Novel and Variant Influenza A Viruses
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Information for Health Professionals on Novel Influenza A Viruses
Including HPAI H5N1
Ask patients with influenza-like illness (ILI) whether they have recent travel or exposure to poultry. Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even outside of the typical influenza season.
If you have suspicion of HPAI H5N1 avian influenza call MDH at 651-201-5414 or 1-877-676-5414 to discuss need for HPAI testing and specimen collection and take a comprehensive patient history for patients, including any close contact with poultry, cattle, or other farm animals or their environments, and any consumption or handling of unpasteurized animal products (such as raw milk).
Specimen Collection and Testing
- Please contact MDH at 651-201-5414 or 1-877-676-5414 for further guidance if a hospitalized patient with influenza-like illness has a recent travel history to a country where a novel influenza strain is known to be circulating is identified.
- MDH has year-round RT-PCR testing on hospitalized patients with ILI or clinical suspicion of influenza. Hospitalized patients meeting clinical and exposure criteria will take priority for testing at MDH-PHL.
- Commercially available rapid influenza diagnostic tests (RIDTs) may not detect novel flu (such as H7N9) virus in respiratory specimens.
For patients admitted with influenza-like illness (ILI) or clinical suspicion of influenza without evidence of pneumonia or other lower respiratory disease – submit one upper respiratory specimen per patient.
- Nasopharyngeal swab is the preferred specimen.
- Other acceptable specimens include nasal swab, nasal wash/aspirate, throat swab, or combined nasal swab with an oropharyngeal swab, and viral culture.
- Place swab in Viral Transport Media (VTM; e.g., M4, M5, Hanks) for transport to MDH. If VTM is not available, then sterile saline or phosphate buffered saline (PBS) is acceptable.
- Specimens transported in VTM must reach MDH within 7 days of collection.
- Specimens not transported in VTM must reach MDH within 5 days of collection.
- If sending leftover saline solution (no other chemicals, preservatives) from rapid testing, you must send at least 500 µl.
- Swabs collected and/or transported in non-sterile containers, baggies, or without transport media (dry) will not be accepted.
- Ship at refrigeration temperature.
- Collection of Nasopharyngeal Specimens with the Swab Technique (Video-New England Journal of Medicine)
NOTE: There is NO fee sticker required for influenza testing.
Hospitalized Patients Only (Project #1492)
Use this form for all specimens submitted from persons hospitalized with ILI or clinical suspicion of influenza. In order to allow for prompt testing of submitted specimens for project #1492, please be sure to fill out the form completely, especially information regarding hospitalization (date of admission, hospital of admission, and outcome) found on the lower right-hand corner of the form.
- Hospitalized Influenza Submission Form Project 1492 (PDF)
- Influenza Form Guidance (PDF)
More information can be found on Forms for the Infectious Disease Laboratory
- Influenza Form Guidance (PDF)
Shipping to MDH-PHL
- Refrigerate specimen until shipping.
Questions?
- For an MDH epidemiologist, call 651-201-5414 or 1-877-676-5414.
- During business hours you can call the Virology Supervisor at 651-201-5035.
Surveillance and Reporting
- Reporting Influenza
In Minnesota, influenza is a reportable disease. - MDH is also conducting enhanced surveillance through established sentinel influenza surveillance sites.
More about seasonal and variant influenza A for Health professionals:
- Influenza Information for Health Professionals
- Information For Health Professionals on Variant Influenza A Virus
Infection Prevention and Control
- CDC: Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease
Infection prevention and control recommendations for confirmed, probable or cases under investigation. - Please contact MDH at 651-201-5414 or 1-877-676-5414 for further infection prevention guidance if a hospitalized patient with influenza-like illness has a recent travel history to a country where a novel influenza strain is known to be circulating is identified.
Environmental cleaning and disinfection:
- Health care facilities should perform environmental cleaning and disinfection procedures in accordance with procedures followed for seasonal influenza.
Personal protective equipment:
- Ensure adherence to Standard Precautions, plus Contact and Airborne Precautions (including eye protection and use of respiratory protection for all patient-care activities)