GUIDE TO SERVICES
Alberta Health Services
The Provincial Laboratory for Public Health
(ProvLab)
Calgary Site:
Edmonton Site:
3030 Hospital Drive NW
Calgary, Alberta T2N 4W4
Walter Mackenzie Health Sciences Centre
University of Alberta Hospital
8440-112 Street
Edmonton, Alberta T6G 2J2
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1
Version Changes – Dates and Details
Version #
Date
Details
7.0
Aug 29, 2015
Biennial Review changes
7.1
Sept 3, 2015
Under Granuloma Inguinale –
Calymmatobacterium deleted Klebsiella inserted
7.2
Sept 14, 2015
‘Version Changes – Dates and Details’ page added
7.3
Sep 24, 2015
‘Con’t…’ removed from page 32
7.4
Oct 28, 2015
Under Antifungal Levels –
remove ‘in serum separator tube (SST)’
7.5
Nov 5, 2015
Added: Tropheryma whipplei and Whipple’s Disease
7.6
Nov 23, 2015
Add ‘Do not centrifuge. Ship on ice or cold pack within 24 hours’ to
sections: Adenovirus, Enterovirus Infections, HSV and Varicella Zoster
Virus Infections
7.7
Jan 6, 2016
7.8
Feb 12, 2016
Updates to multiple zoonotic entries and modifications
Feb 12, 2016
Add Zika virus
Viral Hemmorrhagic Fever, Ebola Virus
Add “Only if advised by the MOC/VOC to collect specimens; follow
this link for instructions: (link provided)”
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TABLE OF CONTENTS
Version Changes – Dates and Details ......................................................................... 2
Preface ........................................................................................................................... 6
Laboratory Contact Information .................................................................................. 7
Services Available......................................................................................................... 8
Diagnostic Testing ............................................................................................. 8
Investigation of Outbreaks ................................................................................ 8
Identification of Isolates Referred From Other Laboratories.......................... 9
Calgary Site Specific Information .............................................................................. 10
Hours of Operation........................................................................................... 10
Specimen Deliveries......................................................................................... 10
Hours of Operation for Environmental Waters Laboratory........................... 10
Specimen Collection Kits/Requisition Order Form ....................................... 10
Map: Provlab – Calgary Site ............................................................................ 11
Edmonton Site Specific Information.......................................................................... 12
Hours of Operation........................................................................................... 12
Specimen Deliveries......................................................................................... 12
Hours of Operation for Environmental Microbiology Laboratory ................ 12
Specimen Collection Kit Order Form .............................................................. 12
Map: Provlab – Edmonton Site........................................................................ 13
General Test Ordering and Specimen Collection Information ................................ 14
Clinical Specimens........................................................................................... 14
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Requisitions ........................................................................................... 14
STAT Requests ...................................................................................... 15
Specimen Collection, Labelling, and Submission .............................. 15
Specimen Rejection............................................................................... 16
Water and Ice Samples ............................................................................................... 16
Sample Rejection.............................................................................................. 16
Requisitions ...................................................................................................... 17
Special Notes Regarding Water Requisitions ................................................ 17
How to Collect a Water Sample for Bacteria Testing .................................... 17
Ordering Supplies ............................................................................................ 18
Water and Ice Sample Labelling...................................................................... 18
Water and Ice Sample Delivery........................................................................ 18
Requests for Examination of Specific Pathogens in Water Samples (i.e.
Salmonella or E. coli O157:H7, Giardia or Cryptosporidium) ....................... 19
Water Samples for Legionella ......................................................................... 19
Submission of Ice Samples for Analysis........................................................ 19
Biological Indicators (BI)[Spore Strips and Vials].................................................... 19
Sample Rejection.............................................................................................. 19
Requisitions ...................................................................................................... 19
Special Notes Regarding Biological Indicator Requisitions......................... 20
Ordering Supplies ............................................................................................ 20
Food Samples.............................................................................................................. 20
Acceptance Criteria.......................................................................................... 20
Rejection Criteria.............................................................................................. 21
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Guidelines for Submitting Food Samples to the Provincial Laboratory for
Public Health..................................................................................................... 21
Requisition ........................................................................................................ 21
Sample Submission ......................................................................................... 21
Transportation .................................................................................................. 22
Transport Media .......................................................................................................... 23
Transport of Diagnostic Specimens and Infectious Substances............................ 24
Transportation of Category A or Category B Infectious Substances .......... 25
Guide to Specimen Collection – Contact Numbers.................................................. 26
Index for Guide to Specimen Collection ................................................................. 158
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PREFACE
The Guide to Services is a comprehensive reference resource produced by the Provincial Laboratory
for Public Health (ProvLab) for our partners in acute and community health care. ProvLab works to
provide critical support to health zones and government through testing, research, education and
surveillance activities.
The Guide contains information on appropriate sampling, use of collection devices, and transport
requirements for specimens tested to support acute care microbiology at the University of Alberta
Hospital, specialized and reference testing services, outbreak investigation, and public health programs
throughout the province. Every effort has been made to provide an all-inclusive list of disease
processes and associated specimen collection guidelines so that laboratory investigations are complete
and timely for optimal patient care and public health action.
This website-based document will be updated on a regular basis to ensure you have access to current
testing information and collection requirements. Our laboratories are committed to excellence, and
strive to provide you with the highest quality of service. We welcome your comments and suggestions
for improvement. Please feel free to address any concerns with our Webmaster, Deborah Green at
780-407-3303 or by email at ProvLabContactUs@albertahealthservices.ca .
Graham Tipples PhD FCCM D(ABMM)
Medical Scientific Director
ProvLab
Marie Louie MD FRCPC
Associate Medical Director
ProvLab
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LABORATORY CONTACT INFORMATION-------------CALGARY
PRIMARY INQUIRIES
(To all departments and/or staff)
MICROBIOLOGIST/VIROLOGIST
ON CALL (MOC/VOC)
(Clinical Consultation)
PRENATAL RESULTS HOTLINE
SPECIMEN COLLECTION KIT
ORDERS
Ph: 403-944-1200
Fax: 403-270-2216
Ph: 403-944-1200 (ask
for MOC/VOC)
Packing Area:
Ph: 403-944-2583
Fax 403-944-2317
EDMONTON
Ph: 780-407-7121
Fax: 780-407-3864
Ph: 780-407-8822
(UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC/VOC)
Ph: 780-407-8667
Distribution Centre:
Ph: 780-407-8971
Fax: 780-407-8984
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SERVICES AVAILABLE
DIAGNOSTIC TESTING
The Provincial Laboratory for Public Health (ProvLab) hereafter called the Laboratory, provides the
following laboratory testing services*:





Bacteriology
Mycology
Mycoplasma
Parasitology
Environmental Microbiology (Water,
Ice and Biological Indicators [BI])





Food Microbiology
Serology
Molecular Diagnostics
Virus Isolation
Mycobacteriology
* Some services provided by the Edmonton Site Laboratory may not be available to customers outside
the Edmonton Health Zone. Please refer to the laboratory service provider defined by zone contracts
for testing.
Turnaround times have been established for all tests performed in the Laboratory, and are one of the
quality indicators used internally to measure our performance. The turnaround time data is captured
and monitored on a regular basis.
INVESTIGATION OF OUTBREAKS:
HOW TO ESTABLISH AN EXPOSURE INVESTIGATION (EI)
The Laboratory provides support for investigation of outbreaks of suspected bacterial, viral,
parasitological or fungal origin. All investigations must be coordinated through local Public Health or
Environmental Heath services. When an outbreak is suspected:
1. Contact the local Medical Officer of Health, Health Zone Offices or Environmental Health Officer
for the zone or other appropriate health official.
2. The local Medical Officer of Health, Health Zone Offices or Environmental Health Officer for the
zone or other appropriate health official will contact the Laboratory at Calgary or Edmonton and
ask for the Microbiologist/Virologist On Call (MOC/VOC). Please refer to Laboratory Contact
Information.
3. The local Medical Officer of Health, Health Zone Offices or Environmental Health Officer for the
zone or other appropriate health official will provide, in consultation with the MOC/VOC, the
following details:
a. External contact person (External Investigator) for the outbreak (name, telephone, fax)
b. Zone where the outbreak has occurred
c. Type of outbreak (respiratory, gastrointestinal, sexually transmitted disease or rash
related)
d. Type of facility involved (long term care facility, school, restaurant, etc.) and location
e. Number of persons ill and at risk
f. Date of onset of infection and predominant clinical symptoms
g. Number and type of samples to be submitted
There may be more information required as each outbreak is unique unto itself. Additional
information required will be determined in consultation with the MOC/VOC.
CON’T…
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4. The MOC/VOC will provide the External Investigator with a laboratory derived tracking number
(“EI number”), which will be used to clearly label all specimens and requisitions that are
submitted for laboratory investigation.
5. The MOC/VOC will be responsible for all follow-up contact with the External Investigator and will
ensure that the appropriate laboratory and public health are notified. This data will be
incorporated into the web-based EI system.
6. The External Investigator will arrange to have the appropriate specimens (based on the type of
outbreak) collected from symptomatic persons and submitted to the Laboratory as discussed
with the MOC/VOC.
7. The External Investigator will retrieve data directly from the EI System.
8. The External Investigator will close the EI under the assigned EI number when the investigation
is completed.
9. As requested by MOH’s IPC has been given access to the EI system and permission to contact
MOC/VOC to open EI’s in some health zones.
IDENTIFICATION OF ISOLATES REFERRED FROM OTHER LABORATORIES
The Laboratory provides various specialized reference functions to assist in the identification and/or
typing of clinically relevant microorganisms isolated in other medical microbiology laboratories.
 Please use appropriate requisitions for Streptococcus or Mycology reference isolates.
These requisitions are available from the Laboratory or the ProvLab website.
 Submit isolates in PURE CULTURE as lyophilized or frozen cultures, or on slants of
appropriate media, or in charcoal transport media.
 For anaerobic identification, swab a PURE 48 hour culture of the organism and submerge in
anaerobic transport medium or chopped meat broth.
 DO NOT use petri dishes to transport specimens; the agar may become dislodged and
contamination frequently occurs.
Serotyping/serogrouping for the following bacteria is available:
Escherichia coli O157:H7
Haemophilus influenzae
Legionella pneumophila*
Listeria monocytogenes*
Neisseria meningitidis*
Salmonella
Shigella
Streptococcus agalactiae (Group B)
Streptococcus pneumoniae
Streptococcus pyogenes (Group A)
Vibrio cholerae
Yersinia enterocolitica**
*Referred to the National Microbiology Laboratory, Winnipeg, Manitoba.
** Referred to the Public Health, Ontario (Laboratories).
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CALGARY SITE SPECIFIC INFORMATION
HOURS OF OPERATION
0700 to 2300 Hours Monday to Friday
0700 to 1800 Hours Saturday
0700 to 1700 Hours Sunday and statutory holidays
NOTE:
Emergency service is available 24 hours daily. Please contact the Microbiologist/Virologist
On Call at 403-944-1200 (ask for MOC/VOC) to access this testing.
SPECIMEN DELIVERIES
ProvLab
3030 Hospital Drive NW
Calgary, Alberta T2N 4W4
Telephone 403-944-1200
Entrance is located on the West side of Foothills Hospital, Special Services Building.
Hours of access for this entrance are:
0700 – 2300 Hours Monday to Friday *
0700 to 1800 Hours Saturday
0700 to 1700 Hours Sunday and statutory holidays
* There is a phone outside the front door, west entrance, which can be used to contact an employee for
specimen pick-up after 1900 Hours, Monday to Friday.
NOTE: For Water Samples Only:
HOURS OF OPERATION for Environmental Waters Laboratory:
0800 to 1630 hours 7 days a week and statutory holidays
Samples submitted for routine testing, received in the laboratory after 1600 hours, are processed the
next day; exceptions may apply for special investigative or follow-up sampling. If water samples must
be processed after regular hours, on weekends or statutory holidays, contact the Environmental Waters
Laboratory at 403-944-1215, press “5”, during regular working hours to make special arrangements.
Specimen Collection Kit/Requisition Order Form
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MAP: PROVLAB – CALGARY SITE
Provincial Laboratory for Public Health (ProvLab) – Calgary Site
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EDMONTON SITE SPECIFIC INFORMATION
HOURS OF OPERATION
24 Hour service available on a daily basis
NOTE:
For clinical consultation please contact the Microbiologist/Virologist On Call at
780-407- 8822 (UAH Switchboard) or 780-407-7121 (Laboratory).
SPECIMEN DELIVERIES
ProvLab and Medical Microbiology Laboratory, UAH
Walter Mackenzie Health Sciences Centre
University of Alberta Hospitals
8440-112 Street
Edmonton, Alberta T6G 2J2
Telephone: 780-407-7121
Use the Provincial Laboratory Entrance, South end of Walter Mackenzie Health Sciences Centre
(83 Avenue)
Hours of access for this entrance are 0500 to 1800 Hours Monday to Friday
0500 to 1300 Hours weekends and statutory holidays
After hours, specimens may be hand delivered to Room 2B4.04 by using the Emergency entrance to
the University Hospital. Security personnel will be located at the Emergency entrance after 2100 hours
every night. You will need to inform them that you will be coming to Microbiology (Room 2B4.04) to
drop off specimens. (Security may ask for some form of identification).
NOTE: For Water Samples Only:
HOURS OF OPERATION for Environmental Microbiology Laboratory:
0700 to 1630 hours Monday to Friday
0745 to 1600 hours Saturday, Sunday and statutory holidays
Samples submitted for routine testing received in the laboratory after 1600 hours are processed the
next day; exceptions may apply for special investigative or follow-up sampling. If water samples must
be processed after regular hours, on weekends or statutory holidays, contact the Environmental
Microbiology Laboratory at 780-407-8925, press “4” during regular working hours to make special
arrangements.
Specimen Collection Kit/Requisition Order Form
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MAP: PROVLAB – EDMONTON SITE
Provincial Laboratory for Public Health (ProvLab) – Edmonton Site
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GENERAL TEST ORDERING AND SPECIMEN
COLLECTION INFORMATION
1.
CLINICAL SPECIMENS:
a. Requisitions:
Provide the following information:
 Complete name of patient including first and last name
 Personal Health Number (PHN) including province name. If PHN is not available,
provide RCMP, Military, Hospital, Medical Record or Clinic Number.
 Date of Birth (dd/mm/yyyy)
 Gender
 Patient’s home address and phone number
 Complete name and address of ordering physician/health care provider
 Report destination (please use location code if known)
 Specimen type and anatomical source
 Date and time of collection
 Specific test(s) requested
 Diagnosis or clinical information:
- Antimicrobial therapy
- Dates of onset of illness and therapy
- Clinical diagnosis
- Recent immunization history if relevant
- Risk factors for disease e.g. HCV, HIV
- Specification of “source” versus “recipient” for occupational exposure
- Travel history including visits to tropical countries or endemic areas
 Third party billing (non public health, insurance, occupational, VISA, etc.
requirements)
 If carbon copy of report is requested, provide the receiver’s first and last name and
complete address
 If fax report is requested, provide the receiver’s first and last name and the fax
number with area code
If information on the requisition is incomplete, a delay in testing and/or reporting
may occur.
CON’T…
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b. STAT Requests:
A clearly indicated STAT request must be submitted with complete patient, specimen
and test request information on the requisition.
Include name and telephone number of the person to contact with results.
Phone the Laboratory (Calgary 403-944-1200 or Edmonton 780-407-7121) to notify staff
of the STAT request, and provide the following information:
 Name of submitting facility
 Name of patient
 Tests requested – type of specimen
 Method of delivery and expected time of arrival
 Name and phone number of contact person (for tracking specimen if necessary and
phoning results).
The specimen must be properly packaged for transport and must be “flagged” as STAT
so it will be obvious to the receiver (use red ribbon or tape).
Transport STAT specimens IMMEDIATELY to the Laboratory.
c. Specimen Collection, Labelling, and Submission:
For test specific collection requirements, refer to the:
Index for Guide to Specimen Collection.
Accurate and complete specimen labelling is a laboratory requirement. All specimens
must be labelled with:
 Complete name of patient including first and last name
 Personal Health Number (PHN) – if PHN is not available, provide RCMP, Military,
Hospital, Medical Record or Clinic Number.
 Specimen type and anatomical source
 Time and date of collection
Unlabelled or unmatched specimens will not be processed.
Prompt delivery of specimens is necessary to ensure minimum delay in processing.
For packaging and transport information, refer to:
Transport of Diagnostic Specimens and Infectious Substances and
Transportation of Category A or Category B Infectious Substances .
CON’T…
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d. Specimen Rejection
Rejection criteria are designed to ensure the provision of valid and timely laboratory
results in the delivery of quality patient care. Specimens and requisitions should be
labelled in accordance with the Alberta Health Service Specimen Acceptance Policy.
For more information about the policy as well as test request (requisition) requirements,
please see Alberta Health Services Laboratory Bulletin, August 22, 2011 ‘Reminder:
Laboratory Policy – Acceptance of Laboratory Samples and Test Requests’ .
Specimens may be rejected for the following reasons:











2.
Specimens lacking two unique identifiers
Improperly labelled specimen
Unlabelled specimen
Incomplete information on the requisition
Sub-optimal specimen, i.e.:
- Leaking
- Inappropriate specimen container
- Insufficient quantity of specimen
- Inappropriate collection device
- Inappropriate transport medium
Duplicate microbiology samples received on the same day, i.e. multiple stool,
sputum specimens
Integrity of sample compromised by effects of uncontrolled transport temperatures,
i.e. freezing, heating
Specimen delayed in transit
Test no longer available/performed by the Laboratory
Specimen submitted is inappropriate for test requested.
No specimen source indicated
WATER AND ICE SAMPLES:
a. Sample Rejection
Rejection criteria are designed to ensure the provision of valid and timely results.
Samples are rejected for the following reasons:

Sample was not in the standard microbiological container

No identification number on the bottle or ice jar

Identification number on the requisition does not match the number on the bottle
or ice jar

Water sample was frozen

Water/Ice sample was received more than 6 hours after collection without coolant

Water/Ice sample was received more than 24 hours after collection

Date and/or time of collection was not indicated

Date and time of collection is LATER than the date and time of receipt in the
Laboratory

Sample leaked in transit

Test request is not related to water quality for human health

Bacteriological testing of water related to sale of property is requested

Insufficient amount of sample received

Insufficient information provided to verify sample
CON’T…
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b. Requisitions:
Provide the following:

Sample Collection Details
o
o

Collection Site Details
o
o
o
o
o
o
o

Date and time of collection; including AM OR PM (mandatory)
Name and daytime contact phone number (including area code) of sample
collector
Access Number (if applicable)
AESRD Approval Number (if applicable)
Feature Code Number (First Nations only)
Complete name, address and phone number for: Facility or
Homeowner(name)/Water Supply For(name) ?
Collection site (e.g. kitchen tap)
Legal land description and/or GPS coordinates (if a private homeowner) - if
known
Name and address of Health Agency, that is nearest to the collection site,
where the laboratory report is to be sent
Remarks / Requests
o
o
o
Study Number (if applicable)
AESRD Reference Number (if applicable)
Other comments (as applicable)
Special Notes Regarding Water Requisitions:




Check ONE sample box only which represents the type of water being submitted
Check the appropriate box if a resample is being submitted due to previous coliform
contamination
For pools designed to be maintained at a temperature greater than 30°C (e.g.
whirlpools), check the appropriate box
Non-drinking Raw Source Water represents either surface water or groundwater
that will undergo treatment before being consumed
c. How to Collect a Water Sample for Bacteriological Analysis

Contact your local Alberta Health Services (AHS) Environmental Health Zone /
Agency.

