Influenza A (H5) Virus RNA, Qualitative Real-Time PCR, Respiratory and Conjunctiva

Quest offers 2 tests that can be used when an individual is suspected of having avian influenza (H5). The 2 tests differ based on the specimen type: respiratory vs conjunctiva.

• Influenza A and B RNA, Qualitative Real-Time PCR, Respiratory with Reflex to H5 (test code 18201)
• Influenza A and B RNA, Qualitative Real-Time PCR, Conjunctiva with Reflex to H5 (test code 18203)

These tests are qualitative molecular diagnostic tests that detect the influenza A H5 virus, including H5N1, commonly known as avian influenza. These tests also detect influenza B, but do not detect other respiratory viruses. The tests are intended to be performed on their indicated specimen type (respiratory vs conjunctiva) collected from individuals suspected of infection with influenza A H5 or from those who meet the Centers for Disease Control and Prevention (CDC) clinical and/or epidemiological criteria for influenza A H5 testing.

Influenza A and B RNA, Qualitative Real-Time PCR, Respiratory with Reflex to H5 (test code 18201)

Preferred:

• Nasopharyngeal, anterior nares, or oropharyngeal swab submitted in 1 mL VCM (green cap) or equivalent (UTM) tube

OR

• 1 mL bronchial alveolar lavage (BAL)/wash collected in a sterile, leak-proof container

Influenza A and B RNA, Qualitative Real-Time PCR, Conjunctiva with Reflex to H5 (test code 18203)

Preferred: 

•  Conjunctiva swab submitted in 1 mL VCM (green-cap) or equivalent (UTM) tube 

Instructions for both 18201 and 18203: Each specimen should be accompanied by its own separate requisition and transport container in its own sealed bag, which may differ from specimen collection instructions for testing performed at other laboratories

Specimens should be transported refrigerated (cold packs). Frozen specimens are also acceptable. 

The assay used to detect influenza A/B is an FDA-cleared assay. If positive, the reflex assay used for H5 subtyping is an immediate-response test. The immediate-response tests have not been reviewed or authorized by the FDA. They were developed and their analytical performance characteristics were determined by Quest Diagnostics pursuant to CLIA regulations for clinical purposes. These tests can only be ordered by a licensed healthcare professional (for prescription use only).

Performance characteristics are listed in Table 1. Studies were conducted in the R&D Infectious Disease and Molecular Infectious Disease Department at Quest Diagnostics Nichols Institute, 33608 Ortega Highway, San Juan Capistrano, California 92675.

Influenza antivirals are available and may be used to treat seasonal or avian flu.

Candidate vaccines to prevent H5 infection have been developed, but they are not available for widespread use. Seasonal influenza vaccine does not protect against H5.²

For details, visit the following CDC website: Treatment of Bird Flu | Bird Flu | CDC.³

Quest has several testing options available that can subtype influenza A and detect other respiratory viruses (Table 2). Quest offers assays that will also type for the seasonal human influenza strains (ie, H1 and H3).

The influenza A subtyping tests (95512 and 37444) will not specifically identify an influenza A strain as H5 but would identify such a strain as a non-typeable influenza A strain.