MERS-CoV PCR to CDC (Sendout)

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General Information

Lab Name
Lab Code
594
External Test Id
CDC-10488
Description

Test Information: Molecular test to diagnose active infection (presence of MERS-CoV) in clinical specimens.

Ordering Recommendations: CDC recommends collecting and testing multiple specimens for the rRT-PCR assay, including lower (bronchoalveolar lavage, sputum and tracheal aspirates) and upper (nasopharyngeal and oropharyngeal swabs) respiratory specimens. For patients with possible MERS-CoV pneumonia, lower respiratory specimens are the preferred specimen type, because they have higher test sensitivity.

Ordering Requirements:

  • Providers must obtain approval from designated CDC contacts prior to sample submission (refer to "CDC Pre-Approval" section of the MERS-CoV Molecular Detection Test Guide for points of contact).
    • Alternatively, samples may be sent through Washington State PHL with prior approval from the the LHJ (Local Health Jurisdiction) epidemiologist of the patient's county of residence (see "Resources" below for contact information).
  • Complete the CDC Requisition Form 50.34 or provide relevant clinical information (date of onset, brief clinical summary, state of illness, type of infection, therapeutic agent(s) administered, travel history, previous laboratory results, etc.) in the Epic order comments.
References

Resources:

Forms & Requisitions
Synonyms
CDC-10488, MERS CoV PCR, MERS-CoV, MERS-CoV Molecular Detection, Middle East Respiratory Syndrome Coronavirus
Components

Interpretation

Guidelines
Method

Polymerase Chain Reaction (PCR)

Reference Range
References

Resources:

Ordering & Collection

Specimen Type
Nasopharyngeal and/or Oropharyngeal swabs, sputum, and lower respiratory tract aspirates/washes.
Collection

Collection Recommendations: CDC recommends collecting and testing multiple specimens for the rRT-PCR assay, including lower (bronchoalveolar lavage, sputum and tracheal aspirates) and upper (nasopharyngeal and oropharyngeal swabs) respiratory specimens. For patients with possible MERS-CoV pneumonia, lower respiratory specimens are the preferred specimen type, because they have higher test sensitivity.

Nasopharyngeal or Oropharyngeal Swab:

  • After swabbing the site, place the swab into a sterile tube containing 2-3 mL of transport media.
  • Use only synthetic fiber swabs with thin plastic or wire 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.
  • NP and OP specimens can be combined, placing both swabs in the same vial.

Bronchoalveolar lavage, Tracheal aspirate: Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.

Sputum: 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. A minimum of 200 µL is required for testing.

Label all specimens with at least two matching patient identifiers, the specimen site, and collection date/time.

Additional Resource: CDC Laboratory Testing for MERS

Forms & Requisitions
Handling Instructions

Outside Laboratories: Clients outside of the UW Medicine system should arrange for testing directly with WA DOH or CDC.

Quantity
Requested: 3 mL BAL/tracheal aspirate; swab in 3 mL of viral transport media; 200 µL sputum
Minimum: 0.5 mL BAL/tracheal aspirate; swab in 2 mL of viral transport media; 200 µL sputum

Processing

Receiving Instructions

Refrigerate specimens while awaiting shipment. Specimens can be stored at 2-8°C for up to 72 hours after collection.

SPS: At order entry, include the modifier comment "Possible MERS" for all other Virology tests being requested along with MERS. Accession a separate order for each specimen type received.

Login: SPMSND-;REFRIG, POSSIBLE MERS

  • MSNDTO: CDC
  • MSPTYP: [Enter the appropriate specimen code below]
  • MTSTRQ: ;MERS CoV Molecular Detection (CDC Test CDC.10488)

Specimen Type:

ETC Translation
SWAB Swab
NPS Nasopharyngeal Swab
ORPH-SWAB Oropharyngeal Swab
TASP Tracheal Aspirate
BAL Bronchoalveolar Lavage
SPUT Sputum

Sendouts:

  • Requisitions that are pre-filled by the provider may require additional information to be added after sample collection. This may include: collection date, sample type, date sent to CDC, specimen ID number, etc. Per CDC requirements, additional information may be written on an electronically completed form as long as it is initialed by lab staff making the correction/addition.
  • If a CDC form is not provided, complete Requisition Form 50.34.
    • CAST must be entered as the "intermediate submitter" to ensure that result reports are properly routed to the lab from the WAPHL.
  • There must be two matching patient identifiers present on the sample and on the CDC requisition. One identifier must be the name, the other identifier can be the MRN, specimen ID, or date of birth. Note that because Sunquest CID labels do not contain the DOB, then either or the MRN or specimen ID must be included on the requisition or the date of birth added to the specimen label.
  • Freeze samples prior to shipment.
  • Ship samples on dry ice via FedEx Priority Overnight, Monday through Thursday only. Do not ship on Fridays or before holidays.
  • Ship To:
    • Centers for Disease Control and Prevention
    • ATTN: [CDC Point of Contact]
    • 1600 Clifton Road, NE
    • RDSB/STATT Unit 84
    • Atlanta, GA 30329

Stability: Refrigerated: 72 hrs. Samples 72 hours or older: Freeze at -70°C. Samples should be shipped frozen.

Misc Sendout

Performance

Lab Department
Frequency
Turnaround Time: 2 Weeks from sample receipt at CDC Laboratories.
Available STAT?
No
Performing Location(s)
Sendout Centers for Disease Control and Prevention
855-612-7575

1600 Clifton Road NE
Atlanta, GA 30333

Billing & Coding