| (Microbiology) |
| Investigations | Coronaviruses Seasonal coronaviruses Coronoviruses OC43, 229E, NL63 and HKU1 are responsible for a substantial fraction of cases of the common cold, but are not known to cause severe respiratory infections. They are not included in the standard respiratory virus panel in this laboratory, but can be specifically tested upon request. High consequence coronaviruses These viruses include Severe Acute Respiratory Syndrome (SARS; no reported cases since 2004), Middle East Respiratory Syndrome (MERS, circulation ongoing in the Middle East) and the 2019 novel coronavirus (COVID-19, SARS-CoV-2, formerly known as "Wuhan" coronavirus). They are characterised by high rates of transmission, particularly in healthcare settings, and higher mortality than seasonal respiratory viruses. Suspected cases of high consequence coronaviruses should be discussed with the Infectious Diseases or Medical Microbiology service. If clinically stable and not currently in hospital, suspected cases should discouraged from attending hospital until a plan has been made for assessment, sampling and isolation. For the latest Public Health England guidance on 2019-nCoV, see https://www.gov.uk/government/collections/wuhan-novel-coronavirus Molecular Tests Coronavirus PCR and LAMP | |
| Inform lab before sending | No for seasonal coronaviruses Yes for high consequence coronaviruses. Contact the laboratory on 0151 706 4410. | |
| Specimen type |
Molecular Swabs: Take a nose and then a throat swab and put both in the single green-topped Virocult tube before returning it to the Virology laboratory. REMEL swab (RED CAPPED) collection kits are a suitable alternative swab collection kit. Nasopharyngeal aspirate: Collected in a sterile leak-proof container. Bronchoalveolar lavage: Collected in a sterile leak-proof container. Sputum: Collected in a sterile leak-proof container. Saliva: Collected in a sterile leak-proof container. Lower respiratory tract samples are not indicated for seasonal coronaviruses. < | |
| Ideal time to take specimen | Saliva : Before brushing teeth or eating (or 2hrs post brushing teeth/eating) | |
| Labelling requirements | click here | |
| How to take the specimen | Nose swab - tilt the patient’s head back and gently insert the swab along the medial part of the nasal septum, as far as possible. Rotate the swab several times and then remove and put it into the Virocult tube – you will need to break the shaft of the swab to fit inside the tube. Throat swab – vigorously swab only the posterior pharyngeal wall and put it into the Virocult tube. Saliva collection - Tilt head forward to allow the saliva to pool in the front of mouth, spit into the tube without coughing. For high consequence coronaviruses, ensure appropriate personal protective equipment is worn when collecting specimens. The sample must be triple-bagged and hand-delivered to the laboratory in a hard-shell container alongside the appropriate Public Health England request form. | |
| Transport to the laboratory | If transport is delayed then store at +4°C | |
| Test Times | Seasonal coronaviruses: upon request High consequence coronaviruses: daily, in the Public Health England reference laboratory. | |
| Turnround | 48 hours | |
| Additional information | For the latest Public Health England guidance on 2019-nCoV, including case definitions and infection prevention and control advice, see https://www.gov.uk/government/collections/wuhan-novel-coronavirus | |
| Additional Examination Requests | click here |