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Excellence in Pathology and Laboratory Services New Assay: Respiratory Virus Panel by PCR Overview October, 2009 PathGroup Labs is pleased to announce the immediate availability the FDA-cleared Luminex Respiratory Virus Panel by PCR assay. This assay detects the following 10 different common respiratory viruses from a single nasopharyngeal specimen: Influenza A (subtype H1), Influenza A (subtype H3), Influenza A (other subtype), Influenza B, Respiratory Syncytial Virus subtype A, Respiratory Syncytial Virus subtype B, Parainfluenza 1, Parainfluenza 2, and Parainfluenza 3 virus, Human Metapneumovirus, Rhinovirus, and Adenovirus. This assay will be performed 5 days a week, Tuesday through Saturday, so that a 24-48 hour turn-around time is achieved. This quick detection and identification of specific viral nucleic acids from individuals presenting with signs and symptoms of respiratory infection will aid in the diagnosis and treatment of respiratory viral infection. Influenza A and Novel H1N1 (swine) Influenza A: This panel will detect all known Influenza A viruses and subtype the common seasonal H1 and H3 viruses. It is important to note that this assay does not directly subtype the novel H1N1 (swine) Influenza A virus that has been in circulation since Spring, 2009. A specimen that is positive for the novel H1N1 (swine) Influenza A will have a result of Influenza A (other subtype) Detected. Current recommendations from the CDC and most state health departments are that specific identification of the novel H1N1 (swine) Influenza A is not necessary to begin treatment; the identification of Influenza A is necessary and sufficient for treatment. Clinical Utility Detection and identification of common respiratory viruses Methodology: Reverse-transcription Polymerase Chain Reaction and xMAP Detection Test Codes: RVP CPT Codes: 87798 (10 units) Specimen Collection: Collect a nasopharyngeal specimen using the supplied flocked swabs and M4 media. Place the swab in the M4 container and break the swab shaft at the scored mark. Leave the swab head in the media. Do not use wooden shaft swabs or cotton tip swabs. Dacron head nylon shaft swabs are acceptable but not preferred. Store specimens frozen. Informative videos on collecting nasopharyngeal specimens can be found at http://copanusa.com/videos/education/index.php Shipping and Handling: Transport specimens frozen. Associated Pathologists, PLC and PathGroup Labs 658 Grassmere Park Suite 101 Nashville TN 37211 615-562-9300 888-474-5227 Excellence in Pathology and Laboratory Services Reference Ranges: The reference range for each virus is Not Detected. Turnaround Time: 1-2 days References 1. Anzueto, A. and M. S. Niederman (2003). "Diagnosis and treatment of rhinovirus respiratory infections." Chest 123(5): 1664-72. 2. Arruda, E., A. Pitkaranta, et al. (1997). "Frequency and natural history of rhinovirus infections in adults during autumn." J Clin Microbiol 35(11): 2864-8. 3. Brandt, C. D., H. W. Kim, et al. (1969). "Infections in 18,000 infants and children in a controlled study of respiratory tract disease. I. Adenovirus pathogenicity in relation to serologic type and illness syndrome." Am J Epidemiol 90(6): 484-500. 4. Chidgey, S. M. and K. J. Broadley (2005). "Respiratory syncytial virus infections: characteristics and treatment." J Pharm Pharmacol 57(11): 1371-81. 5. Edwards, K. M., J. Thompson, et al. (1985). "Adenovirus infections in young children." Pediatrics 76(3): 420-4. 6. Hayden, F. G. and M. G. Ison (2005). Respiratory Viruses. ACP Medicine. 2006. 7. Heirholzer J.C. (1992). “Adenoviruses in the immunocompromised host.” Clin Microbiol Rev. 5(3): 262-74. 8. Kuiken, T., R. A. Fouchier, et al. (2003). "Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome." Lancet 362(9380): 263-70. 9. Makela, M. J., T. Puhakka, et al. (1998). "Viruses and bacteria in the etiology of the common cold." J Clin Microbiol 36(2): 539-42. 10. MMWR (2007). “Acute respiratory disease associated with adenovirus serotype 14 – Four States, 2006-2007.” 56(45); 1181-1184. 11. MMWR (2007). “Update – Influenza Activity – United States and Worldwide, 2006-07 flu season, and composition of the 2007-08 Influenza vaccine”. 56(31):789-794. 12. MMWR (2006). “Brief report – Respiratory Syncytial virus activity – United States 2005-06”. 55(47):1277-1279. 13. Monto, A. S. (1994). "Studies of the community and family: acute respiratory illness and infection." Epidemiol Rev 16(2): 351-73. 14. Mullins, J. A., D. D. Erdman, et al. (2004). "Human metapneumovirus infection among children hospitalized with acute respiratory illness." Emerg Infect Dis 10(4): 700-5. 15. Pitkaranta, A. and F. G. Hayden (1998). "Rhinoviruses: important respiratory pathogens." Ann Med 30(6): 529-37. 16. Rota, P. A., M. S. Oberste, et al. (2003). "Characterization of a novel coronavirus associated with severe acute respiratory syndrome." Science 300(5624): 1394-9. 17. Rotbart, H. A. and F. G. Hayden (2000). "Picornavirus infections: a primer for the practitioner." Arch Fam Med 9(9): 913-20. 18. Ryan M.a., Gray G.C., et al. (2002). “Large epidemic of respiratory illness due to adenovirus types 7 and 3 in healthy young adults.” Clin Infect Dis. 34(5): 577-82. 19. Stalkup, J. R. and S. Chilukuri (2002). "Enterovirus infections: a review of clinical presentation, diagnosis, and treatment." Dermatol Clin 20(2): 217-23. 20. Turner, R. B. (1998). "The common cold." Pediatr Ann 27(12): 790-5. 21. van den Hoogen, B. G., J. C. de Jong, et al. (2001). "A newly discovered human pneumovirus isolated from young children with respiratory tract disease." Nat Med 7(6): 719-24. 22. van der Hoek, L., K. Pyrc, et al. (2004). "Identification of a new human coronavirus." Nat Med 10(4): 368-73. 23. Williams, J. V., P. A. Harris, et al. (2004). "Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children." N Engl J Med 350(5): 443-50. 24. Yarush, L. I. and R. W. Steele (2000). "Diagnosis and prospective treatment of enteroviral infections in children." Clin Pediatr (Phila) 39(4): 209-11. Associated Pathologists, PLC and PathGroup Labs 658 Grassmere Park Suite 101 Nashville TN 37211 615-562-9300 888-474-5227