

Urine samples for virology should be sent in sterile containers,do not use containers with boric acid preservative

Transport

Samples should reach the laboratory within 24 hrs. If this is not possible refrigerate.

HIV and Hepatitis Viral Load samples must be centrifuged within 24 hours of the sample been taken so should be sent without delay. External users of this service can send serum samples instead of whole blood if transport is likely to be delayed.

TB QuantiFERON tests and T spot should not be refrigerated and must be received within 16 hours of collection. See sampling for TB QuantiFERON tests and T spot on our tests and tubes site

Viruses Associated by Clinical Syndrome

Clinical Syndrome/Details

Viruses Associated

Specimen & Comments

Test Method

Conjunctivitis/Keratitis/ Retinitis

Herpes Simplex Virus (HSV)

Adenovirus

Varicella-zoster virus (VZV)

Enterovirus

Cytomegalovirus (CMV)

Viral Eye Swab

PCR

Mucous or cutaneous membranes - vesicular or ulcerative lesions

Herpes Simplex Virus (HSV)

Adenovirus

Varicella-zoster virus (VZV)

Enterovirus

 

Viral Swab sample, skin lesions, mouth, lip samples

PCR

Maculopapular rash

Measles

Parvovirus B19

Enterovirus

Rubella

Syphilis

 

Various samples see test repertoire

PCR and serology

Respiratory Infection

Adenovirus

Influenza viruses A and B

Respiratory Syncytial Virus (RSV)

Parainfluenzaviruses 1-4

Metapneumovirus

Rhinovirus

 

NPA

BAL

Tracheal Aspirate

Nose and Throat swabs in VTM.

PCR

Exposure to Blood Bourne Virus

Hepatitis B surface antigen

Hepatitis C antibody

HIV

Serum sample

Acute recipient samples will be stored only.

If recipient post 3 month please include hepatitis B vaccination history in clinical details

Donor samples should indicate known infection if applicable

Serology

Meningitis and Encephalitis

HSV

VZV

Adenovirus

Enterovirus.

In addition for immunocompromised patients: CMV

EBV

JC.

CSF sample

 

 

Faeces samples for enterovirus only

PCR

Myocarditis and Pericarditis

Enterovirus

Parvovirus

Influenza A&B (seasonal)

EDTA sample

Faeces sample for enterovirus only

Respiratory samples

PCR

Haemorrhagic cystitis

Adenovirus

CMV

BK virus

Urine Sample

PCR

Gastroenteritis

Norovirus

Rotavirus

Adenovirus*

Sapovirus*

Astrovirus*

 

Faeces Sample

* Tested on patients <5 years, all immunocompromised and immunosuppressed. External users should specifically request extended testing if required

 

PCR

Acute Hepatitis

Jaundice

Abnormal LFT’s

Hepatomegaly

Dark urine/pale stools

Hepatitis A, B, C, E

 

Serum sample

Serology

Viral Neonatal Fever

HSV

Adenovirus

Enterovirus

CMV

EBV

VZV

EDTA sample

Faeces sample for enterovirus only

PCR

Viral Fever > 3 months

Adenovirus

Epstein Barr Virus

CMV

EDTA sample

PCR

Viral Rash

Herpes Simplex

Varicella Zoster

Adeno

Enterovirus.

UTM sample of affected site

Faeces sample for enterovirus only

PCR