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All buffy coat (peripheral blood leukocyte) specimens are processed for the CMV antigenemia assay. The CMV antigenemia assay for buffy coat is stained for CMV antigen the day after it is received in the laboratory. The buffy coat specimen should be collected in either a heparinized or EDTA tube and sent to the lab within 24 hours. If desired, a viral culture on the Buffy coat can also be requested. Buffy coat cultures are maintained for 21 days before a final negative report is issued.
Search "VCCMVA" or CMVA" code in the online Laboratory Test Catalog for information on CMV Antigenemia & Culture
The Virology Laboratory can complete the identification of viruses isolated in other laboratories. HSV isolates are confirmed as HSV‑1 or HSV‑2 by direct FA. Non‑HSV isolates are identified and confirmed by monoclonal antibody. Submit the infected cell culture as soon as possible after detecting cytopathic changes in the cell monolayer. Call the laboratory (206) 685‑8037 to arrange this service.
Isolation of Epstein‑Barr Virus is not routinely available; see PCR or serologic detection methods. PCR for Human Herpes Virus type 6 (HHV6) and HHV8 are also available. Please see the Molecular Diagnostic (PCR) section for PCR tests.
Search "HSST" code in the online Laboratory Test Catalog for information on Herpes Simplex Virus - Subtype 1 & 2 Only.
Specimens submitted for this assay are processed primarily for the identification of Cytomegalovirus (CMV), Herpes simplex type 1 (HSV‑1), Herpes simplex type 2 (HSV‑2) and Varicella Zoster Virus (VZV). Appropriate specimens include lesions, genital sites, conjunctival swabs, throat swabs, rectal swabs, buffy coats (EDTA or heparinized), BAL fluid or tissues. First morning voids of urine are more concentrated and contain the highest titers of virus.
Specimens to rule out HSV‑1 or HSV‑2 are read daily for 5 days, and then every other day before being reported as negative after 14 days of observation. CMV and VZV are slower growing viruses and their cultures are maintained up to 21 days before being reported as negative. All Herpes group cultures receive a preliminary negative report after 5 days incubation. All positive cultures are confirmed by FA and HSV isolates are subtyped with monoclonal antisera.
Herpes group Viral cultures can be combined with either the Herpes group FA (detects HSV or VZV), the CMV antigenemia assay or the CMV rapid assay. Because of the extreme lability of VZV, any culture for this virus is automatically combined with the Herpes group FA to detect VZV antigen.
Search "VCIT" code in the online Laboratory Test Catalog for information on Viral Culture & Herpes Group FA, Tissue for tissue samples.
Search "VCHG" code in the online Laboratory Test Catalog for information on all other sample types of Herpes Group Culture (HSV 1 & 2, CMV, VZ).
CDC does not recommend that virus isolation studies on respiratory specimens from patients who meet criteria for suspected avian influenza A (H5N1) be conducted unless stringent BSL 3+ conditions can be met. Therefore, respiratory virus cultures should not be performed in most clinical laboratories and cultures should not be ordered for patients suspected of having H5N1 infection. Contact the Washington State Epidemiologist at (206) 361‑2831 with questions.
Specimens that are submitted for a Viral culture screen are processed to detect the following:
- Coxsackie A
- Coxsackie B
- Enterovirus 71
- Herpes Group Viruses
- Respiratory Syncytial Virus (RSV)
Appropriate specimens include throat swabs, nasopharyngeal swabs, nasal washes, rectal swabs, conjunctival swabs, lesion swabs, urine, CSF and tissues. All positive cultures are confirmed by monoclonal antibody (FA). Order "Viral Culture: Screen".
Specimens are read every other day for 14 days before a final report is issued. Some specimen sites are appropriate for slower growing viruses such as CMV or VZV. Preliminary negative reports are issued at 5 days and the final report follows in 21 days.
Search "VCT" code in the online Laboratory Test Catalog for information on Viral Culture Screen, Tissue for tissue samples.
Search "VCS" code in the online Laboratory Test Catalog for information on Viral Culture Screen for all other sample types.
