Sample type and Volume required:
Lower respiratory tract samples are the preferred specimen eg Bronchoalveolar lavage (BAL) or non-directed Bronchoalveolar Lavage (NBAL) to be collected in a self-sealed valved container with no additives. Nose, throat or nose and throat swabs (NTS) in Universal Transport Medium (UTM) can also be tested. Currently the assay has not been validated on sputum samples. If a NBL/BAL is not available, but a sputum sample is, this will be forwarded to the referral laboratory at PHE Birmingham.
Call in advance:
Public Health England (PHE) has extensive guidance on the management and investigation of possible cases. At GSTT all cases meeting the current PHE possible case definition should be discussed with the duty Virology consultant. Patients retrieved from Health care settings in countries where MERS-CoV is endemic should be tested prior to transfer and again on arrival at GSTT.
Storage and transport:
Since MERS-CoV is a HG3 organisim transport of samples from the ward to the laboratory must follow the Management of HG4 and similar pathogens of high consequence pathway. The microbiology BMS bleep holder (bleep 1802) should be notified a soon as the Virology consultant determines MERS-CoV testing is appropriate. Place labelled sample in a sealed bag, then into a second sample bag (double bagged) and hand deliver promptly to CSR. Do NOT send samples via the air chute system. CSR will place the samples in the yellow internal transport box in CSR pre-sort and immediately call the Microbiology BMS bleep holder (bleep 1802) who will pick up the samples and take them to the CL3 laboratory.