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Surveillance and Specimen Collection for Swine Influenza A (H1N1) Virus

Novel Influenza H1N1 (Swine Flu): Laboratory Guidelines for Suspected Cases

Effective immediately, The Kentucky Department for Public Health (KDPH) is no longer accepting specimens from patients who do not meet new criteria. Specimens from patients who test positive for rapid influenza A are no longer being requested unless the patient meets the following criteria:

KDPH is asking the health care community to submit influenza viral specimens from patients with acute febrile respiratory illness and those:

  1. experiencing severe illness that indicates the need for hospitalization, or
  2. have traveled to US or foreign communities with known transmission of novel H1N1 within seven days prior to illness onset or
  3. are close contacts with people with confirmed cases of novel H1N1.

Before sending a specimen to the Division of Laboratory Services, please call the Kentucky Department for Public Health Operations Center at 1(888) 398-0013 for tracking and guidance.

Obtain any of the following:

Nasopharyngeal swab
Collect a nasopharyngeal swab using a Dacron tip and aluminum or plastic shaft. Do not use swabs that are calcium alginate, cotton or have wooden shafts.

If a rapid influenza test has been performed, use a separate and clean nasopharyngeal swab when obtaining the specimen for influenza testing that will be performed at the state laboratory. Package this swab in viral transport media and ship.

Nasal aspirate

Combined nasal swab with a throat swab

Nasal wash

For infants and younger children, DLS recommends obtaining a nasal wash [1] instead of a nasopharyngeal swab for submission. To collect a nasal wash:

Have the infant or young child sit on the parent's lap facing forward, with the child's back against the parent‘s chest. The parent should wrap one arm around the child in a manner that will restrain the child's body and arms.

Fill bulb syringe with 1-3 mL of sterile saline, depending on size of the patient, and instill saline into one nostril, while the head is tilted back.

Release the pressure on the bulb to aspirate the specimen back into the bulb.

Transfer the specimen into specimen container with approved viral media.

Repeat procedure on other nostril, transferring second specimen into the same specimen container.

Offer tissues as appropriate.

Label specimen container, package and ship to DLS, as directed.

[1] Specimen Collection - Nasal Aspirate, Wash or Swab, Version 1.1., University of California at San Francisco Clinical Laboratories. March 2008.

Specimens should be placed into sterile viral transport media (M4RT) and immediately placed on ice or cold packs or at 4 degrees Celsius (refrigerator) for transport to the laboratory.

  • Place specimen in container with cold packs.
  • Label container as Biological substance, Category B UN3373.
  • Ship immediately, refrigerate specimens that cannot be shipped immediately.

Viral Packaging Instructions


Submit specimens with Lab Form 275. The form can be printed directly from this Web site.

Please contact the lab at (502)564-4446 (normal business hours) or (502)330-6235 (emergency number) with any questions.

Send specimens to:

ATTN: Virology
KY Division of Laboratory Services
100 Sower Blvd.
Frankfort, KY 40601


Last Updated 5/11/2009