Viral cultures can be performed alone or combined with several antigen detection assays to yield a rapid preliminary result. The Viral culture screen can be combined with any of the procedures listed below:
For rapid detection of Adenovirus, the specimen is inoculated by centrifugation onto a monolayer and stained for Adenovirus antigen with monoclonal antibody at 24 and 72 hours post inoculation (in addition to standard viral culture). Swabs (in Viral Transport Media), body fluids or tissue can be submitted.
Search "ADSV" code in the online Laboratory Test Catalog for information on Adenovirus Shell Vial.
For rapid detection of Cytomegalovirus (CMV) in peripheral blood, the leukocytes are isolated, cytocentrifuged onto a glass slide, and stained with a fluorescent antibody to an early CMV antigen. Results from the CMV antigenemia assay are available within 24 hours of specimen receipt in the laboratory. Freshly drawn specimens received in the laboratory before 12 PM Monday through Friday are processed the same day and read the following day. Transport blood at room temperature.
Search "CMVA" code in the online Laboratory Test Catalog for information on CMV Antigenemia Surveillance.
For rapid detection of Cytomegalovirus (CMV), the specimen is inoculated by centrifugation onto a monolayer and stained for CMV antigen with monoclonal antibody at 24 and 48 hours post inoculation in addition to standard viral culture. Swabs (in Viral Transport Media), body fluids or tissue can be submitted. This test is recommended for all lung biopsies, bronchoalveolar lavage specimens and tissue specimens.
Search "RPDCMV" code in the online Laboratory Test Catalog for information on Rapid Detection Cytomegalovirus.
The Herpes group FA detects Herpes Simplex virus (HSV) or Varicella Zoster virus (VZV) antigens in infected cells. A slide is usually prepared at the Virology Laboratory from cells in the vial of transport media. HSV subtyping (HSV‑1 vs. HSV‑2) is done on culture isolates only. Lesions must be aggressively swabbed to obtain adequate numbers of cells for a valid assay. Order "Viral Culture: Herpes Group, plus Herpes Group FA".
In addition to being more rapid than Viral culture, FA can detect viral antigens in infected cells even if the virus is no longer viable. Due to the extreme lability of Varicella Zoster Virus, FA is routinely performed on all VZV culture requests and is recommended on all skin/eye sites.
Search "FAHS" code in the online Laboratory Test Catalog for information on Herpes Simplex & Varicella Zoster FA.
Fluorescent antibody (FA) staining of respiratory epithelial cells is the most rapid method to identify Respiratory Syncytial Virus (RSV), Parainfluenza, Adenovirus, human Metapneumovirus and Influenza A and B. We recommend that a nasal wash be submitted - if not, then combine a throat and nasopharyngeal swab in the same vial of transport media. The Respiratory FA can be combined with a Viral culture; order "Viral Culture: Screen, plus Respiratory FA". A culture is recommended during the non‑Influenza season (April through October) when the viruses detected by FA are not in circulation. For a summary of seasonal virus detections, see UW Clinical Virology Laboratory.
*Note: For immunocompromised patients, a full brochoalveolar lavage workup is recommended. This includes CMV and RSV rapid assays and both a herpes group and respiratory with FA.
Search "FARV" code in the online Laboratory Test Catalog for information on Respiratory Virus FA.
For rapid detection of Respiratory Syncytial Virus (RSV), the specimen is inoculated by centrifugation onto a monolayer and stained for RSV antigen with monoclonal antibody at 24 and 72 hours post inoculation in addition to standard viral culture. Nasal washes or NPT swabs are the specimen of choice; BAL fluid is appropriate as well. A viral culture is done in conjunction with this test order.
Search "RSVSV" code in the online Laboratory Test Catalog for information on RSV Shell Viral Assay.
These are EIA assays for the detection of antigens in stool. These viruses do not grow in standard tissue culture so this is the preferred method of detection.
Search "SORTA" code in the online Laboratory Test Catalog for information on Rotavirus Antigen by EIA, STL.
Search "SADEIA" code in the online Laboratory Test Catalog for information on Enteric Adenovirus by EIA, STL.
Last updated: 04/17/2015