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Instructions for Collecting Nasopharyngeal Swab Specimens

To rule out H1N1 (Swine) Influenza A

All suspected cases must be immediately reported to the appropriate County Health Department to ensure that patients meet the clinical criteria.

Clinical criteria and risk factors meeting possible influenza A H1N1 (swine flu) case definition: Persons with influenza-like illness (ILI— Fever >37.8°C (100°F) and a cough and/or sore throat) regardless of rapid influenza test status or travel history and persons with ILI and the appropriate travel history (Mexico or other communities with confirmed cases).

Please contact IRL at 954-777-0018 X433, of any suspect cases prior to submitting specimens, to ensure proper specimen testing and management.

Specimen Collection Instructions

1. An N-95 respirator and other appropriate PPE (gown/gloves) should be worn throughout the collection procedure.
2. The specimen should be collected with a single nasopharyngeal (NP) swab. Only mini tip flexible aluminum wire swabs should be used. Collect specimen by passing the NP swab through the nares until resistance is met by virtue of contact with the nasopharynx. Although a contact time of 30 seconds is advocated, in practice a few seconds of contact often induces coughing or patient resistance, either of which is adequate incentive to remove the swab.
3. Other acceptable specimens include nasal aspirates, nasal swabs and oropharyngeal swabs.
4. Viral transport medium (VTM) is used to collect the specimen. The media should be stored refrigerated (4-8C). Do not freeze.
5. Following specimen collection, inoculate the VTM. Bend the wire to fit the transport medium tube and reattach the cap securely. Ensure that the cap is tightly screwed on to prevent specimen from leaking.
6. Label the transport tube with the name and specimen source.
7. Place the labeled transport medium tube in a biohazard bag. Order Rapid Influenza A&B and Viral culture. Add a comment “Rule out H1N1 Swine flu”.
8. Transport specimen to the laboratory ASAP.