For Locations refer to the link found in the “Water: Microbiological Analysis” item on
the Education page of our website www.ProvLab.ab.ca ; Click Services then
Education or click on the following link to go to the Education page
http://www.provlab.ab.ca/education.htm .
CON’T…
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d. Ordering Supplies:

Use only sample bottles / ice jars and requisition forms available from your local
Alberta Health Services (AHS) Environmental Health Zone / Agency.

For locations refer to the link found in the “Water: Microbiological Analysis” item on
the Education page of our website www.ProvLab.ab.ca ; Click Services then
Education or click on the following link to go to the Education page
http://www.provlab.ab.ca/education.htm

For those areas serviced by Edmonton ProvLab, these supplies may also be
ordered though the Distribution Centre; Phone 780 407 8971
e. Water and Ice Sample Labelling:
Detach the identification number label from the requisition form and affix to the
corresponding sample bottle /ice jar. Note: Unlabeled bottles and ice jars will not be
tested.
f. Water and Ice Sample Delivery:

Samples are to be delivered to the laboratory between Monday and Friday. For
hours of operation refer to the ProvLab Guide to Services table of contents. When
circumstances or follow-up investigations require delivery after hours or on
weekends, contact the laboratory beforehand (phone numbers below).

Samples are accepted at your local AHS Environmental Public Health Zone /
Agency or at ProvLab at the address locations listed below.

Deliver samples to the laboratory as soon as possible. If there will be a delay of
more than six hours, samples must be refrigerated (not frozen). Transport samples
in a cooler with frozen cold packs to maintain a temperature of 2°C to 8°C until they
reach the laboratory. Samples received by the Environmental Microbiology
laboratory more than 24 hours after collection will be rejected.

Arrange to have samples delivered to your nearest ProvLab site:
8440 – 112 Street
Edmonton, AB
T6G 2J2
Tel: 780 407 8925
Fax: 780 407 8984
3030 Hospital Drive NW
Calgary, AB
T2N 4W4
Tel: 403 944 1215
Fax: 403 270 2216
CON’T…
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g. Requests for Examination of Specific Pathogens in Water Samples (i.e.
Salmonella, E. coli O157:H7, Giardia or Cryptosporidium):
The Program Leader (Dr. Norman Neumann, 780-901-5991,
Norman.Neumann@albertahealthservices.ca ) or the Microbiologist/Virologist On Call
at Calgary or Edmonton must be consulted prior to submission of samples requesting
examination for specific pathogens.
h. Water Samples for Legionella: Refer to Guide to Specimen Collection Water:
Legionella
i.
Submission of Ice Samples for Analysis:
Bacteriological analysis of packaged ice is provided when authorized by Environmental
Public Health personnel. Samples should be submitted in sterile ice collection jars which
are available from the Laboratory by contacting:
- Calgary Packing Room 403-944-2583
- Edmonton Distribution Center 780-407-8971
3.
BIOLOGICAL INDICATORS (BI) [Spore Strips and Vials]:
a. Sample Rejection:
Rejection criteria is designed to ensure the provision of valid and timely results.
Samples are rejected for the following reasons:

Leaking/broken vial

Frozen vial

No control vial or spore strip received

Vial or spore strip expired

Glassine envelope damaged

Lot # or expiry date on test(s) and control do not match

Chemical process indicator on test vial unchanged

Chemical indicator on control vial indicates it has undergone sterilization

Sample received more than 5 days after collection

No access number on BI vials/spore strips
b. Requisitions:
Provide the following information:

Access number

Facility name, address and phone number including area code.

Date and time test was run, including AM or PM

Name and daytime contact phone number (including area code) of sample collector

Lot number/expiry of control (Control and test must be the same lot/expiry)

Name/model number of unit

Sterilizer type

Sterilization cycle (temperature ºC and time in minutes)
CON’T…
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19
Special Notes Regarding Biological Indicator Requisitions:
Follow the instructions provided on the reverse side of the Biological Indicator
Requisition for completing all relevant information regarding the packaging, labelling and
submission of Biological Indicators
c. Ordering Supplies:

First time submitters should contact the Environmental Laboratory to obtain an
Access number and other pertinent information
Calgary
403-944-1215, press “5”
Edmonton 780-407-8925, press “4”


Test kits must be pre-paid based on the current price list. Receipts are provided
Test kits can be ordered from the Laboratory by contacting:
Calgary Business Office
Edmonton Distribution Centre
4.
403-944-4613
780-407-8971
FOOD SAMPLES:
MOC at the original receiving site provides consultation with Public Health Investigator
or other Public Health Professionals as required.
Consultation with the Microbiologist/Virologist On Call PRIOR to submission of samples
if they fall OUTSIDE the parameters of current acceptance criteria is REQUIRED to
insure prompt referral to an appropriate certified testing agency.
a. Acceptance Criteria:
ProvLab will process:



Food for human consumption that is collected from a patient’s residence, a
restaurant or from a banquet
Food for animal consumption that has been opened and exposed to humans
associated with enteric bacterial infection
Pet feces if associated with human enteric bacterial infection
Samples MUST be:


Associated with human cases(s) or investigations(s) (may or may not have an EI# at
time of submission) related to human infection AND
Submitted by a Medical Officer of Health (MOH) or designate (eg. PHI, EHO)
CON’T…
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20
b. Rejection Criteria:
ProvLab will NOT process:

Commercial/retail human food products for which packaging is intact (i.e. has not
been opened) even if the product has been collected from a patient’s residence.

Food samples collected from commercial retail outlets including stores, markets and
manufacturing/processing plants/production lines.

Commercial animal food products for which packaging is intact (i.e. has not been
opened)

Live or dead whole animal products typically used as reptile feed (e.g. mice, chicks,
crickets)

Environmental swabs

Litter used to house animals suspected of being the source of human infection
c. Guidelines for Submitting Food Samples to the Provincial Laboratory for Public
Health
All food and non-clinical sample testing associated with a public health investigation of
foodborne disease is performed at ProvLab, Calgary.
Samples received by ProvLab, Edmonton will be sent to Calgary the same day if:
 samples arrive before 1000h Monday through Friday
 samples arrive before 0900h Saturday, Sunday and holidays
MOC/VOC at the original receiving site provides consultation with Public Health Investigator
or other Public Health Professionals as required.
e. Requisition
A separate requisition (ProvLab Food Sample Submission form) must accompany EACH
sample submitted for laboratory investigation.
Complete ALL fields of the requisition (ProvLab Food Sample Submission form) for
EACH sample submitted.
f. Sample Submission







Label a sterile WHIRL-PAK® bag or sterile leak-proof container for each sample to
be submitted.
Label sample with sample type/description and sample collection location.
Ensure Sample Type and Sample Collection Location matches the respective
requisition for each sample.
Submit 100 Grams or 100mL whenever possible. If insufficient sample is submitted,
bacteriological testing may need to be prioritized.
Place sample in the labelled container using aseptic technique.
Place the labelled WHIRL-PAK® bag or sterile leak-proof container into a larger
biohazard bag and seal to prevent accidental leakage during transport.
Place requisition within the external flap of the biohazard bag.
CON’T…
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21
g. Transportation 1

Place all samples in a rigid-sided container or cooler and transport within 24hrs to
the Laboratory.

Samples should be stored and transported as follows:
- Shelf-stable samples at room temperature
- Perishable samples with sufficient ice packs to maintain refrigeration temperature
(eg: between 0˚C and 7˚C).
- Frozen samples with sufficient ice packs to maintain freezing temperature.
- Do NOT allow frozen samples to thaw during shipment.

