To aid in the diagnosis of viral infections caused by Influenza A, Influenza B, RSV or SARS-CoV2 viruses.

•	Negative result does not exclude the possibility of viral infection since very low levels of infection or sampling error may cause a false-negative result.  
•	This test is subject to interference by various factors including the presence of PCR inhibitors. Inhibitors may include heme present in bloody respiratory specimens, as well as unidentified inhibitors (proteases, DNAses, and other enzymes) present in respiratory specimens.  
•	Colonized or sub-clinically infected patients have lower organism burden compared to patients with active viral infection. Correlation of PCR results with clinical, radiographic, and other laboratory parameters is needed in these cases. A repeat specimen may be considered for re-testing if clinical 
                 suspicion remains high.  
•	This test does not rule out infection with viral agents other than those indicated.  
•	PCR does not differentiate between viable and non-viable viruses.

This test is performed using the FDA approved Cepheid GeneXpert and Abbott Alinity m assays. The performance of the assay has been verified in the DUHS Clinical Microbiology Laboratory, and performed in accordance with the FDA packet insert.

Collect specimens as follows:

NASOPHARYNGEAL (NP) SWAB:
1.	Using a mini-tip/NP swab gently pass through the nose and into the nasopharynx. Stay near the septum and floor of nose.
2.	Rotate the swab slowly for 5 seconds to absorb secretions.
3.	Remove swab from the nasopharynx. 
a.	For metal shaft, aseptically cut the holder (top) from the metal shaft to fit the swab and shaft into the collection tube containing viral transport media (VTM).
b.	For scored plastic shaft, place the swab into the tube containing VTM. Break swab at the indicated break line and cap the specimen collection tube tightly.
4.	To avoid specimen contamination, do not touch the swab tip to anything other than the inside of the nose/nasopharynx.

NASAL SWAB:
1.	Insert a nasal swab 1 to 1.5 cm into a nostril. Rotate the swab against the inside of the nostril for 3 seconds while applying pressure with a finger to the outside of the nostril.
2.	Repeat on the other nostril with the same swab, using external pressure on the outside of the other nostril. To avoid specimen contamination, do not touch the swab tip to anything other than the inside of the nostril.
3.	Remove and place the swab into the tube containing viral transport medium. Break swab at the indicated break line and cap the specimen collection tube tightly.

NASAL WASHING:
1.	Tilt patient's head back about 70° angle or place the patient on his/her side in a supine position.
2.	Aspirate 3-7 mL of sterile saline or Viral Transport Medium (VTM) into a rubber bulb.
3.	Gently press one nostril closed with finger pressure.
4.	Use the point of the bulb to completely occlude the other side. The saline or VTM is then squeezed into the nose and quickly aspirated.
5.	Submit specimen in sterile, screw-capped container.

Note 1: When using the preferred Sherwood trap collection container, replace the cap attached to the collection tubing with the second screw cap contained in the package to prevent specimen leakage during transport. Discard the primary cap with tubing as biohazard waste.
Note 2: Contact Respiratory Therapy to collect specimen for best results.

BRONCHIAL:

1.	Collect 2-5 mL of bronchial washings aspirated through the inner channel of the bronchoscope with or without irrigating solutions.
2.	Submit specimen in a sterile, screw-capped, collection cup.
NOTE: When using the preferred Sherwood trap collection container, replace the cap attached to the collection tubing with the second screw cap contained in the package to prevent specimen leakage during transport. Discard the primary cap with tubing as biohazard waste.

Causes for Rejection:
1.	Specimen not labeled with patient's name, MRN, date and time of collection, and collector's initials.
2.	Specimen received on calcium alginate swab.
3.	Specimen received on dry swab.
4.	Specimen received on swab with wooden shaft.
5.	Specimen not listed above will be rejected and order will be cancelled.