Notify the Bacteriology laboratory when food samples are being submitted.
- 403-944-1214 (ProvLab, Calgary)
- 780-407-7703 (ProvLab, Edmonton)
1.
Compendium of Analytical Methods Appendix B Volumes 1-3 November 2006
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22
TRANSPORT MEDIA
PRE-SPECIMEN
COLLECTION
STORAGE
POST-SPECIMEN
COLLECTION
TRANSPORT
REQUIREMENTS
USE FOR
MEDIA
DESCRIPTION
Anaerobic
organisms
Cary-Blair
(anaerobic)
Transport media
Charcoal
Transport media
Opaque media
Room temperature
Room temperature
Black swab
Room temperature
Room temperature
Universal
Transport
Medium (UTM)
Clear pink
Room temperature
Refrigerate at 4C
Page’s Saline
Clear
Refrigerate at 4C
Room temperature
Plain (routine)
Transport media
Clear swab
Room temperature
Refrigerate at 4C
Regan-Lowe
Transport media
Black
Refrigerate at 4C
Todd Hewitt
Broth (1 ml)
Straw colour
Refrigerate at 4C
Refrigerate at 4º C if
transport to the
Laboratory is to be
delayed
Room temperature
Sensitive
pathogens and
most cervical and
urethral specimens
Isolation or
detection of
respiratory viruses,
mycoplasma or
ureaplasma
Acanthamoeba –
available only on
request
Collection of
routine swabs for
culture and
sensitivity
Pertussis
investigation
Bronchoscopy
brush collection
For access to transport media, contact the Packing Area (Calgary) at 403-944-2583 or the
Distribution Centre (Edmonton) at 780-407-8971.
NOTE: Expiry dates are indicated on each vial. Do not use after expiry date. Specimens
submitted in expired transport media will NOT be processed.
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23
TRANSPORT OF DIAGNOSTIC SPECIMENS AND INFECTIOUS
SUBSTANCES
Diagnostic specimens or reference isolates sent to the Laboratory for diagnosis or investigation
must be packaged in compliance with the regulations defined under the Canadian
Transportation of Dangerous Goods Act and Transportation of Dangerous Goods Regulations
(TDGR), including the most recent Clear Language Amendments and subsequent updates or
amendments (refer to website link: http://www.tc.gc.ca/TDG/menu.htm). Transport Canada also
endorses the International Civil Aviation Organization (ICAO) Technical Instructions and the
Dangerous Goods Regulations published annually by the International Air Transport Association
(IATA DGR). For air transport, both the ICAO/IATA and TDG regulations must be followed.
Persons packaging diagnostic specimens and infectious substances for transport must be
trained and hold valid Transport of Dangerous Goods certificates.
PACKAGING FOR TRANSPORT:
The packaging must include:
1. Inner packaging (same for both Category A and B):
 A watertight primary container (e.g. vacutainer, screw-capped tube, specimen bottle)
reinforced with parafilm around top to prevent leakage.
 A watertight secondary packaging (eg. ziplock bag, Saf-T-Pak or other polypropylene
container or metal container). Several tubes may be shipped together in a single
secondary packaging but must be wrapped individually to prevent contact between
them or placed into racks.
 An absorbent material (e.g. cotton batting, commercial absorbent) placed between
the primary container and the secondary packaging. This material must be capable
of absorbing the entire liquid contents of all primary containers.
2. List of contents (same for Category A and B):
Enclose an itemized list of contents between the secondary packaging and the outer
packaging (e.g. laboratory requisition or letter listing specimens etc). NOTE: this list
needs to be placed so that it is the first thing seen when package is opened.
3. Outer packaging:
 Diagnostic specimens shipped via ground transport – use a fiberboard container
marked with TC125-1B or an ‘equivalent’ outer packaging (e.g. cooler, toolbox,
unmarked fiberboard box). However, the packaging used must not allow the escape
of its contents under normal condition of handling and transport.
 Diagnostic specimens shipped via air transport – use a fiberboard box marked with
TC125-1B and follow IATA packing instruction 650.
 Infectious substances shipped via ground or air – use a certified fiberboard container
marked with TC125-1A and the approved UN marking. Shipping documents must
comply with Transportation Canada regulations and/or IATA Packing Instruction 620.
Documents must accompany the package at all times.
Questions regarding any aspect of specimen transport may be directed to the Packing Area
(Calgary) at 403-944-2583 or to the Distribution Centre (Edmonton) at 780-407-8971.
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24
Transportation of Category A or Category B Infectious Substances
For transport purposes the classification of infectious substances according to Risk Groups was
removed from the Dangerous Goods Regulations in the 46th edition. Infectious substances are
now classified as Category A or Category B for transport purposes. There is no direct
relationship between Risk Groups and Category A and Category B.
NOTE: Package classification for transportation should always err on the side of caution.
For more information on the transportation of Category A and Category B Infectious Substances
please consult:
1. The ProvLab Guide to Services under the specific disease/syndrome or causal
agent, and/or
2. Check:
a. Classification of Infectious Substances
b. Exempt Human Specimens - Packing Instructions
c. Infectious Substances Category A- IATA Packing Instructions P620Job Aid
d. Biological Substances Category B- IATA Packing Instructions P650 Job Aid
or
3. Call the Laboratory and speak with the Microbiologist/Virologist On Call
For Packaging for the Transport of Diagnostic Specimens and Infectious Substances refer to
Transport of Diagnostic Specimens and Infectious Substances on the previous page of this
document.
For suspected Category A investigations
(e.g. smallpox, viral hemorrhagic fevers, Ebola etc.)
Consult the Microbiologist/Virologist On Call
prior to collecting and sending samples.
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25
GUIDE TO SPECIMEN COLLECTION
CONTACT NUMBERS
PRIMARY INQUIRIES
(To all departments and/or
staff)
CALGARY SITE
EDMONTON SITE
403-944-1200
780-407-7121
MICROBIOLOGIST/VIROLOGIST 403-944-1200
(ask for MOC/VOC)
ON CALL (MOC/VOC)
780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(Clinical consultation)
(ask for MOC/VOC)
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26
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Acanthamoebae
Acanthamoeba sp.
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Corneal scrapings
(several) in Page’s
Saline
Microscopy, culture
Parasitology
Specimens are cultured by prior arrangement; please
consult the Laboratory before submitting.
Page’s Saline available on request. (Collection kit
attachment)
DO NOT refrigerate specimens.
Acid Fast Bacilli - See: Mycobacteria
Acquired Immune Deficiency Syndrome (AIDS) – See: Human Immunodeficiency Virus
Actinomycosis
Actinomyces israelii
Actinomyces sp.
Pus, preferably with
granules in Cary Blair
(anaerobic) transport
media
Microscopy, culture
Bacteriology
Organisms may take 10 or more days to grow in culture.
Adenovirus Infections
Adenovirus
(over 50 antigenic types)
Nasopharyngeal aspirate
or nasopharyngeal,
throat swab in Universal
Transport Medium
(UTM).
1 – 2 mL Bronchial
Alveolar Lavage (BAL) in
sterile container.
NAT (PCR)
- Tested as part of
respiratory virus panel
Molecular
Diagnostics
Refrigerate but DO NOT freeze specimens.
Feces in a sterile
container
- Electron microscopy
- NAT (PCR)
4 mL blood in EDTA
(lavender top) tube
Consultation with Microbiologist/Virologist On Call is
required.
- specific NAT(PCR)
Plasma PCR*
Viral load (quantitative
PCR)
Virology
Molecular
Diagnostics
Refrigerate at 4°C if transport will exceed 2 hours.
Consultation with Microbiologist/Virologist On Call
required.
Molecular
Diagnostics
Patients on Alemtuzumab BMT protocol are approved
for 15 weeks monitoring. Do not centrifuge. Ship on
ice or cold pack within 24 hours.
Con’t…
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27
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Conjunctival/Eye swab
Eye infection panel
Molecular
Diagnostics
Consultation with Microbiologist/Virologist On Call
required
Aqueous/vitreous fluids
NAT (PCR)
Molecular
Diagnostics
Consultation with Microbiologist/Virologist On Call
required
Lesions
NAT (PCR)
Molecular
Diagnostics
Microbiologist/Virologist On Call consult required.
Urine – minimum 1mL
NAT (PCR)
Molecular
Diagnostics
Microbiologist/Virologist On Call consult required.
Tissues (autopsy/biopsy)
NAT (PCR)
Molecular
Diagnostics
Microbiologist/Virologist On Call consult required.
AFB - See: Mycobacteria
AIDS - See: Human Immunodeficiency Virus
Contact the Department of Biochemistry, University of
Alberta at 780-492-8159.
Algal Toxins
Cyanobacteria
Amoebic Dysentery - See: Diarrhea, Parasitic
Entamoeba histolytica
Amoebic Encephalitis,
Primary
Naegleria sp.*
Acanthamoeba sp.
* (Risk Group 3)
CSF
Microscopy, culture
Parasitology
Brain/meningeal biopsy
Microscopy, culture
Parasitology
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DO NOT refrigerate CSF specimens; keep at room
temperature. Contact the Laboratory before
submitting.
* Ship as Category A: if cultures only
* Ship as Category B: if patient specimens
28
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Amoebic Hepatitis
Entamoeba histolytica
Anaerobic Infections
Actinomyces sp.
Bacteroides sp. (particularly
B. sp. fragilis group)
Clostridium sp.,
Eubacterium sp.,
Fusobacterium sp.,
Peptostreptococcus sp.,
Porphyromonas sp.,
Prevotella sp.,
Propionibacterium sp.
Gas gangrene
Clostridium perfringens,
Clostridium septicum,
Clostridium novyi,
and other species
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Abscess wall section
(NOT PUS) or aspirate of
contents.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Microscopy
Parasitology
Serology EIA
Parasitic Serology
Consult with Microbiologist/Virologist On Call prior to
collecting specimen.
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec
Pus, from deep abscess
or body cavity, preferably
taken by needle
aspiration from under
skin flaps or from deep
pockets in Cary-Blair
(anaerobic) transport
media
Microscopy, culture
Bacteriology
Transport specimens at room temperature – DO NOT
refrigerate.
Lesion swab; necrotic
tissue in Cary Blair
(anaerobic) transport
media
Microscopy, culture
Bacteriology
Transport specimens at room temperature – DO NOT
refrigerate.
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NOTES
29
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Anaplasma
phagocytophilum
Human granulocytic
ehrlichiosis [HGE]
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Molecular Testing
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Contact the Microbiologist/Virologist On Call if molecular
testing is required.
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
Ancylostomiasis - See: Hookworm Disease
Anisakiasis
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology
Parasitic Serology
Referred to the Mahidol University, Bangkok, Thailand
Anthrax
Bacillus anthracis
Lesion swab in plain
transport media (RTM)
Microscopy, culture
Bacteriology
Pustular fluid from skin
lesion
Microscopy, culture
Bacteriology
If lesion is dry, moisten swab in sterile water, saline or
broth and rotate beneath the edge of the eschar.
Contact the Microbiologist/Virologist On Call before
collecting specimens or submitting Bacillus
anthracis isolates for confirmation.
Please indicate on requisition if anthrax is
suspected.
Con’t…
(Risk Group 3)
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30
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Sputum (pulmonary
infection)
Microscopy, culture
Bacteriology
8-10 mL blood for culture
(See: Blood Culture,
Bacteriology for
collection details)
Culture
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Ship as Category A: if cultures only
Ship as Category B: if patient specimens
Bacteriology
Antifungal Levels
Voriconazole
1 mL serum
Mycology
Send serum on ice.
Itraconazole
1 mL serum
Mycology
Send serum on ice. Referred out.
Posaconazole
1 mL serum
Mycology
Send serum on ice. Referred out.
Arbovirus Infections
Global distribution caused
by various viruses, common
examples are:
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
West Nile virus
Dengue virus
Chikungunya virus
Eastern Equine virus
Jamestown Canyon virus*
Snowshoe Hare virus*
Powassan virus
Zika virus*
Serology
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Some agents (West Nile & dengue virus) are tested at
ProvLab; refer to separate entries in this Guide to
Services.
For a comprehensive listing of arboviruses and testing
availability refer to the Zoonotic Testing Supplement
(Posted on the ProvLab website:
Con’t…
www.provlab.ab.ca/education ).
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31
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
(Risk Group 3)
* (Risk Group 2)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Ascariasis
Ascaris lumbricoides
Aseptic meningitis
Usually enterovirus,
parechovirus, HSV-1, HSV2 ,VZV, WNV*, JC, HHV etc
* (Risk Group 3)
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for eggs
Parasitology
Worm (passed in feces
or vomit) in a Closed
Container, or in sterile
saline
Worm Identification
Parasitology
At least 0.5-1 mL
DEDICATED CSF
sample in a sterile
container.
NAT (PCR) CSF Panel:
enterovirus, parechovirus,
HSV-1, HSV-2, VZV
Molecular
Diagnostics
West Nile virus
Emulsify feces in SAF preservative immediately after
collection.
Specify etiology if known on the requisition.
Bloody CSF is not optimal for NAT (PCR) test.
If specimen can be received in the Laboratory within 24
hours of collection then ship on ice/cold packs. If
transportation may exceed 24 hours from collection then
freeze at -70°C and transport on dry ice.
Both West Nile virus and enterovirus are seasonal, and
may present with a similar clinical picture. See:
Enterovirus.
For suspect West Nile virus infection, also request West
Con’t…
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32
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Nile serology on a serum (SST) and submit a plasma
(EDTA) tube of blood for RT-PCR.
See: West Nile Virus.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens
Other viruses (eg JC,
HHV-6)
Microbiologist/Virologist On Call consult required.
Aspergillosis - See: Fungal Infections
Aspergillus antigen
detection
5 mL serum in serum
separator tube (SST)
Galactomannan
Mycology
Electron microscopy
Virology
Bronchoalveolar lavage
(BAL) in a sterile
container
Astrovirus Infections
Astrovirus
Feces in a Closed
Container
Acceptable samples are those collected within the first
48 hours after onset of symptoms. Formed stool is of no
0
diagnostic value. Refrigerate at 4 C if not transported
within 2 hours of collection.
Electron microscopy by request only. The Laboratory
will only report as ‘small round structured virus’ as it is
not possible to identify astrovirus specifically by electron
microscopy.
Attest ™– See: Biological Indicators
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33
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
B Virus Infection
Herpesvirus simiae, also
known as Herpes simiae,
Cercopithecine
herpesvirus 1
(B virus)
(Risk Group 4)
Babesiosis
Babesia species
Chiefly B. microti
(protozoan parasites)
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Virology
Consult Microbiologist/Virologist On Call in Calgary or
Edmonton before collecting specimens of either human
or animal origin. Specimens will be referred for testing
to National Microbiology Laboratory, Winnipeg,
Manitoba.
Ship as Category A
Blood smears OR 5-7 mL
blood in citrate (blue top)
or EDTA (lavender top)
tube
Microscopy
Parasitology
Submit a full travel history.
5mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube.
Serology
Parasitic Serology
Submit a full travel history. Serology performed at
National Reference Centre for Parasitology, McGill
University Centre for Tropical Disease/Centre for
Disease Control, Atlanta, Georgia, U.S.A.
Offered only after consultation with
Microbiologist/Virologist On Call, Edmonton site.
Bacterial Antigen Detection – See: Meningitis, Bacterial
Balanitis
CALGARY
Swab in charcoal
transport media (CTM)
Microscopy, culture
Bacteriology
Balantidiasis (Balantidium coli) - See: Diarrhea, Parasitic
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34
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Bartonella henselae
(Cat scratch fever)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
5 mL serum in a serum
separator tube (SST);
pediatrics may use 2 mL
red top tube.
Serology
Virology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Contact the Microbiologist/Virologist On Call if molecular
testing is required.
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
Aspirate from wound,
sample of pus, fluid
and/or tissue from lymph
nodes or heart valve.
Molecular Testing
Bacteriology
Biopsy submitted in a
sterile container. At least
1 ml of fluid sample is
required. If swab is used,
submit in clear transport
medium
Bilharziasis - See: Schistosomiasis
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35
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Biological Indicators
BK Virus
Polyomavirus – usually
benign infection but
important cause of renal
dysfunction and graft loss in
renal transplant recipients
Blastocystis
Blastocystis hominis
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Spore Strips
Attest™ vials
Culture
Environmental
Microbiology
Spore strips suitable for testing dry heat, ethylene oxide
or formaldehyde sterilizer.
Submit two test strips and one unprocessed control strip
of the same lot#/expiry.
Attest™ vials suitable for testing steam autoclaves.
Submit one test vial and one unprocessed control vial of
the same lot#/expiry. Access number must be attached
to strips or vials.
Do not expose to extreme heat or cold during transport
to the laboratory
Early morning first-void
urine sample in a sterile
container.
Quantitative PCR
Molecular
Diagnostics
Test only available for renal and bone marrow transplant
patients. Consult with Microbiologist/Virologist On Call
for additional testing.
5 – 7 mL blood in EDTA
(lavender top) tube, 2 mL
acceptable for infants.
DO NOT centrifuge.
DO NOT freeze.
Transport on cold packs/
ice. Must be received in
less than 48 hours of
collection.
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Plasma will not be processed unless the urine is
positive.
Microscopy
Parasitology
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Emulsify feces in SAF preservative immediately after
collection.
36
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Culture
Bacteriology
Please refer to the following link for collection
instructions: Blood Culture Collection Guidelines for
Phlebotomists.
Blastomycosis - See: Fungal Infections and Fungal Serology
Blood Culture,
Bacteriology
(Edmonton site only)
See: NOTES
Blood Culture, TB – See: Mycobacteria
Bone Chips
Bone chips in Cary Blair
(anaerobic) transport
media
Culture
Bacteriology
Immerse specimen in Cary Blair transport medium so
that it is covered and anaerobes are viable. Transport
specimens at room temperature – DO NOT refrigerate.
Bone Marrow Culture,
Bacteriology
(Edmonton Site Only)
Adults: 2 mL bone
marrow in one
BACTEC™ Peds Plus/F
vial.
Pediatrics: 1.5 mL bone
marrow in one
BACTEC™ Peds Plus/F
vial.
1 mL bone marrow in
Isolator tube
Culture
Bacteriology
Inoculate 2 mL maximum into vial. BACTEC vials are
stored at room temperature pre/post inoculation.
Referred specimens should be incubated at 35-37°C or
kept at room temperature.
Culture
Bacteriology
Culture
Mycology
Bone Marrow Culture,
Mycology
Fungal culture performed by request only, please
indicate on requisition.
Submit bone marrow for Histoplasma in Isolator tubes.
Isolator tubes can be obtained by calling the Laboratory
at the Edmonton site. Submit blood for culture of other
fungi in Bactec vials. (See: Blood Culture, Bacteriology
for collection details).
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37
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Refrigerate until transport. DO NOT FREEZE
Specify the virus, e.g. CMV, VZV, etc
Microbiologist/Virologist On Call consult required.
Bone Marrow Culture, TB – See: Mycobacteria
Bone Marrow:
CMV
VZV
HSV
Adenovirus
2 mL bone marrow
aspirate minimum in
EDTA
(lavender top) tube
NAT(PCR)
Molecular
Diagnostics
Parvovirus B19
DEDICATED sample
(2 mL) bone marrow in
EDTA (lavender top)
tube.
NAT(PCR)
NML
HHV-6
Microbiologist/Virologist On Call consult required.
Parvovirus PCR is performed on immunocompromised
host or specific hematological disorders only; parvovirus
serology IgG and IgM are preferred tests for otherwise
healthy patients. Parvovirus PCR is referred to the
National Microbiology Laboratory, Winnipeg, Manitoba
for testing. Submit samples to the Laboratory Monday to
Wednesday to allow shipping time to reference
laboratory.
NML
Microbiologist/Virologist On Call consult required.
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Bordetella Infections - See: Pertussis
Borrelia burgdorferi, afzelii & garinii - See: Lyme disease
Borrelia spp - See: Borrelia hermsii
Borrelia hermsii
(Tick-borne relapsing fever
[TBRF]
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Con’t…
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38
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
Testing for B.hermsii must include travel to and tick bite
in endemic areas.
Bornholm Disease - See: Enterovirus Infections
Borreliosis - See: Lyme Disease
Botulism
Food-borne Botulism
Infant Botulism
Suspected food in sterile
container or original
container.
Feces (10 g), serum
(from 20 mL blood),
gastric contents in
Closed Container
Infant feces (10 g) or
enema fluid (15-20 mL)
in a Closed Container or
rectal swab or soiled
parts of diaper.
Serum (2 mL)
Toxin,
Culture
Bacteriology
Consult Microbiologist/Virologist On Call
immediately. All requests for Clostridium botulinum
culture or toxin must be approved by the Microbiologist
On Call. All testing is performed at the Botulism
Reference Service (BRS), Ottawa, Ontario.
.
Toxin,
Culture
Bacteriology
Laboratory investigations of infant botulism are generally
limited to the analysis of toxin and culture detection of C.
botulinum in stools. Reported cases with detectable
toxin levels in serum are rare.
The preferred specimen for confirming the
diagnosis of infant botulism is the infant’s feces.
Stool: Infant feces or enema fluid in a sterile container.
Blood: Serum collected BEFORE administration of
antitoxin (BIG).
Con’t…
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39
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Food: Implicated food samples may be leftovers or
unopened containers; for commercial foods, it is
important to include the label, and manufacturer’s lot
number. Food specimens should be transported on ice
packs.
Testing of suspect cases of infant botulism will be
coordinated through the office of the Medical Officer of
Health. The Microbiologist/Virologist On Call can be
contacted for further information on laboratory
investigations.
Refrigerate (4ºC) samples after collection and during
transport to laboratory
Wound Botulism
Swab in anaerobic
transport media (Cary
Blair).
Culture
Bacteriology
PCR and RT-PCR –
Respiratory Virus Panel
Molecular
Diagnostics
See notes for Food-borne Botulism.
Transport specimens in anaerobic transport media at
room temperature. DO NOT refrigerate.
Brills Disease - See: Rickettsial Infections
Bronchiolitis of Infants
Respiratory Syncytial Virus
(RSV), Parainfluenza Virus
*, Influenza Virus*,(Flu A, B)
Adenovirus, human meta
pneumovirus, coronavirus
and rhinoviruses
Nasopharyngeal (NP)
swab, throat swab,
aspirate or auger suction
in Universal Transport
Medium (UTM) (see:
Nasopharyngeal
Aspirates, Viral for
collection details)
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
*(if highly pathogenic eg.
H2N2 - Risk Group 3)
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40
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Bronchitis
Haemophilus influenzae,
Streptococcus pneumoniae
and other bacteria
Sputum
Microscopy, culture
Bacteriology
Preferably collected on waking in the morning.
Brucellosis
Brucella abortus,
Brucella melitensis,
Brucella suis
Acute Brucellosis: 8 - 10
mL blood for culture
(see: Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Acute, subacute, and
chronic Brucellosis: 2 mL
bone marrow for culture
(see: Bone marrow,
Bacteriology for
collection details)
Culture
Bacteriology
Sputum is an unsuitable sample for virus culture, a
throat swab or nasopharyngeal sample in Universal
Transport Medium (UTM) is required.
(Risk Group 3)
Multiple cultures recommended. Diagnosis confirmed if
culture is positive or if clinical symptoms are compatible
with brucellosis and serum shows a 4-fold or greater rise
in agglutination titre between acute and
convalescent specimens obtained two or more weeks
apart and studied at the same laboratory.
A presumptive acute case is one with compatible clinical
symptoms and a single or stable agglutination titre of at
least 1:160 in serum obtained after the onset of
symptoms.
Contact the Microbiologist/Virologist On Call before
collecting specimens or submitting suspected
Brucella isolates for confirmation. Please indicate
on requisition if Brucellosis is suspected.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
Serology
Virology
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Con’t…
41
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
tube, submit acute and
convalescent (at least 2
weeks apart)
Brugia sps. – See: Filariasis
Burkholderia pseudomallei – See: Melioidosis
Calicivirus Infections: Calicivirus, includes Norovirus – See: Diarrhea, Viral
Campylobacter - See: Diarrhea Bacterial and Food-borne Bacterial Disease/Syndrome
Candidiasis - See: Fungal Infections and Genital Infections
Cat Scratch Disease/Fever - See: Bartonella henselae
Cervicitis - See: Genital Infections
Chagas Disease - See: Trypanosomiasis
Chancroid - See: Genital Infections – Chancroid
Chickenpox, Varicella and Zoster (shingles) - See: Varicella Zoster Virus Infections
Chinese Liver Fluke Disease - See: Clonorchiasis
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42
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Chikungunya virus
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
As dengue and Chikungunya viruses co-circulate in
some regions, requests for Chikungunya will
automatically include testing for dengue.
Testing for Chikungunya virus performed at the National
Microbiology Laboratory, Winnipeg, Manitoba.
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43
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Chlamydophila Infections,
Chlamydia psittaci *
includes agents of
C. psittacosis, ornithosis
and various diseases of
animals
Chlamydia psittaci:
*(Risk Group 3)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Nasopharyngeal aspirate
or nasopharyngeal throat
swab in Universal
Transport Medium
(UTM).
Molecular detection
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
1 – 2 mL Bronchial
Alveolar Lavage (BAL) in
sterile container
Molecular detection
Virology
CSF specimens may be
tested but not ideal.
Molecular detection
Virology
Molecular testing referred to the National Microbiology
Laboratory, Winnipeg, Manitoba. Consultation with
Microbiologist/Virologist On Call required. Clinical
history including bird or animal contact is required or test
will not be performed. TAT is 12 calendar days once
specimen received at NML.
*If Chlamydia psittaci suspected:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology Microimmunofluorescence:
IgG, IgM
Virology
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
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Serology referred to the National Microbiology
Laboratory, Winnipeg, Manitoba. Clinical history
including bird or animal contact is required or test will
not be performed. TAT is 12 calendar days once
specimen is received at NML.
44
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Chlamydophila
pneumonia
Atypical pneumonia
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
NOTES
Nasopharyngeal aspirate
or nasopharyngeal,
throat swab in Universal
Transport Medium (UTM)
Molecular detection (Not
routinely performed – See
Notes )
1 – 2 mL Bronchial
Alveolar Lavage (BAL) in
sterile container
Molecular detection
Virology
CSF specimens may be
tested but not ideal.
Molecular detection
Virology
Endocervical Swab:
Use Gen-Probe
APTIMA® unisex swab
specimen collection kit
available from Laboratory
NAAT
Bacteriology
In females, specimens should be obtained from the
cervix if possible; vaginal swabs have not been validated
in the laboratory
NAAT
Bacteriology
Urethral swabs may cause discomfort to male patients.
A urine is an appropriate
specimen that can be taken instead of a urethral swab.
NAAT
Bacteriology
First catch urine without having voided for at least
Con’t…
Not routinely performed. Serologic testing not
available. Molecular testing referred to the National
Microbiology Laboratory, Winnipeg, Manitoba.
Consultation with Microbiologist / Virologist On Call
required. Clinical history is required or test will not be
performed. TAT is 12 calendar days once specimen is
received at NML.
Chlamydial Infections,
Chlamydia trachomatis
Male Urethral Swab:
Use Gen-Probe
APTIMA® unisex swab
specimen collection kit
available from Laboratory
Urine (Male and
Female): Use Gen-Probe
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45
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
1 hour: 20-30 ml (beginning of a stream in a sterile
container). Transfer 2 ml urine to a
Gen-Probe APTIMA® Urine collection kit within 24 hours
of collection.
*Vaginal swabs have not been validated in the
Laboratory but may be processed (if the cervix is absent,
or for children under 12 years of age) following
consultation with the Microbiologist/Virologist On Call.
APTIMA® urine
specimen collection kit
available from Laboratory
Vagina Swabs*: Use
Gen-Probe APTIMA®
vaginal swab collection
kit available from
Laboratory
NAAT
Bacteriology
Eye Swabs: Use GenProbe APTIMA® unisex
swab specimen
collection kit available
from Laboratory
NAAT
Bacteriology
Call and speak with Microbiologist/Virologist On Call.
Other Extragenital
Sites: See Notes
None of the current commercial NAAT testing platforms
have Health Canada of FDA approval for extra-genital
specimen testing. For non-STI clinic and nonreproductive health clinic patients, if CT/NG on other
extragenital site specimens is required please contact
the Microbiologist/Virologist On Call.
Rectal: Use Gen-Probe
APTIMA® unisex swab
specimen collection kit
available from Laboratory
NAAT
Bacteriology
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Con’t
46
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Lymphogranuloma
Venereum (LGV)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Genital and Rectal
Swab: in a GEN-PROBE
APTIMA® Unisex Swab
Specimen transport kit,
Urine: 2mL urine in a
GEN-PROBE APTIMA®
urine specimen collection
kit
NAAT
Bacteriology
If LGV is suspected, contact the Microbiologist/
Virologist On Call. LGV investigation referred to the
National Microbiology Laboratory, Winnipeg, Manitoba.
Microscopy for eggs
Parasitology
It is difficult to differentiate the eggs of these and related
species and when in doubt they are reported as
"opisthorchid" ova.
Tissue: in a sterile
container,
Bubo aspirate: in a
sterile container
Cholera - See: Diarrhea Bacterial also See: Vibrio
Clonorchiasis
Opisthorchis
Clonorchis sinensis
(the Chinese liver fluke)
Feces in SAF
preservative (see
Diarrhea, Parasitic for
collection details)
Clostridium Difficile Toxin - See: Diarrhea Antibiotic Associated
CMV - See: Cytomegalovirus Infections
Coccidioidomycosis - See: Fungal Infections
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47
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Colitis, Haemorrhagic
Escherichia coli O157:H7
Feces in a Closed
Container; fill container
1/3 full or at least 1
tablespoon (minimum)
Do not contaminate with
water or urine.
Culture
Bacteriology
Also see: Diarrhea Bacterial and Food-borne Bacterial
Disease/Syndrome
Colorado tick fever virus
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
For Mother:
Maternal serological
tests* 5 mL serum
separator tube (SST)
Serology
Virology
Special request through Microbiologist/Virologist On
Call.
Serology
Specify virus requested
e.g. Rubella, Toxoplasma
Virology
*For suspected congenital infection, parallel testing of
maternal prenatal screening sample and post-partum
sample for suspected viral serology can be very helpful.
Contact Microbiologist/Virologist On Call in Calgary or
Edmonton if testing is required.
Congenital Infections
caused by viral and
microbial agents:
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48
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
e.g. Rubella virus, CMV,
HSV, Parvovirus, Syphilis,
Toxoplasma, etc.
SPECIMEN
COLLECTION
REQUIREMENTS
For Neonate:
Suspected CMV
infection: Please collect
a single urine sample in
sterile container and/or
throat swab in Universal
Transport Medium (UTM)
within first four weeks of
delivery.
Suspected rubella
infection:
Collect 1 - 2 mL neonatal
blood in red top tube
(serum),
Urine in sterile container
and throat swab in
Universal Transport
Medium (UTM)**
Suspected HSV
infection:
Using a single swab,
collect a swab specimen
from conjunctiva, oral
pharynx in Universal
Transport Medium (UTM)
for HSV culture. Unroof
and swab suspicious
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
CMV DNA
NAT (PCR)
Virology
Molecular
Diagnostics
Urine for CMV is the gold standard. Serology (IgG and
IgM) is not reliable.
NAT (PCR) testing has now replace shell-vial culture.
Only 1 urine sample is required for testing for screening
for congenital CMV
Rubella serology (IgG and
IgM)
Virology
Rubella RT-PCR
NML
HSV
NAT (PCR)
Molecular
Diagnostics
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**Urine and throat swab will be referred to the National
Microbiology Laboratory, Winnipeg, Manitoba, if clinical
picture and serological result support the diagnosis of
rubella infection.
Con’t….
49
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
CSF Panel
Molecular
Diagnostics
Bloody CSF is not optimal for NAT (PCR)
If specimen can be received in the Laboratory within 24
hours of collection then ship on ice/ cold packs. If
transportation might exceed 24 hours from collection
then freeze at -70°C and transport on dry ice.
Toxoplasma serology (IgG
and IgM)
Virology
Please provide history.
lesion (usually blister or
superficial ulcer)
vigorously and transport
in Universal Transport
Medium (UTM).
For neonate with
seizures or
neurological
symptoms:
Submit 0.5-1 mL
DEDICATED CSF
sample in a sterile
container for CSF panel
(HSV-1/2, VZV and
enterovirus/parechovirus
NAT)
For neonate with
sepsis syndrome collect
1-2 mL blood in EDTA for
HSV-PCR
Suspected
Toxoplasma:
Collect neonatal serum 1
- 2 mL in red top tube
and see above for
maternal serology test
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Con’t….
50
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Suspected Parvovirus:
Collect neonatal serum 1
- 2 mL in red top tube
and see above for
maternal serology test
Parvovirus serology (IgG
and IgM)
Virology
Please provide history.
Suspected Syphilis:
Collect maternal serum 3
- 5 mL in red top tube or
serum separator tube for
initial screening.
Neonatal testing may be
required if maternal
serological result is
abnormal
EIA, RPR, INNO-LIA
Virology
Using maternal serology as initial screen can decrease
the amount of blood draw from the neonate. Please
provide history.
Congo – Crimean Hemorrhagic Fever – See: Viral Hemorrhagic Fever
Conjunctivitis - See: Eye Infections
Coronavirus Infections - See: Respiratory Infections, Viral and Atypical Bacteria
Corynebacterium diphtheriae – See: Diphtheria
Cowpox - See: Poxvirus Infections
Coxiella burnetii - See: Rickettsial Infections
Coxsackie Virus Infections – See: Enterovirus Infections
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51
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Creutzfeldt-Jakob
Disease
Unclassified agent causing
subacute spongiform
encephalopathy.
(Risk Group 3)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Biopsy material (brain);
autopsy material (brain
and other organs)
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Performed by
Pathology
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
CSF (a DEDICATED
sample of at least 2 mL)*
14-3-3 protein*
Tau
S100B
Virology
A neurology consult and clinical history is required
before 14-3-3 protein testing is performed. Consult the
Microbiologist/Virologist On Call before submitting
specimen. Sample is referred to National Microbiology
Laboratory, Winnipeg, Manitoba. Requisition must be
clearly labelled to identify specimen as suspected
Risk Group 3 Agent.
Cryptococcus (LA)
Bacteriology
For specimens from patients from the Calgary Zone,
refer to Calgary Laboratory Services for testing.
Microscopy for oocysts
Parasitology
Croup - See: Bronchiolitis of Infants
Most commonly caused by Parainfluenza virus.
Cryptococcal Antigen
Detection
Cryptococcosis
CSF 0.5 mL minimum in
a sterile container
Serum 2 mL in serum
separator tube (SST)
Cryptococcus - See: Fungal Infections
Cryptosporidiosis
Cryptosporidium sp.
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Water, see: Water:
Parasites and Enteric
Pathogens
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52
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Cyclospora
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for oocysts
Parasitology
Cysticercosis
Taenia solium
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology Immunoblot
Parasitic Serology
Cytomegalovirus
Infections (CMV)
Cytomegalovirus
e.g. heterophile negative
mononucleosis, congenital
infection (see: Congenital
Infections caused by viral
and microbial agents),
1 - 2 mL urine; BAL in
sterile containers
CMV
NAT (PCR)
Molecular
Diagnostics
Throat swab in Universal
Transport Medium (UTM)
(new born only)
NAT (PCR)
Virology
5-7mL EDTA (lavender
top)tube
2 mL acceptable for
infants.
Quantitative PCR
Viral Load (Quantitative
PCR)
Molecular
Diagnostics
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA:
IgG, IgM
Virology
CMV reactivation or primary
infection in solid organ
or bone marrow transplant
recipients.
NOTES
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease
Transport on ice/cold packs and DO NOT freeze. Must
be received within 48 hours of collection.
Test only available for transplant recipient patients and
immunodeficient population. Consult with
Microbiologist/Virologist On Call for additional testing.
Avidity
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Serology performed 3 times/week.
Please provide history.
CMV IgG avidity is used to distinguish primary CMV
infection from
Con’t….
53
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
reactivation in CMV IgM and CMV IgG positive patients.
Mostly relevant to prenatal. Microbiologist/Virologist On
Call consult required
Autopsy material, biopsy
material submitted in
sterile container
Dengue virus/Dengue
Fever
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Molecular
Diagnostics
Serology
Virology
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education ).
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Dermatophytes
Epidermophyton sp.,
Microsporum sp.,
Trichophyton sp.
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Skin scrapings; nail
clippings; hair, submit in
fungus/mycology kit
Microscopy, culture
Mycology
Biopsy material in sterile
container
Microscopy, culture
Mycology
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Contact Microbiologist/Virologist On Call if molecular
testing is required
Hair - pull hair from the center and periphery of lesion.
Place hair, base of shaft, and crust onto the piece of 4x4
paper supplied in the kit. DO NOT use slides, cotton
wool or tubes.
Nails/skin - clean site with 70% alcohol. Collect 5-6
scrapings onto the piece of 4x4 paper supplied in the kit.
Fold paper 3 times and place in envelope. DO NOT use
slides, cotton wool, or tubes.
54
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Diarrhea Antibiotic
Associated
Clostridium difficile
(Pseudomembranous
colitis)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Feces, fill container 1/3
full or at least 1
tablespoon (minimum)
Do not contaminate with
water or urine.
Toxin studies
Bacteriology
DO NOT submit feces specimens in transport media for
toxin studies.
Specimens should be
kept refrigerated and
transported to the
laboratory as soon as
possible (toxin is stable
for <24 hours) If
transport is expected
to be >24 hours; freeze
specimen and
transport on dry ice.
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DO NOT submit formed stools.
Repeat C. difficile testing on previous negative or
positive sample within 7 days will only be performed if
approved by the Microbiologist/Virologist On Call.
55
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Diarrhea Bacterial
Numerous species
including: Aeromonas,
Campylobacter, Escherichia
coli O157:H7, Salmonella,
Shigella, Yersinia
Vibrio species
(Cholera)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Feces in a Closed
Container; fill container
1/3 full or at least 1
tablespoon (minimum)
Do not contaminate with
water or urine.
Send feces containing
blood or mucus if these
are present. If transport
of fecal sample exceeds
24 hours, submit in
enteric transport media
(Enteric transport media
is not supplied by the
Laboratory)
Culture (routine)
Bacteriology
Routine culture includes examination for Aeromonas,
Campylobacter, Escherichia coli O157:H7, Salmonella,
Shigella, and Yersinia.
Multiple specimens from the same day are not
processed.
Stool specimens from inpatients after the third day of
hospital stay are not processed without consultation.
Culture for Vibrio available on request
Culture
Other enteric foodborne
pathogens
Culture for specific enteric pathogens and foodpoisoning investigations is available on request. Consult
the Microbiologist/Virologist On Call in the case of
outbreaks.
Also See: Food-Borne
Bacterial
Disease/Syndrome
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56
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Diarrhea Parasitic
Many parasites including
helminths, coccidians, (ie:
Cryptosporidium, Isospora,
Cyclospora) and amoebae
(ie: E. histolytica, Giardia
lamblia, Dientamoeba
fragilis)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Feces in SAF
preservative. Important:
Follow instructions on
SAF container.
Microscopy
Parasitology
Emulsify feces in SAF preservative immediately after
collection. Submit 3 specimens at one or more day
intervals (maximum one per day). Collect specimens
while patient is not on antibiotics, and before
administration of anti-diarrhetics and radiological dyes.
Mineral oil, bismuth, antibiotics, anti-malaria agents, and
non-absorbable anti-diarrheal preparations interfere with
the detection of intestinal protozoa.
Specimens submitted in enteric transport media are not
acceptable.
Scrapings from ulcerated
bowel collected by
sigmoidoscopy in SAF
preservative (primary
amoebic dysentery)
Microscopy, culture
Parasitology
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA
Virology
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Consult Microbiologist/Virologist On Call at Calgary or
Edmonton.
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57
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Diarrhea Viral
Common gastroenteritis
viruses: rotavirus,
norovirus, sapovirus,
astrovirus and adenovirus
Diphtheria
Corynebacterium
diphtheriae (gravis,
intermedius, mitis and
belfanti biotypes), and
Corynebacterium ulcerans
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Feces in a Closed
container
Depending on patient
population*, stool samples
are tested by:
1) Electron microscopy
(EM), or
2) Molecular methods
(PCR)
Virology (EM)
and
Molecular
Diagnostic (PCR)
Collect feces as early in illness as possible. Refrigerate
specimens and transport to the Laboratory
immediately. Refrigerate but DO NOT freeze
specimens. Specify on the requisition that testing for
gastroenteritis virus is required and if appropriate,
indicate patient is hospitalized so that PCR can be
performed on the specimen.
Throat; nasal; skin lesion
swab in plain transport
media (RTM)
2 mL serum (red top
tube)
* PCR is available only for
outbreak investigations
and specimens from
hospitalized patients if their
status is identifiable by
information provided on the
requisitions. Otherwise
PCR is only available upon
special request and
approval by the virologist/
microbiologist on call. To
initiate an outbreak
investigation, contact your
local Medical Officer of
Health and Microbiologist/
Virologist On Call at
Calgary or Edmonton.
Microscopy, culture
Bacteriology
Culture only by request, please indicate on requisition.
Consult Microbiologist/Virologist On Call for culture and
suspected infection. Toxigenicity tests require an
additional 48-72 hours.
Anti-toxin determination
Bacteriology
Test performed weekly.
By EM, rotavirus and adenoviruses can be well
identified. Electron microscope can also detect, as a
group, small-round-structured viruses (SRSV) which
includes norovirus, sapovirus and astrovirus.
PCR can detect all five gastroenteritis viruses including
rotavirus, norovirus genogroup I and genogroup II,
sapovirus, astrovirus and adenovirus).
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58
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Diphyllobothriasis
Diphyllobothrium latum
(fish tape worm)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Segments of worm
Microscopy for eggs and
segments
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
Microscopy
Parasitology
It is important that segments not be preserved. Submit
in sterile container or in saline.
Microscopy
Parasitology
Dirofilaria immitis – See: Filariasis
Dracunculiasis
(guinea worm)
Dracunculus medinenses
Adult worm extracted
from skin in sterile saline
Dysentery, Amoebic - See: Diarrhea Parasitic
Dysentery, Bacillary - See: Diarrhea Bacterial
E. coli - See: Diarrhea Bacterial or Food-borne Bacterial Disease/Syndrome
Ear Infections, Otitis
Externa
Several species of bacteria,
fungi, and viruses
Ear swab in plain
transport media (RTM)
for bacteria, fungi
Culture
Bacteriology
Mycology
Submit swabs in appropriate transport media for culture
of different organisms.
Ear infections, Otitis
Media
Several species of bacteria,
viruses and fungi;
Ear swab in plain
transport media (RTM)
for bacteria, fungi or
Culture
Bacteriology
Mycology
Molecular
Diagnostics
Submit swabs in appropriate transport media for culture
of different organisms. Specify the culture required.
Occasionally
Mycoplasma pneumoniae
Universal Transport
Medium (UTM) for
mycoplasma.
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Molecular testing for Mycoplasma and for respiratory
viruses is available upon consultation with
Microbiologist/Virologist On Call.
Con’t…
59
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
Ear aspirate; tympanocentesis aspirate in
sterile container.
Indicated specific viral
detection required if
appropriate for clinical
picture.
Eastern Equine
Encephalitis
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
TESTS AVAILABLE
SECTION
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Not routinely performed. Molecular testing referred to
the National Microbiology Laboratory, Winnipeg,
Manitoba. Consultation with Microbiologist/Virologist On
Call required. Clinical history is required or test will not
be performed. TAT is 12 calendar days once specimen
is received at NML.
Mycoplasma pneumoniae
Molecular testing (Not
routinely performed – See
Notes )
Serology
CALGARY
Virology
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Ebola Virus - See: Viral Hemorrhagic Fever
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education )
EBV - See: Epstein-Barr Virus Infections
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60
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Echinococcosis
Echinococcus granulosus ,
Echinococcus multilocularis
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Aspirated fluid from cyst;
excised cyst
Microscopy for hydatid
"sand" (protoscolices)
Parasitology
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA
Parasitic Serology
Sensitivity of the test depends on cyst location, integrity
and vitality. False positives are seen in other helminth
infections, as well as cirrhosis or cancer of the liver.
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Echovirus - See: Enterovirus Infections
Ectoparasites
Arthropods
Parasite
Identification
Parasitology
Send specimen in clean dry container or in 70% alcohol
(ethanol).
Ehrlichia chaffeensis
(Human monocytic
ehrilichiosis [HME]
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education ).
Only performed if recent travel to endemic region and
tick bite is verified.
Contact Microbiologist/Virologist On Call if molecular
testing is required.
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba.
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61
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Encephalitis, Viral
Including epidemic,
sporadic, and postinfectious types.
Several viruses: Herpes
simplex virus, enterovirus,
parechovirus , West Nile
virus*, varicella zoster virus,
arbovirus*, lymphocytic
choriomeningitis virus*,
influenza virus, rubella
virus, mumps virus,
measles virus, vaccinia
virus, rabies virus**
If Arbovirus, West Nile
Virus, lymphocytic
choriomeningitis virus or
rabies is suspected – (Risk
Group 3)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
If multiple PCR tests are
requested on a CSF,
submit at least 1 mL of
DEDICATED CSF and
specify the virus for
PCR test request
NAT (PCR)
Molecular
Diagnostics
Bloody CSF is not optimal for PCR tests.
If specimen can be received in the Laboratory within 24
hours of collection then ship on ice/cold packs. If
transportation might exceed 24 hours from collection
then freeze at -70°C and transport on dry ice.
Standard panel for viral
encephalitis consists of
HSV, VZV, enterovirus and
parechovirus.
WNV testing is available
during WMV season by
specific request.
Suspected HSV
encephalitis: see
Herpes Simplex Virus
Infections.
Providing clinical information with the test request is
extremely helpful for the Laboratory. Specifying the
suspected virus is key to appropriate testing.
* If rabies virus is suspected, consult with the
Microbiologist/Virologist On Call.
Suspected enterovirus
encephalitis:
See Enterovirus
Infections
Suspected West Nile
encephalitis:
See West Nile Virus
Infections
Suspected varicella
encephalitis:
See Varicella Zoster
Virus Infections
Suspected influenza
related encephalitis:
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62
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Collect nasopharyngeal
swab in Universal
Transport Medium (UTM)
RT-PCR
Virology
Molecular
Diagnostics
Specify testing for influenza viruses on the requisition.
Influenza – consult Microbiologist/Virologist On Call.
Biopsy / autopsy
material:
Discuss with Virologist on
Call before submission
* If Arbovirus, West Nile Virus, lymphocytic
choriomeningitis virus or rabies is suspected :
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Suspected Arbovirus
encephalitis:
See: Arbovirus
Infections
Consult Microbiologist / Virologist On Call.
Suspected other
viruses
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63
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Endocarditis, Bacterial
Many bacterial and fungal
species
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Blood for culture should be taken when patient is febrile.
Multiple cultures recommended. When catheters are
present, blood should be collected from other sites.
* Coxiella burnetii (Q Fever)
* (Risk Group 3)
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology EIA IgG
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Contact Microbiologist / Virologist On Call if molecular
testing or culture is required and BEFORE samples are
collected.
Submit acute (at onset)
and convalescent (14 to
21 days) bloods
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
*Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Entamoebae - See: Diarrhea Parasitic
Enteric Fever - See: Typhoid Fever
Enterobiasis - Pinworms
(Cellophane Tape Test)
Enterobius vermicularis
(pinworm)
Cellophane tape applied
to peri-anal region
(instruction sheet
available from the
Parasitology Bench,
Edmonton site).
Microscopy for ova
Parasitology
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Collect pinworm ova by folding clear cellophane tape
around the end of a tongue depressor, adhesive side
out. DO NOT use frosted tape. Spread buttocks and
firmly press the tape on the anal area, using a rocking
motion to cover as much of the peri-anal mucosa as
possible. Remove tape and apply firmly to a clear glass
slide. Label with the patient’s full name and a second
Con’t…
64
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
unique identifier. The female pinworm (Enterobius
vermicularis) generally migrates out to the anus to
deposit her eggs at night. Take samples in the evening
after the patient has been sleeping for several hours or
first thing in the morning before washing or going to the
bathroom.
NOTE: Commercial devices can also be used in
accordance with the manufacturer’s instructions.
Enterovirus Infections
Poliovirus*, Coxsackievirus
A viruses,
(Serotypes 1-22 and 24)
Coxsackievirus B viruses,
(Serotypes 1-6),
Echoviruses. Usually
seasonal with incidence
highest over summer.
Disease syndrome: Hand,
foot and mouth disease,
other types of rash illness,
myocarditis, aseptic
meningitis / encephalitis,
sepsis-like picture in
neonates and
immunocompromised
Stool in a Closed
Container
NAT (RT-PCR)
Molecular
Diagnostics
Throat or NP swab in
Universal Transport
Medium (UTM)
NAT (RT-PCR)
Molecular
Diagnostics
Specify enterovirus testing on the requisition for all
specimen types.
Characterization of enteroviruses is available for the
clinical management of suspect unusual or severe cases
of respiratory illness (e.g. asthma exacerbation,
bronchitis, pneumonitis, pneumonia, ICU admission) or
for management of unusual clusters/outbreaks.
If typing is required contact a ProvLab MOC/VOC to
identify severe and unusual cases. Use a manual
(paper) ProvLab requisition to order respiratory virus
testing. Complete all fields and indicate in writing “Do
enterovirus typing testing”. Collect and submit a
properly labelled specimen with this requisition as you
would for routine respiratory virus testing. On approved
respiratory specimens, the respiratory virus panel will
identify to the level of entero-rhinoviruses. Further
classification will occur depending on your discussion
with the ProvLab MOC/VOC.
* (Risk Group 3)
Con’t…
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65
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
* If Poliovirus suspected:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
For suspected cases of acute flaccid paralysis (AFP)
you must contact your local Medical Officer of
Health (MOH) prior to specimen collection for
direction on specimen collection, and coordination
of testing. For guidance on suspect AFP patients
please contact your local MOH prior to specimen
collection.
Vesicle ** swab** in
Universal Transport
Medium (UTM) (stool
and throat swab are
preferred specimens).
NAT (RT-PCR)
Molecular
Diagnostics
**Unroof new lesion and vigorously swab the lesion with
a rayon swab; submit swab in Universal Transport
Medium (UTM).
Mouth ulcer swab
NAT (RT-PCR)***
Molecular
Diagnostics
***Oral infection panel (HSV-1, HSV-2, VZV,
enterovirus, parechovirus)
One EDTA (lavender
top) 4 mL tube
NAT (RT-PCR)
Molecular
Diagnostics
Blood: Test only available on immunodeficient
populations, myocarditis, neonates or on consultation
with Microbiologist/ Virologist On Call. Do not
centrifuge. Ship on Ice or cold pack within 24 hours.
DEDICATED CSF
sample (0.5-1 mL
minimum) in a sterile
container
NAT (RT-PCR)
Molecular
Diagnostics
Bloody CSF is not optimal for molecular tests.
If specimen can be received in the Laboratory within 24
hours of collection then ship on ice/cold packs. If
transportation might exceed 24 hours from collection
then freeze at -70°C and transport on dry ice.
CSF Panel (HSV-1, HSV-2,
VZV, enterovirus,
parechovirus
Molecular
Diagnostics
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Epiglottitis, Acute
Haemophilus influenzae
Epstein-Barr Virus
Infections
Epstein-Barr Virus
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Nasopharyngeal; throat
swab in plain transport
media (RTM)
Culture
Bacteriology
Specify diagnosis and culture request.
Blood culture (see Blood
Culture, Bacteriology for
collection details)
Culture
Bacteriology
For acute EBV infection:
5 mL serum (red top or
serum separator (SST)
tube)
Panel EBV IgM, EBV VCA
IgG and EBNA IgG
Virology
EBV VCA IgG AND IgM and EBNA IgG performed.
For pre-transplant
assessment:
5 mL serum (red top or
serum separator (SST)
tube)
Panel EBV IgM, EBV VCA
IgG and EBNA IgG
Virology
EBV VCA IgG AND IgM and EBNA IgG performed.
For transplant recipients
only:
4 – 7 mL blood in EDTA
(lavender top) tube.
1 mL acceptable for
infants.
Viral Load
Molecular
Diagnostics
DO NOT centrifuge the specimen and refrigerate until
ready to transport. Transport on ice/cold pack and DO
NOT freeze. The specimen must be received within 48
hours from time of collection. Please provide clinical
history and/or use surveillance fax form.
Viral load is available ONLY for suspected acute EBVrelated illness in solid organ or bone marrow transplant
patients.
For PTLD monitoring, testing is restricted to a weekly (7
day) frequency. If higher frequency is required consult
the Microbiologist/Virologist On Call.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Erlichiosis - See: Rickettsial Infections
Erysipelas - See: Streptococcal Infections
Erysipeloid
Erysipelothrix rhusiopathiae
Inject saline into lesion
and aspirate; biopsy
Culture
Bacteriology
Eye Infections, Bacterial/
Fungal/Parasitic
Conjunctival swab in
plain transport media
(RTM)
Microscopy, culture
Bacteriology
Mycology
Swabs must be taken prior to the application of topical
anaesthetics.
Submit samples to the laboratory within 24 hours.
Use anaerobic transport media for aqueous/vitreous
aspirates if anaerobic culture is indicated.
Aqueous/vitreous aspirates should be transported to the
laboratory within 2 hours.
Conjunctival scrapings
Culture
Mycology
**Consult the Laboratory, Edmonton site, prior to
specimen collection. Appropriate culture media will be
supplied for inoculation at the bedside.
Also See: Acanthamoeba**
Eye Infections,
Chlamydial
Chlamydia trachomatis
Use Gen-Probe
APTIMA® unisex swab
specimen collection kit
available from
Laboratory.
NAAT
Bacteriology
Swabs must be taken prior to the application of topical
anaesthetic.
Conjunctival swab or
scrapings in Universal
Transport Medium (UTM)
Panel test for adenovirus
Molecular
Diagnostics
Refrigerate culture specimens at 4° C and Transport
immediately. Swabs must be taken prior to the
application of topical anaesthetic.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
NAT (PCR)
NAT (RT-PCR)
Eye infection panel
(HSV, VZV, enterovirus,
parechovirus and
adenovirus)
NAT (PCR)
Panel tests for HSV 1/2
VZV and CMV
Molecular
Diagnostics
Consult Microbiologist/Virologist On Call for other
viruses. Specify the virus suspected on the requisition.
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for eggs
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology
Parasitic Serology
Serology performed in Puerto Rico
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for eggs
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
Eye Infections - See: Genital Infections - Gonorrhea
Eye Infections, Viral
Conjunctival swab or
scrapings in Universal
Transport Medium (UTM)
Eye Fluids (aqueous,
vitreous)
Fascioliasis
Fasciola gigantica
Fasciola hepatica
Fasciolopsiasis
Fasciolopsis buski
Favus - See: Dermatomycosis
Fifth Disease - See: Parvovirus Infections
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Filariasis
Wuchereria bancrofti
Brugia sps.
Loa Loa
Mansonella sps.
Onchocerca volvulus
Dirofilaria immitis
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Thick and thin blood films
in slide mailer
OR
5 - 7 mL blood with
anticoagulant sodium
citrate (blue top) tube or
EDTA (lavender top)
tube.
Microscopy for
microfilariae
Parasitology
Microfilariae are usually present in very small numbers
in blood during the daytime with peak parasitemia
occurring around midnight. To detect nocturnal species,
collect blood between 2200 Hours and 0200 Hours. To
detect a sub periodic species, blood may be drawn at
any time; however, peak filariasis occurs in late
afternoon.
Parasitic Serology
Note: For optimal
diagnosis, use
specialized collection kits
available through the
Laboratory by prior
arrangement (phone
780-407-7031).
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube.
Microfilaria of Loa Loa have diurnal periodicity, and
blood should be drawn between 1000 Hours and 1400
Hours.
If species of filarial is not known collect two
specimens(between 1000 Hours and 1400 Hours and
between 2200 – 0200 Hours)
Serology EIA
Parasitic Serology
Procedure for Collection of Blood for Detection of
Microfilaria
Serology referred to the National Institute of Health,
Bethesda, Maryland, USA. Travel history and clinical
details must be provided on special history form
available from the Laboratory.
Flea-borne spotted fever - See: Rickettsia felis
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Food-borne Bacterial
Disease/Syndrome
Aeromonas,
Campylobacter,
Escherichia coli O157,
Salmonella,
Shigella*,
Yersinia,
Vibrio
Food Poisoning Organisms:
Bacillus cereus,
Clostridium perfringens,
Staphylococcus aureus,
Listeria monocytogenes,
Clostridium botulinum
*Shigella dysenteriae
(Risk Group 2 but
shipped at higher level –
see: Notes)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Feces in Closed
Container
Culture (routine)
SECTION
Food samples should be
accompanied by feces
from the case and a
detailed history when
possible.
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Fecal and suspect food samples associated with Food
Poisoning Pathogens are routinely examined for
Aeromonas, Bacillus cereus, Campylobacter,
Clostridium perfringens, Escherichia coli O157,
Salmonella, Shigella, Staphylococcus aureus, and
Yersinia.
For outbreak investigations, please call
Microbiologist/Virologist On Call to coordinate
appropriate testing and set up EI #.
Follow the Guidelines for
Submitting Food
Samples to the
Laboratory (in this
document)
Follow the Guidelines for
Submitting Food
Samples to the
Laboratory (in this
document)
CALGARY
Food samples are accepted for investigation ONLY
when associated with human cases(s) or
investigations(s) (may or may not have and EI# at
time of submission) related to human infection
AND
Submitted by a Medical Officer of Health (MOH) or
designate (eg. PHI, EHO)
Specific pathogens culture as requested.
Culture of food samples for Listeria is referred to the
Listeriosis Reference Laboratory, Ottawa, Ontario.
Culture of food samples and feces for Clostridium
botulinum is referred to the Botulism Reference
Service, Ottawa, Ontario.
For *Shigella dysenteriae :
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Also See:
Botulism and Listeriosis
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Food Poisoning Organisms - See: Diarrhea Bacterial or Food-borne Bacterial Disease/Syndrome
Francisella - See: Tularemia
Fungaemia
Yeast
Blood in Bactec vials or
Isolator tubes
Microscopy, culture
Bacteriology
Mycology
Fungal Infections
Aspergillus, Blastomyces*,
Candida, Coccidioides*,
Cryptococcus, Fusarium,
Histoplasma, Mucor,
Rhizopus and other fungi
1 - 2 mL sputum;
respiratory aspirate in
sterile container
Microscopy, culture
Mycology
CSF 1 mL minimum in
sterile container
Antigen Detection, culture
Mycology
2 - 10 mL urine in sterile
container
Microscopy, culture
Mycology
Biopsy material; pus with
granules in a sterile
container
Microscopy, culture
Mycology
Ear swab, mouth swab,
lip swab, lesion swab in
plain transport media
(RTM)
1 mL bone marrow in a
citrated tube (blue top
Microscopy, culture
Mycology
Microscopy, culture
Mycology
* (Risk Group 3)
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Submit blood for Histoplasma in Isolator tubes. Isolator
tubes can be obtained by calling the Laboratory at the
Edmonton site. Submit blood for culture of other fungi in
Bactec vials. (See: Blood Culture, Bacteriology for
collection details).
Con’t….
72
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Nail; skin scraping or
scales; hair
Microscopy, culture
Mycology
See: Dermatophytes for collection of hair, skin and
nails.
Corneal or conjunctival
scraping
Microscopy, culture
Mycology
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Blastomycosis (ID),
Coccidioidomycosis (EIA,
ID), Histoplasmosis (ID)
Please specify
Virology
Culture
Bacteriology
tube)
Blastomycosis*,
Coccidioidomycosis*, and
Histoplasmosis
For Coccidioides and Blastomyces/Blastomycosis:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
* (Risk Group 3)
Galactomannan - See: Aspergillus Antigen Detection
Gas Gangrene - See: Anaerobic Infections
Gastritis
Helicobacter pylori
Gastric or peptic ulcer
biopsy submitted in a
sterile container with
1mL sterile normal saline
Transport to lab ASAP (within 2 hours)
Gastroenteritis - See: Food-borne Bacterial Disease/Syndrome and Diarrhea, Parasitic and Diarrhea, Viral
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73
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Genital Infections Bacterial Vaginosis
Vaginal smear and/or
vaginal swab in plain
transport media (RTM)
Air dry slide, DO NOT
fix
Microscopy,
(Culture is not routinely
performed)
Bacteriology
Only specimens with relevant clinical details will be
cultured, after consultation with Microbiologist/Virologist.
Only bacteria known to be pathogenic in the female
genital tract are reported.
The presence of Trichomonas or yeast may be reported
from the smear.
Genital Infections Candidiasis
Vaginal or urethral smear
AND swab in plain
transport media (RTM)
Microscopy
Bacteriology
Only genital specimens with relevant clinical details are
cultured for Candida sp.
Identification and susceptibility testing only performed
for the following indications:
1. Recurrent Candidiasis
2. Treatment failure
3. Immunocompromised
Genital Infections Chancroid (soft chancre)
Haemophilus ducreyi
Bubo pus – Bubo
aspirate is obtained
using needle and syringe
to aspirate pustular
material from the bubo.
Place aspirate into
securely-closed sterile
unbreak-able tube.
Dacron or cotton swab –
Best collected by
cleansing the area by
flushing with sterile
physiological saline, and
then collecting material
from the base of the
PCR
Bacteriology
Specimens are referred to the National Microbiology
Laboratory, Winnipeg Manitoba.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Urethral, vaginal, cervical
swabs in Universal
Transport Medium (UTM)
Mycoplasma Culture
Ureaplasma Culture
Bacteriology
Routine culture of Mycoplasma hominis and Ureaplasma
urealyticum is not performed without relevant clinical
diagnosis.
Urethral, vaginal, endocervical specimens *
Prostatic fluid, amniotic
fluid, endometrial tissue
in sterile containers
Chlamydia NAAT
Bacteriology
Mycoplasma culture
Bacteriology
* See Chlamydia Infections, Chlamydia trachomatis for
collection details.
Ureaplasma may be implicated in non-gonococcal
urethritis, Reiter’s syndrome and infertility.
ulcer. Swab may be
submitted dry, or placed
into 1mL Universal
Transport Medium (UTM)
Hold specimen at 4ºC
(refrigerate) prior to
transport to ProvLab.
Genital Infections Chlamydia, Mycoplasma
and Ureaplasma
Infections
Chlamydia trachomatis,
Ureaplasma urealyticum,
Mycoplasma hominis
Chlamydia trachomatis only
PCR
See Chlamydia Infections, Chlamydia trachomatis
Genital Infections Gonorrhea
Neisseria gonorrhoeae
including infections of the
urethra, vulva, vagina,
cervix, rectum, conjunctiva,
joints, throat
Endocervical Swab:
Use Gen-Probe
NAAT
Bacteriology
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In females, specimens should be obtained from the
cervix if possible; vaginal swabs have not Con’t….
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
APTIMA® unisex swab
specimen collection kit
available from
Laboratory
Male Urethral Swab:
Use Gen-Probe
APTIMA® unisex swab
specimen collection kit
available from
Laboratory
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
been validated in the laboratory.
NAAT
Bacteriology
Urethral swabs may cause discomfort to male patients.
A urine is an appropriate specimen that can be taken
instead of a urethral swab.
Urine (Male and
female): Use Gen-Probe
APTIMA® collection kit
available from Laboratory
NAAT
Bacteriology
Vaginal swabs*:
Use Gen-Probe
APTIMA® vaginal swab
specimen collection kit
available from
Laboratory
Extragenital sites:
See Notes *
NAAT
Bacteriology
First catch urine without having voided for at least 1
hour: 20-30 ml (beginning of a stream in a sterile
container). Transfer 2 ml urine to a Gen-Probe
APTIMA® Urine collection kit within 24 hours of
collection.
* Vaginal swabs have not been validated in the
laboratory but may be processed (if the cervix is
absent, or for children under 12 years of age) following
consultation with the Microbiologist/Virologist On call.
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* None of the current commercial NAAT testing platforms
have Health Canada or FDA approval for extra-genital
specimen testing. For non-STI clinic and nonreproductive health clinic patients, if CT/NG on extragenital specimens is required, in addition to or instead of
culture, please contact the Microbiologist/Virologist On
Call.
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76
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Genital swab:
Endocervical and male
urethral
Culture
Bacteriology
Swabs: Specimens should be collected with Dacron or
Rayon swabs and submitted in charcoal transport
medium. Calcium alginate swabs may be
toxic to gonococci and therefore they should be avoided.
Cervical - insert swabs into endocervical canal exposed
with a speculum moistened with warm water (no other
lubricant). Allow 10-20 seconds for absorption of
exudate.
Male urethral swab - swab anterior 3 cm of urethra
using thin tipped swab - wipe orifice dry, massaging
urethra towards it to express exudate.
Ano-rectal: swab in
charcoal transport media
(CTM)
Culture
Bacteriology
Ano-rectal - swab crypts inside anal ring, allowing 10
seconds for absorption of pus.
Conjunctival swab: in
charcoal transport media
(CTM)
Culture
Bacteriology
Throat: swab in
charcoal transport media
(CTM)
Culture
Bacteriology
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Vaginal - not acceptable for culture from adults but may
be sent from children (12 years and younger) with
suspected vulvovaginitis or from post-hysterectomy
patients.
Organisms may not survive if transit exceeds 12
hours. If transport delayed, keep specimens in CTM
at room temperature – DO NOT refrigerate.
Genital Infections Herpes Simplex Virus
Joint aspirate in a sterile
container
Microscopy, culture
Bacteriology
Cervical, urethral, lesion
swab in Universal
Transport Medium (UTM)
NAT (PCR)
Virology
Herpes B virus:
(Risk Group 4)
Vigorously swab base of lesion. Specimen must contain
basal epithelial cells. Place swab in Universal Transport
Medium (UTM). Refrigerate but DO NOT freeze
specimens.
If Herpes B virus is suspected:
Ship as Category A
Genital Infections Trichomoniasis
Trichomonas vaginalis
Urethral, vaginal, cervical
swab in plain transport
media (RTM)
Culture available in
selected cases
Bacteriology
Vaginal smear
Microscopy
Bacteriology
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Microscopy for
trophozoites and cysts
Parasitology
Emulsify feces in SAF preservative immediately after
collection. Specimens taken in the acute stage are
usually positive but occasionally the parasite is not
detectable during the first week or two of the disease.
German Measles - See: Rubella
Giardiasis
Giardia lamblia
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Water: see: Water:
Parasites and Enteric
Bacteria
Gnathosomiasis
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology
Parasitic Serology
Referred to the Mahidol University, Bangkok, Thailand
Granuloma Inguinale
(venereum)
Klebsiella granulomatis
Biopsy (punch)
granulation tissue from
edge of lesion
Microscopy
Bacteriology
Microscopy for the characteristic intracellular Donovan
bodies.
Smears from undersurface of biopsy
Microscopy
Bacteriology
Culture
Bacteriology
Guinea-Worm Disease - See: Dracunculiasis
Haemolytic Uremic
Syndrome (HUS)
Feces in a Closed
Container; fill container
1/3 full or at least 1
tablespoon (minimum)
Do not contaminate with
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Feces from HUS cases will be cultured for routine
bacterial enteric pathogens including Verotoxinproducing (Shiga toxin-producing) E. coli
(eg. O157:H7) and Shigella.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Shiga toxin (Vero toxin)
PCR
Bacterial Typing
Unit
PCR can be performed on enriched culture directly or on
bacterial isolates. Testing available only on consultation
with the Microbiologist/Virologist On Call.
water or urine.
Send feces containing
blood or mucus if these
are present. If transport
of fecal sample exceeds
24 hours, submit in
enteric transport media
(Enteric transport media
is not supplied by the
Laboratory)
If Streptococcus pneumoniae is the suspected agent of
HUS, consult Microbiologist/Virologist On Call.
Haemophilus ducreyi - See: Genital Infections – Chancroid
Haemophilus influenzae - See: Meningitis, Bacterial and Epiglottitis
Hand-foot-and-mouth Disease - See: Enterovirus Infections
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Hantavirus
Adult Respiratory Distress
Syndrome
(Sin Nombre virus is the
etiologic agent of HPS)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
7 mL blood, clotted (red
top tube)
Serology EIA,
IgM, IgG
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education ).
(Risk Group 3)
Contact Microbiologist/Virologist On Call if STAT or
molecular testing is required for suspected cases,
including haemorrhagic fever with Renal Syndrome
(HRFS), Cardio-Pulmonary Syndrome (HPS or HCPS)
or related hantavirus infections.
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
5 mL blood (EDTA,
lavender top tube)
PCR
Ship as Category A
Helicobacter pylori - See: Gastritis
Hepatitis A Virus
(Infectious Hepatitis,
HAV)
5 mL serum separator
tube (SST)
Serology EIA:
HAV IgM,
HAV IgG
Virology
Pediatrics use 2 mL red
top tube.
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Specify HAV IgM for suspected acute illness or HAV IgG
for immunity determination.
IgM may be negative if the patient is tested in the first 3 5 days after onset. Consider retesting 7 - 10 days later
if Hepatitis A is suspected.
Note: HAV IgM antibody may be detectable after the
patient has been recently immunized.
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81
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
For assessment of immunity to Hepatitis A, request
HAV IgG. Testing after two doses of the vaccine is not
required unless the patient is immunocompromised or
there are reasons to ensure immunity.
Frequency of testing: Daily Monday to Friday (IgG);
twice weekly (IgM)
Hepatitis B Virus
(Serum Hepatitis, HBV)
5 mL serum separator
tube (SST)
Pediatrics use 2 mL red
top tube
Serology *:
HBsAg
Anti-HBs
Anti-HBc total
HBc IgM
HBeAg
Anti-HBe
Virology
* For diagnosis of:
1. Acute Hepatitis B
a. Request HBsAg
2.
Chronic Hepatitis B carrier status
a. Request HBsAg
3.
Previous exposure to Hepatitis B virus
a. Request anti-HBc total, HBsAg and
anti-HBs
4.
Assessment of immunity to Hepatitis B
a. Request anti-HBs
Please specify which tests
are required.
IgM antibody to core (HBc IgM) is helpful in assessing
(1) An acute infection, (2) If the patient is in the “window
period” when HBsAg is absent and anti-HBs is not yet
detectable, or (3) Reactivation of IgM in chronic carriers.
HBV e antigen (HBeAg) and anti-HBe are helpful in the
evaluation of a chronically infected patient for treatment
or monitoring.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Hepatitis B Virus
(Quantitation of Surface
Antigen)
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
5 mL serum separator
tube (SST)
Quantitative HBsAg
(qHBsAg)
Virology
Pediatrics use 2 mL red
top
Tube
Synonyms :
HbsAg Quant
Quant surface antigen
HBSQAG
This test can only be ordered by a select list of specialist
hepatologist / ID physicians that manage chronic HBV
infections on a regular basis. Such patients will be
already on treatment with interferon or nucleos(t)ide
analogues, for whom this test (in conjunction with the
HBV VL test) will be helpful in managing their antiviral
therapy.
Ship on ice/cold pack
(Not frozen)
Hepatitis B Virus
(Viral Load)
CALGARY
Two full DEDICATED
4 mL EDTA (lavender
top) tubes.
Pediatric only: Collect
one full DEDICATED
2 mL EDTA (lavender
top) tube.
Frequency of testing: Once per week (Wednesday)
HBV DNA PCR
(Quantitative)
Virology
Synonyms:
HBV Quant
HBV PCR
HBV Qual*
DO NOT centrifuge.
DO NOT open tubes.
Ship on ice/cold pack
(NOT FROZEN).
Must reach the
Laboratory within 24
hours of collection.
The HBV-DNA assay is a measure of viral replication
and is indicated for monitoring patients who are on
treatment, or are being evaluated for treatment.
Samples submitted for molecular investigations must be
DEDICATED specimens to avoid contamination or
degradation of the viral nucleic acid.
One test every 3 months is permitted for patients on
therapy, and one test every 6 months for patients who
are not on therapy.
*Please note, only a HBV quantitative viral load assay is
available, therefore requests for qualitative HBV PCR
will be performed using the quantitative assay.
Frequency of testing: Daily Monday – Friday
TAT: 7 days
A special requisition
requesting specific
clinical information is
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83
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
HCV Antibody
Virology
Hepatitis C virus HCV antibody testing is an assessment
for exposure to and infection with HCV. Detection of
antibody to hepatitis C can be due to a chronic infection
or a recent infection.
required for ordering of
HBV DNA PCR test.
Please contact the
Distribution Centre,
Edmonton site, to obtain
this requisition.
Hepatitis C Virus
(HCV)
5 mL serum separator
tube (SST)
Pediatrics use: 2 mL red
top tube
Synonyms:
HCV Ab
HCV serology
Frequency of testing: Daily Monday – Sunday
TAT: 48 hours
Hepatitis C Virus
(Viral Load)
Blood: at least 3
mL/tube in two
DEDICATED serum
separator tubes (SST)
Centrifuge at 3000 RPM
for 10 minutes, DO NOT
pour off, refrigerate until
transport. Transport on
ice.
Must be received within
24 hours of collection.
HCV RNA PCR
(quantitative)
Virology
Synonyms:
HCV PCR
HCV Quant
HCV Quantative
HCV viral load monitoring
HCV RNA
HCV Qualitative*
Pediatrics use: at least
one 2 mL DEDICATED
red top tube.
DO NOT spin.
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HCV RNA PCR (quantitative) testing is performed only if
the patient is being assessed for treatment or is on
treatment. The molecular assay is helpful in diagnosis
of the presence or absence of viraemia, especially for a
patient with indeterminate serology.
Samples submitted for molecular investigations must be
DEDICATED specimens to avoid contamination or
degradation of the viral nucleic acid.
A special requisition requesting specific clinical
information is required for ordering of HCV PCR test.
Please contact the Distribution Centre, Edmonton Site to
obtain this requisition.
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84
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
DO NOT pour off.
Ship on ice/cold packs
(NOT FROZEN).
Must be received within
24 hours of collection.
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
*Please note, only a HCV quantitative viral load assay is
available; therefore requests for qualitative HCV PCR
will be performed using the quantitative assay.
Only two pre-treatment and one post-treatment test are
permitted. For patients on therapy, testing frequency is
dictated by treatment regimen. For additional testing
consult the Microbiologist/Virologist On Call at Calgary
or Edmonton prior to specimen submission.
Frequency of testing: Daily Monday – Friday
TAT: 7 days
Hepatitis C Virus
(Genotyping)
Blood: at least 3
mL/tube in two
DEDICATED serum
separator tubes (SST)
Centrifuge at 3000 RPM
for 10 minutes, DO NOT
pour off, refrigerate until
transport. Transport on
ice.
Must be received within
24 hours of collection.
HCV genotyping
Virology
Synonyms:
HCV geno
Pediatrics use: at least
one 2 mL DEDICATED
red top tube.
DO NOT spin.
DO NOT pour off.
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HCV genotyping is performed only if the patient is being
assessed for treatment or is on treatment.
Samples submitted for molecular investigation must be
DEDICATED specimens to avoid contamination or
degradation of the viral nucleic acid.
A special requisition requesting specific clinical
information is required for ordering of HCV genotype
test. Please contact the Distribution Centre, Edmonton
Site to obtain this requisition.
Frequency of testing: twice per week.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Serology EIA: anti-HDV
Virology
NAT
Molecular
Diagnostics
Clinical history required. Patient must be HBsAg
positive before further testing for Hepatitis D virus. HDV
infections are rare in Canada. Referred to the National
Microbiology Laboratory, Winnipeg, Manitoba.
Ship on ice/cold packs
(NOT FROZEN).
Must be received within
24 hours of collection.
Hepatitis Delta Virus – See: Hepatitis D Virus
Hepatitis D Virus
(Delta Hepatitis, Delta
Agent, HDV, Hepatitis
Delta Virus)
5 mL serum separator
tube (SST)
Hepatitis E Virus
(HEV)
5 mL serum separator
tube (SST)
Serology EIA: anti-HEV
Virology
Pediatrics use: 2 mL red
top tube
NAT
Molecular
Diagnostics
Pediatrics use: 2 mL red
top tube
The extent of endemic HEV infections in Canada and
USA is uncertain. Exclude other common causes of
infectious hepatitis, eg. HAV and HBV before requesting
HEV testing.
Referred to the National Microbiology Laboratory,
Winnipeg, Manitoba.
Herpangina – See: Enteroviruses
Herpes Simiae Virus Infections - See: B Virus Infections
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86
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Herpes Simplex Virus
Infections (HSV)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Lesion swab* in
Universal Transport
Medium (UTM)
NAT (PCR)
Virology
Swab base of lesion and place swab in Universal
Transport Medium (UTM). Refrigerate but DO NOT
freeze specimens. Swab of lesion (blister) for PCR is
more specific and a more appropriate specimen than
serology.
Bronchoscopy
HSV, NAT (PCR)
Virology
For suspected aseptic
meningitis or
encephalitis: At least 0.51mL DEDICATED CSF
sample for CSF panel
PCR tests in a sterile
container
NAT (PCR)
CSF Panel (HSV, VZV,
enterovirus, parechovirus)
Molecular
Diagnostics
Bloody CSF is not optimal for PCR tests.
Providing clinical information with the test request is
extremely helpful for the Laboratory. Refrigerate CSF
until transport. If specimen can be received in the
Laboratory within 24 hours of collection then ship on
ice/cold packs. If transportation might exceed 24 hours
from collection then freeze at -70°C and transport on
dry ice.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA:
HSV IgG
Type specific HSV
serology**
Virology
** Specify HSV type specific serology on the requisition.
Provide clinical history and indication of testing. Contact
the Laboratory prior to collection.
HSV IgM serology is no longer available.
For visceral
disseminated disease of
the newborn or the
immunodeficient 1 – 2
mL blood in
EDTA(Lavender top)
tube
NAT (PCR)
Molecular
Diagnostics
Do not centrifuge. Ship on ice or cold pack within
24 hours.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Biopsy material/ autopsy
material in a sterile
container
NAT (PCR)
Molecular
Diagnostics
Consult Microbiologist/Virologist On Call
Herpes Zoster Virus - See: Varicella Zoster Virus Infections
Heterophile Negative Mononucleosis - See: Cytomegalovirus Infections
Heterophyiasis
Feces in SAF
Microscopy for eggs
Parasitology
preservative (see
Heterophyes heterophyes,
Diarrhea, Parasitic for
Metagonimus yokogawai
(opisthorchids)
collection details)
Histoplasmosis (Histoplasma capsulatum)- See: Fungal Infections and Fungal Serology
Emulsify feces in SAF preservative immediately after
collection.
HIV - See: Human Immunodeficiency Virus
Hookworm Disease
Feces in SAF
preservative (see:
Ancylostoma duodenale,
Diarrhea, Parasitic for
Necator americanus,
Trichostrongylus sp.
collection details)
HPV – see: Human Papilloma Virus
Microscopy for eggs and/or
larvae
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
HSV - See: Herpes Simplex Virus Infections
HTLV I/II - See: Human T Cell Leukaemia/Lymphoma Virus
HTLV III - See: Human Immunodeficiency Virus
Human granulocytic ehrlichiosis [HGE] - See: Anaplasma phagocytophilum
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Human Herpesvirus Type
6 (HHV6)
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Plasma – collect > 2 mL
blood in EDTA (lavender
top) tube only.
DO NOT USE heparin as
an anti-coagulant.
Quantitative PCR detection
of Human Herpesvirus 6
(HHV-6) DNA.
Molecular
Quantification
* Indications for HHV6 testing according to the National
Microbiology Laboratory (Public Health
Agency of Canada) testing criteria:
 Primary infection or reactivation in
Immunocompromised individuals: Plasma.
 Encephalitis cases: CSF
CSF – Minimum 500 uL.
Testing performed
according to guidelines*.
Human Immunodeficiency
Virus (HIV 1 and 2, HTLV
III, LAV, AIDS, ARC)
CALGARY
HIV serology: Collect 5
mL serum separator tube
(SST) or pediatrics may
use 2 mL red top tube.
FOR CSF-If specimen can be received in the laboratory
within 24 hours of collection then ship on ice pack/ice. If
transportation might exceed 24 hours
from collection then freeze at -70º C and transport on
dry ice.
Referred to the National Microbiology Laboratory,
Winnipeg, Manitoba.
HIV Antibody-Antigen
Serology screen by EIA,
and confirmation by
Western blot*
Virology
Diagnostic test for acute HIV infection.
All samples are jointly screened for HIV 1 and 2
antibodies and the HIV-1 early antigen p24 by EIA.
(Risk Group 3)
Synonyms:
HIV Antibody
HIVAb
HIV screen
HIV serology
Reactive samples after initial screen are confirmed by
Western blot for first-time cases. All patients must be
counselled appropriately prior to testing for HIV, which is
a notifiable disease in Alberta.
Frequency of Testing: Daily Monday – Sunday
TAT: 72 hours upon receipt in the Laboratory.
Con’t…
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Human Immunodeficiency
Virus 1
(Risk Group 3)
HIV viral load: for
monitoring of patients on
therapy (to be ordered
under guidance of
Infectious Disease
Specialist only):
Two full DEDICATED
4 mL EDTA (lavender
top) tubes.
Pediatric only:
One full DEDICATED
2 mL EDTA (lavender
top) tube.
HIV PCR-viral load
(quantitative)
Virology
Synonyms :
HIV PCR
HIV Quantitative
HIV Quant
HIV RNA
HIV VL
HIV viral load monitoring
Specify on the requisition the ID Specialist involved.
Samples submitted for molecular investigations must be
specific DEDICATED specimens to avoid degradation of
the viral nucleic acid.
Frequency of Testing: Daily Monday – Friday
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
DO NOT centrifuge.
Ship on ice or
cold pack (NOT
FROZEN).
Must reach the
Laboratory within 8
hours of collection.
OR
Con’t…
Remote Areas (when
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90
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
HIV proviral DNA PCR
Virology
Consult Microbiologist/Virologist On Call at Calgary or
Edmonton before collecting specimens for HIV proviral
DNA . Testing is referred to the National
Laboratory for HIV Reference Services in Winnipeg,
Manitoba.
specimen delivery is >8
hours to the
Laboratory):
Two full DEDICATED
5 mL PPT (Plasma
Preparation Tubes)
Centrifuge both tubes.
DO NOT open or pour
off. Refrigerate until
transport. Ship on ice or
cold pack.
(For outside Calgary
Zone and Edmonton
Zone PPT may be
ordered from the
Distribution Centre,
Edmonton Site).
Human Immunodeficiency
Virus 1 and 2
(Risk Group 3)
Blood: as much as
possible in two 4 mL
EDTA (lavender top)
tubes.
Pediatric: 1 full 2 mL
EDTA whole blood tube.
Preferred collection on
Monday and Tuesday to
allow shipping of whole
blood before
Wednesday.
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Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
91
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Human Immunodeficiency
Virus 1 Resistance
Testing
(Risk Group 3)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Blood: One full 5 mL
EDTA (lavender top)
tube.
Pediatric: 1 full 2mL
EDTA whole blood tube.
HIV Drug Resistance
Testing (Genotype)
Virology
Specify on the requisition the ID specialist involved.
Samples submitted for molecular investigations must be
specific DEDICATED specimens to avoid degradation of
the viral nucleic acid.
Preferred collection on
Monday and Tuesday to
allow shipping of
specimen before
Wednesday
Synonyms:
Genotype and
Antiretroviral Resistance
Testing (GART)
HIV geno
HIV genotyping
HIV genome detection
Testing is referred to the British Columbia Centre for
Excellence in HIV/AIDS, in Vancouver, BC
HIV Drug Resistance testing can only be performed on
samples that have viral loads >250 copies/mL.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Human Metapneumovirus – See: Respiratory Infections, Viral and Atypical Bacteria
Human monocytic ehrlichiosis [HME] – See: Ehrlichia chaffeensis
Human Papilloma Virus
(HPV)
Tissue specimen to be
submitted in universal
transport medium (UTM)
or phosphate buffered
saline (PBS)
Currently not routinely
available
Virology
HPV testing of liquid based cytology specimens are not
performed by ProvLab. Reference testing by National
Microbiology Laboratory for unique clinical
circumstances requires consultation with the
Microbiologist/Virologist On Call.
ProvLab does not undertake testing for routine HPV
screening. Consult the Guide to Service/Test
Directory of your local laboratory to determine
where the testing is done.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Human T Cell
Leukemia/Lymphoma
Virus Type I HTLV I,
Virus Type II – HTLV II
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
HTLV Antibody Serology
screen by EIA,
confirmation by Western
Blot.
Virology
History is required. Samples are screened at the
Laboratory for HTLV I and II, and reactive sera are
referred to the National Laboratory for HIV Reference
Services in Ottawa, Ontario for Western blot.
Follow-up blood samples for molecular analysis may be
required depending upon serology results.
(Risk Group 3)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Hydatid Disease - See: Echinococcosis
Hymenolepiasis
Hymenolepis nana
Hymenolepis diminuta
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for eggs
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
Ice - See: Water: Bottled and Packaged Ice
Impetigo
Lesion swab in plain
Microscopy, culture
transport media (RTM)
Streptococcus pyogenes
Staphylococcus aureus
Infectious Mononucleosis - See: Epstein-Barr Virus Infections
Influenza
Influenza viruses types A,B
For suspect cases of
emerging influenza
strains (e.g. H5N1, H7N9)
Nasopharyngeal swab or
aspirate, or throat swab
in Universal Transport
Medium (UTM)
Respiratory Virus Panel
NAT (PCR)
Bacteriology
Molecular
Diagnostics
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Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
For cases where you suspect an infection with an
Con’t…
93
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
see NOTES
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
emerging influenza A strain (e.g. H5N1, H7N9), you
must FIRST contact the Zone Medical Officer of
Health prior to sample collection. The investigation
will be coordinated with the Laboratory by your local
zone MOH.
(Risk Group 3)
If highly pathogenic avian influenza or H5N1 or
H7N9 is suspected:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Aspirated material from
respiratory tract in
original collection device,
or bronchoscopy
Respiratory Virus Panel
NAT (PCR)
Molecular
Diagnostics
For suspected outbreak, please contact the Zone
Medical Officer of Health and consult with the
Microbiologist/Virologist On Call at Calgary or Edmonton
to obtain an EI number.
Autopsy or biopsy
material (lung) in sterile
container
Respiratory Virus Panel
NAT (PCR)
Molecular
Diagnostics
Consult Microbiologist/Virologist On Call.
Serology
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Con’t…
Itraconazole Levels - See: Antifungal Levels
Jamestown Canyon virus
(JCV)
(Risk Group 2)
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education ).
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Japanese encephalitis
virus (JEV)
(Risk Group 3)
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Use the ‘Zoonotic Serology Requisition’ when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form.
NACI guidelines do not recommend serologic testing
before or after receipt of the vaccine.
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Kala Azar - See: Leishmaniasis
Kaposi’s Varicelliform Dermatitis - See: Herpes Simplex Virus Infections
Keratomycosis - See: Fungal Infections
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Laryngitis, Viral
Several viruses including
adenovirus, parainfluenza
virus, respiratory syncytial
virus, influenza virus,
rhinovirus, echovirus and
coronavirus
Nasopharyngeal (NP)
swab (rayon swab) or
aspirate or auger suction
in Universal Transport
Medium (UTM) (see:
Nasopharyngeal
Aspirates, Viral for
collection details)
NAT (PCR) – Respiratory
Virus Panel
Molecular
Diagnostics
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
Echovirus: see Enterovirus
Throat swab can also be
collected in Universal
Transport Medium (UTM)
NAT (PCR) – Respiratory
Virus Panel
Molecular
Diagnostics
Serology IFA
Virology
Serology performed only when suitably spaced sera and
relevant history, including onset of symptoms, are
received. Incomplete specimens held for 3 months.
DFA, Culture
Bacteriology
Transport culture specimens to the Laboratory
immediately. If stored, keep at 4°C. Samples in
formalin or saline acceptable for direct fluorescent
antibody (DFA) only.
DFA performed by prior arrangement with
Microbiologist/Virologist On Call only.
Lassa Fever – See: Viral Hemorrhagic Fever
Legionnaires Disease
Legionella sp.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube.
Submit acute before day
8 and convalescent after
day 22.
Lung tissue; 1 - 2 mL
pleural fluid; tracheal
aspirate; bronchoscopy
specimen in sterile
container.
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Calgary clients should submit requests for clinical
Legionella investigation to Calgary Laboratory
Services. Please use CLS requisition.
Leishmaniasis,
Cutaneous Form
Leishmania tropica
Blood culture:
See: Notes
Culture
Bacteriology
If blood stream infection is suspected, contact the
Microbiologist/Virologist On Call for collection details.
Biopsy or aspirate from
edge of lesion
Microscopy, culture
Parasitology
Culture performed only by prior arrangement with
Microbiologist/Virologist. Material from the surface or
from necrotic areas of the ulcer is unsuitable for
detection of the parasite. For details see Leishmania
Specimen Collection Instructions
Note: Serology is unsuitable for diagnosis of cutaneous
Leishmaniasis.
Leishmaniasis,
Mucocutaneous Form
Leishmania brasiliensis
Leishmania mexicana
Biopsy or aspirate from
edge or bed of lesion
Microscopy, culture
Parasitology
Culture performed only by prior arrangement with
Microbiologist/Virologist. Material from the surface or
from necrotic areas of the ulcer is unsuitable for
detection of the parasite.
For details see Leishmania Specimen Collection
Instructions
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology
Parasitic Serology
Serology performed at National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease / Centre for Disease Control, Atlanta, Georgia,
U.S.A.
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Leishmaniasis, Visceral
Form (Kala Azar)
Leishmania donovani
Leprosy
Mycobacterium leprae
Leptospirosis
Leptospira sp.
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Tissue smears of liver,
spleen, lymph nodes in a
slide mailer
Microscopy, culture
Parasitology
Culture performed only by prior arrangement with
Microbiologist/Virologist.
Bone marrow films in a
slide mailer
Microscopy, culture
Parasitology
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology
Parasitic Serology
Serology performed at National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease/Centre for Disease Control, Atlanta, Georgia,
U.S.A.
Biopsy of affected tissue,
usually skin nodes;
submit in sterile screw
cap tube
Microscopy
Mycobacteriology
Slit skin smear (ear lobe
or lesion) in slide mailer
Microscopy
Mycobacteriology
Mycobacterium leprae can be identified only by
microscopic morphology; it does not grow in cultures
which are performed in order to exclude other
mycobacterial infections. Repeated skin biopsies, every
3 months, are a valuable index of therapeutic response
in diagnosed cases under treatment.
Contact Mycobacteriology at 780-407-8989 for further
inquiries.
Consult with Microbiologist/virologist On Call prior to
submission.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Submit acute and
convalescent 4-5 weeks
apart.
Serology
Virology
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Most infections are diagnosed serologically. Serology
referred to the National Microbiology Laboratory,
Winnipeg, Manitoba.
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Listeriosis
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
CSF in sterile container
Microscopy, Culture
Bacteriology
May cause meningitis, or granulomatous disease in the
newborn; abortion and fetal death, and meningitis in
adults.
Blood culture (see Blood
Culture for collection
details)
Culture
Bacteriology
Isolate in plain transport
media (RTM) or blood
agar slant (BAS)
Follow the Guidelines for
Submitting Food
Samples to the
Laboratory (in this
document)
Serotyping
Serotyping is referred to the National Microbiology
Laboratory, Winnipeg, Manitoba.
Culture
Suspect foods are referred for culture to the
Listeriosis Reference Laboratory, Ottawa, Ontario.
Consult Microbiologist/Virologist On Call for food
testing.
See Foodborne Bacterial
Disease / Syndrome
Loiasis – See: Filariasis
Loa loa
Lung Abscess
Various bacteria, especially
anaerobes, often in mixed
culture
1 - 2 mL bronchoscopy
specimens;
transtracheal aspirate
Microscopy, culture
Bacteriology
Lyme Disease
Borrelia burgdorferi, afzelii
and garinii
5 mL serum separator
tube (SST)
EIA
Virology
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The screening EIA detects antibodies to the three
genospecies of Lyme disease; B. burgdorferi, afzelii and
garinnii.
Con’t…
99
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Sera that screen positive and equivocal are referred to
the National Microbiology Laboratory, Winnipeg,
Manitoba for Western Blot confirmation.
B. burgdorferi is only found in North America, hence
travel history and/or residency outside of North
America must be provided for testing to the European
genospecies (B. afzelii and garinii) to be performed
Sera collected within the first two weeks of acute onset
or if the patient is treated in this phase can result in
negative serology. Repeat testing is indicated if the
patient is untreated and clinical suspicion is high.
Punch biopsy from EM in
Viral transport medium
PCR
Tick for identification in
Closed Container
Tick Speciation
Virology
Parasitology
In specific cases a punch biopsy taken from the margin
or centre of the erythema migrans (EM) can be sent for
PCR testing for this agent, before treatment is initiated.
Sensitivity is 50 to 70%. Consult the
Microbiologist/Virologist On Call before sending
samples.
The tick will be speciated if clinically indicated. Consult
the Microbiologist/Virologist On Call if further testing is
necessary under specific circumstances.
For details on tick collection from environmental sources
(NOT clinical samples),see: Alberta Government
"Surveillance of Ticks On Humans and in the
Environment"
Con’t…
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Lyme neuroborreliosis
Paired CSF (2mL) and
5 mL serum separator
tube (SST)
Comparative IgG levels
between serum and CSF
Lymphadenopathy,
Mesenteric
Yersinia
pseudotuberculosis
Yersinia enterocolitica
Mesenteric lymph nodes
in a sterile container
Culture
Bacteriology
Feces in a sterile
container; fill container
1/3 full or at least 1
tablespoon (minimum)
Do not contaminate with
water or urine.
Send feces containing
blood or mucus if these
are present. If transport
of fecal sample exceeds
24 hours, submit in
enteric transport media
(Enteric transport media
is not supplied by the
laboratory)
Culture
Bacteriology
Blood culture (see:
Blood Culture,
Bacteriology for
Culture
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba in strongly suspected cases of
neuroborreliosis Must be confirmed to be serologically
positive for LD.
Total IgG and albumin levels must accompany these
samples. PCR on CSF is available but the yield is
<30%.
Consult the Microbiologist/Virologist On Call before
sending samples.
If feces are sent, specify suspected Yersinia infection.
When transit of feces for bacteriology will exceed 24
hours, submit specimen in enteric transport media.
Specimens for virus detection may also be submitted.
However, stool in enteric transport media is not
appropriate for gastroenteritis virus tests.
Bacteriology
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
collection details)
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Lymphocytic
Choriomeningitis, (LCM)
Lymphocytic
choriomeningitis virus
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube. Submit acute and
th
convalescent before 10 ,
after 21st and again after
50th day.
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Serology
Virology
Serology performed at the Public Health Ontario
Laboratories.
Serology
Virology
Serology referred to the National Microbiology
Laboratory, Winnipeg, Manitoba.
Lymphogranuloma venereum (LGV) – See: Chlamydial infections, Chlamydia trachomatis
Malaria
Plasmodium falciparum,
Plasmodium malariae,
Plasmodium ovale,
Plasmodium vivax
Blood films, both thick
and thin on separate
slides in a slide mailer
Microscopy for parasites
Parasitology
Take films at 6-18 hour intervals for 3 successive days.
Air-dry blood films without heat.
5 – 7 mL blood in EDTA
(lavender top) tube
Microscopy
Parasitology
Restricted test - prior consultation with
Microbiologist/Virologist On Call required.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology
Parasitic Serology
Serological tests are inappropriate for diagnosis of
malaria patients, but can be useful for epidemiological
studies or screening of blood donors.
Serology referred to the National Reference Centre for
Parasitology, Montreal, Quebec
NCPS diagnostic titre: IFA 1:128
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Con’t…
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
5-7 mL blood in EDTA
(lavender top) tube. Ship
specimen on cold pack.
Transit time must not
exceed 48 hours.
Species confirmation by
PCR
Molecular
Diagnostics
Restricted test – smear positive specimens only.
Note: Test available to pathologists/
Hematopathologists only.
Note: Prior consultation with Microbiologist/Virologist
On Call is required. For required information see:
Malaria PCR Order Form.
Please ensure that if the EDTA collection tube submitted
for malaria PCR is used to prepare the peripheral blood
smear that the tube is only sampled once and that
unused blood is not returned to the original tube to
decrease the chances of cross contamination. Recap
the tube ASAP, and keep refrigerated until transported
to ProvLab.
Mansonella sps – See: Filariasis
Marburg Virus Disease – See: Viral Hemorrhagic Fever
Measles
Measles virus
Suspected acute disease
collect ALL of the
samples below:
Must contact zone Medical Officer of Health, who will
arrange for STAT measles testing if required, as
measles is a notifiable disease.
Clinical history including signs, symptoms, onset of
illness, vaccination history, travel and contact with
suspected case(s), must be given on the requisition
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
1) Nasopharyngeal
swab in Universal
Transport medium
(UTM)
2) Urine at least 10 -20
mL in a sterile
container
3) Collect 3 - 5 mL
serum separator tube
(SST) or for pediatrics
2mL red top
Request NAT (RT-PCR)
for measles
Molecular
Diagnostics
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
Request NAT (RT-PCR) for
measles
Molecular
Diagnostics
Urine should preferably be the first voided sample of the
day
Request measles IgM
serology
Virology
Blood collected in the first 3 days after rash onset may
test as falsely negative. Send a convalescent sample 7
to 10 days after the acute sample if the measles IgM is
negative and measles is still strongly suspected
For subacute sclerosing
panencephalitis (SSPE)
collect:
 2 mL CSF in sterile
container AND
 5 mL serum separator
tube (SST) or for
pediatrics 2mL red
top
 Autopsy/Biopsy
samples
Request measles serology
RT-PCR not useful for
SSPE
To determine immunity:
collect 3 - 5 mL serum
separator tube (SST) or
for pediatrics 2 mL red
top
Request measles IgG
serology
SSPE is a rare condition that presents in children and
young adults, if they have a prior history of wild type
measles infection before two years of age. There is an
asymptomatic period of between 6 to 15 years, on
average, before the onset of neurologic and personality
aberrations.
SSPE measles CSF/serum sent to National Microbiology
Laboratory for testing.
Consult the Microbiologist/Virologist on Call prior to
sending autopsy or biopsy samples, such as brain, CSF
and blood
Virology
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MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Melioidosis
Burkholderia pseudomallei
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Sputum
Microscopy, culture
Bacteriology
Consult the Microbiologist/Virologist On Call before
collecting specimens or submitting suspected B.
pseudomallei isolate for confirmation. Please
indicate on requisition if Melioidosis is suspected.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Aspirated lesion material
in a sterile container or
plain transport media
(RTM)
Microscopy, culture
Bacteriology
Blood culture (see Blood
Culture, Bacteriology for
collection details)
Culture
Bacteriology
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Submit samples to the Laboratory immediately for
processing.
CSF 0.5 mL minimum in
a sterile container
Microscopy, culture
Bacteriology
Submit samples to the Laboratory immediately for
processing. If sufficient volume collected, DO NOT
submit first tube for culture investigation. To minimize
skin contamination, submit second tube for culture.
(Risk Group 3)
Meningitis, Bacterial
Haemophilus influenzae,
Listeria monocytogenes,
Neisseria meningitidis,
Streptococcus pneumoniae,
also in newborns; coliform
organisms and streptococci,
especially Streptococcus
agalactiae (Group B)
CALGARY
Bacterial Antigen Detection Test must be approved by
Microbiologist/Virologist On Call; contact the
Con’t…
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Laboratory at the Edmonton site.
* Mycobacterium
tuberculosis– See:
Mycobacteria
* (Risk Group 3)
Isolate on a blood agar
slant (BAS) or isolate in
charcoal transport media
(CTM)
Serogrouping/serotyping
Bacteriology
Serotyping of Haemophilus influenzae and serogrouping
of Neisseria meningitidis performed at the Laboratory.
Serotyping of Neisseria meningitidis and Listeria
monocytogenes is referred to the National Microbiology
Laboratory, Winnipeg, Manitoba.
CSF 0.5 minimum in a
single container
Blood – 5 to 7 ml in
EDTA (lavender top) tube
PCR – Neisseria
meningitidis only
Molecular
Diagnostics
Detection of organism and classification of the common
serogroups A,B, C, W135 and Y by PCR. This assay is
restricted to Medical Officers of Health/designates and
requires approval by Microbiologist/Virologist On Call.
This test does not replace routine blood cultures or CSF
cultures.
Meningitis, Viral or Aseptic See: Aseptic Meningitis and Encephalitis Viral
MERS – Middle East
Respiratory Syndrome
For cases where you suspect a MERS infection, you
must FIRST contact the Zone Medical Officer of
Health prior to sample collection. The investigation
will be coordinated with the Laboratory by your local
zone MOH.
MERS Coronavirus
(MERS-Cov)
(Risk Group 3)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Metapneumovirus – See: Respiratory Infections, Viral and Atypical Bacteria
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Metorchiasis
Metorchis conjunctus
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for eggs
Parasitology
Emulsify feces in SAF preservative immediately after
collection. Ova of this and related species are often
difficult to identify and when in doubt are reported as
"opisthorchid" ova.
Microsporidia
(Nosema, Encephalitosoon,
Enterocytozoon,
Pleistophora)
Microspridium sp.
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Microscopy for spores
Parasitology
Not routinely tested. Testing performed on specimens
from immunocompromised patients only.
Bacteriology
Nose swab – aseptically insert the swab into each nostril
(one swab for both nostrils) until you feel resistance,
then gently circle the inner aspect of the nostril.
Groin swab – roll the swab in the fold of each groin (one
swab for both groins).
Please write “MRSA Screen” on the requisition.
Molluscum Contagiosum - See: Poxvirus Infections
Mononucleosis, Infectious - See: Epstein-Barr Virus Infections
Monospot - See: Epstein-Barr Virus Infections
MRSA Screen
Methicillin Resistant
Staphylococcus aureus
(Edmonton Site only)
Nose, groin and draining
lesions swabs in plain
transport media (RTM)
Culture
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Late
stage/convalescence:
(10 days or more after
onset of parotitis)
Mumps meningitis
(Up to 10 days after onset
of illness)
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Mumps is a notifiable disease and as such the Zone
Medical Officer of Health must be contacted.
Mumps
(Mumps virus)
Note: other agents such as
enterovirus, parainfluenza
or
bacterial infections may
also mimic mumps in their
clinical presentation
Acute illness (up to 10
days after onset of
parotitis):
CALGARY
Provide clinical history on the requisition.
Contact the Microbiologist/Virologist On Call to arrange
for expedited testing, if clinically appropriate.
Buccal swab ** in Viral
Transport medium
And
Blood (3-5mL in gold top
serum separator
vacutainer)
Request mumps NAT (RTPCR) on swab
Molecular
Diagnostics
Request mumps IgM and
IgG antibody * on blood
Virology
Blood (3-5mL in gold top
serum separator
vacutainer)
And
Urine (if within 2 weeks
of onset of parotitis AND
Orchitis/oophoritis were
also noted)
Request mumps IgM and
IgG antibody on blood
Virology
Request mumps NAT (RTPCR) on urine
Molecular
Diagnostics
Blood (3-5mL in gold top
serum separator
vacutainer)
And
CSF (at least 1 mL)
And
Buccal swab ** in Viral
Request mumps IgM and
IgG antibody on blood
Virology
Request mumps NAT (RTPCR) on CSF, swab and
Molecular
Diagnostics
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* If both mumps IgM antibody and detection of virus are
negative AND when there is strong clinical suspicion of
mumps, consult with the Microbiologist/ Virologist On
Call and send a follow-up blood sample 10 – 14 days
after the acute sample.
Label the blood as ‘convalescent sample’ and contact
the Microbiologist/Virologist On Call to alert the
laboratory testing section.
**Buccal swab: Use a sterile polyester/cotton/Dacron
tipped swab. Place the swab into the buccal cavity
(space BETWEEN the cheek and the gums/teeth) all
the way to the back, on the SWOLLEN side of the face.
If the swelling is on the neck, put the swab UNDER the
tongue. Leave the swab in place for about 1 minute in
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Transport medium
urine
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
order to collect the saliva that accumulates.
And
Urine in sterile container
Immunity
Determination/previous
exposure:
5 mL serum separator
tube (SST) or
2 mL (red top or pediatric
SST) for children
NOTES
Urine samples: (5mL or more) should preferably be the
first morning sample
Request mumps IgG
antibody only
Virology
Murine Typhus - See: Rickettsia typhi
Mycobacteria
2-10 mL sputum
Mycobacterium
Tuberculosis Complex
Infection:
Pulmonary, lymphadenitis,
bone, joint, genitourinary,
disseminated disease
10-40 mL urine
Consists of:
M. tuberculosis,
M. bovis,
M. africanum
M. microti
M. canettii
M. caprae
Microscopy:
Auramine Rhodamine
Fluorescent Screening
Ziehl Neelsen Confirmatory
(AFB, Acid Fast Bacilli)
stool
5 - 10 mL body cavity
fluids; joint fluid; bronchial
wash; BAL; auger suction;
purulent exudate;
bronchial brush; aspirates;
abscesses; pleural fluid
TB PCR:
Routinely performed on
direct smear positive
RESPIRATORY specimens
from NEW cases only
Biopsy (tissue, lymph
Culture:
Conventional
Mycobacteriology
Edmonton
(780) 407-7680
Calgary
(403) 944-1209
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Specimen Transport:
All specimens should be refrigerated during transport to
the Laboratory if delivery will be delayed by more than
one hour.
Respiratory Specimens:
For optimal recovery of Mycobacterium species, all
respiratory and gastric wash specimens should be
collected before eating, in the early morning.
Recommended: Three sputum specimens of 5-10 mL
each should be collected (either spontaneously or
induced). Sputum specimens can be collected on the
same day with a minimum 1 hour separation between
collections. If AFB s apart (or longer if necessary)
culture and C&S are both requested, two specimens
should be submitted. For patients without spontaneous
sputum, induction of cough and sputum by Con’t…
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
M. pinipedii
and M. bovis, B.C.G.
(Risk Group 3)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
glands, uterine curettings);
bone chips. DO NOT
place biopsy specimen in
formalin.
BACTEC 960 MGIT
BACTEC 9000 Series
Automated Blood Culture
Systems
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
inhalation of warm sterile aerosol of saline is preferred to
gastric aspiration.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
CSF 1 mL
Nontuberculous
Mycobacteria (NTM):
Examples include:
M. kansasii
M. marinum
M. avium complex (MAC)
M. xenopi
M. haemophilum
M. fortuitum
M. chelonae
M. abscessus
and others
Most common clinically
relevant species listed
above.
All of the above to be
collected in sterile
screw top containers.
DO NOT submit samples
in endotracheal
specimen trap
containers. These
containers frequently
leak, presenting a safety
risk to staff and may
compromise patient care
when these specimens
are rejected.
Gastric washings in
phosphate buffer kit within
4 hours (not a suitable
specimen for NTM)
5-8 mL blood, SPS*
(yellow top) recommended
Susceptibility tests:
A. Mycobacterium
tuberculosis/ complex
infections
-susceptibility tests to
antituberculous drugs
routinely done on all new
cases, and repeat
specimens >=3 months
from case isolate.
Sterile Site Specimens:
Collect into sterile screw top container and deliver as
soon as possible to the Laboratory
Gastric Wash:
Phosphate buffer kits for gastric washes are available
from the Distribution Centre 780-407-8971(Edmonton)
or 403-944-2583 (Calgary)
Swabs of clinical material are NOT recommended.
B. Nontuberculous
Mycobacterial (NTM)
infections
-susceptibility tests to
established drugs are
routinely done on sterile
site specimens or by
request to the
Microbiologist On Call
If necessary, dry swabs are preferred (DO NOT use
transport media)
If nontuberculous Mycobacteria/ atypical (NTM) infection
suspected, please provide clinical details to facilitate
appropriate selection of laboratory
culture/media/incubation parameters to optimize
recovery of fastidious species.
Citrate, heparin or ACD
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
tubes are acceptable
alternatives
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
NEW direct smear positive cases and NEW culture
positive TB complex cases are telephoned immediately
to the appropriate public health agencies.
Bone marrow 1-5 mL in a
SPS* (yellow top)
Culture only
TB smear results are routinely available within 24 hours
of specimen receipt. If STAT Testing is required
Contact the Microbiologist/Virologist on Call to
facilitate testing.
TB PCR results are available within 48 hours of
specimen receipt; reports are phoned or faxed as soon
as they are available.
Mycobacterium leprae
See: Leprosy
*To obtain SPS tubes, please contact the Laboratory
Distribution Centre (Edmonton) or Calgary Laboratory
Services (Calgary)
**To obtain BACTEC Myco/F Lytic vials, please contact
the Mycobacteriology Dept. (Calgary or Edmonton)
Mycoplasma Infections,
Respiratory
Mycoplasma pneumoniae,
(atypical pneumonia)
1 - 2 mL Tracheal
aspirate; bronchial wash;
auger suction in
Universal Transport
Medium (UTM)
Culture
Bacteriology
Mycoplasma pneumoniae causes “primary atypical
pneumonia". Culture results may not be available for up
to four weeks.
“Routine” Mycoplasma culture from respiratory
specimens is not recommended.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
EIA: IgM
Virology
IgM may be falsely negative if collected within first 6
days of illness
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Ureaplasma spp. infections,
respiratory- neonatal or
infants (≤3 months)
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Bacteriology
Ureaplasma spp. Have been associated with respiratory
disease in neonates and infants (≤3 months)
PCR (not routinely done –
see NOTES)
Mycoplasma pneumoniae and other Mycoplasma
species as well as Ureaplasma urealyticum and
Ureaplasma parvum (previously known as
U. urealyticum biovar 1) can be identified using PCR at
(NML) National Microbiology Laboratory, Winnipeg,
Manitoba. TAT is 12-14 days from receipt at NML.
Mycoplasma and Ureaplasma spp. PCR done only with
sufficient clinical history and discussion with
Microbiologist/Virologist On Call at Calgary or
Edmonton.
Mycoplasma Infections,
Ureaplasma Infections,
Genital and NonRespiratory Sites
Ureaplasma urealyticum
Mycoplasma genitalium,
Mycoplasma hominis
Ureaplasma spp
Urethral; vaginal; cervical
swabs in Universal
Transport Medium (UTM)
Culture
Bacteriology
Routine culture of Mycoplasma hominis or Ureaplasma
urealyticum is not performed without relevant clinical
diagnosis.
Ureaplasma strains may be implicated in nongonococcal urethritis, Reiter's syndrome and infertility.
Mycoplasma and Ureaplasma spp. PCR done only with
sufficient clinical history and discussion with
Microbiologist/Virologist On Call at Calgary or
Edmonton.
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Mycoplasma pneumoniae and other Mycoplasma
species as well as Ureaplasma urealyticum and
Ureaplasma parvum (previously known as U.
urealyticum biovar 1) can be identified using PCR at
National Microbiology Laboratory, Winnipeg, Manitoba
Myiasis
Larvae of various flies,
commonly Wohfahrtia
species (flesh flies)
Myocarditis/Pericarditis,
Viral
Coxsackie B viruses and
other enteroviruses,
M pneumoniae Adenovirus,
Parvovirus, CMV and rarely
Influenza virus
Tissue biopsy or living
larvae (maggots) in
Closed screw capped
container
Throat swab in Universal
Transport Medium (UTM)
Microscopy
Parasitology
NAT (RT-PCR) for
enteroviruses
Molecular
Diagnostics
Refrigerate but DO NOT freeze specimens. Specify
enterovirus for appropriate viral testing of throat swab
and stool specimen.
Feces in a Closed
Container
NAT (RT-PCR) for
enteroviruses
Molecular
Diagnostics
Refrigerate but DO NOT freeze
NP Swab
Respiratory viruses
One 4 mL EDTA
(lavender top) tube for
molecular assays
NAT (PCR) for
adenoviruses, CMV
NAT (RT-PCR) for
enteroviruses
NAT Parvovirus
Molecular
Diagnostics
Molecular
Diagnostics
Myocardial biopsy (if
available) in sterile
container or Universal
NAT (PCR) for
adenoviruses, CMV, NAT
(RT-PCR) for
NML
Sample referred to National Microbiology Laboratory,
Winnipeg, Canada.
Molecular
Diagnostics
*NAT (PCR) test available for adenovirus, CMV and
NAT (RT-PCR) for enterovirus if specifically requested.
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Transport Medium (UTM)
enteroviruses
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
NML
Consult Microbiologist/Virologist On Call.
NAT Parvovirus
Pericardial fluid in sterile
container
Nasopharyngeal Aspirate,
Viral Upper Respiratory
Infections
Secretions in Universal
Transport Medium (UTM)
Molecular
Diagnostics
RT-PCR – Respiratory
Virus Panel.
Specify specimen source
and suspected virus on the
requisition.
Molecular
Diagnostics
Use the smallest available feeding tube (preferably a
size 6) and attach it to a 3 or 5 mL syringe.
Measure the distance from the corner of the nose to
the front of the ear and insert the feeding tube for half
this length into the posterior nasopharynx. Gently
apply suction on the syringe and pull the inserted tube
out at the same time. Note: insertion of the tube usually
induces a cough.
Place the inserted end of the feeding tube into the
transport medium and use gentle suction with the
syringe to rinse the feeding tube a few times. Use
scissors to cut the end of the feeding tube so that it does
not protrude above the rim of the transport medium
container. Ensure that the lid of the container is
screwed on tight.
Refrigerate but DO NOT freeze specimens.
Send immediately to the Laboratory.
Nasopharyngeal aspirates are NOT appropriate for
routine bacterial culture.
NGU - (non-gonococcal urethritis) See: Genital Infections and Chlamydia (Trachomatis) and Mycoplasma Infections
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Nocardiosis
Nocardia sp.
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Submit specimen in a
sterile container
Culture
Mycology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Norovirus See: Diarrhea Viral
(renamed from Norwalk Virus, Norwalk agent, Norwalk-like viruses)
Onchocerciasis
Onchocerca volvulus
Dipetalonemia (Mansonella)
Dipetalonema
Streptocerciasa
Aspirated material from
skin nodules; excision of
nodule; skin snips
Microscopy for
microfilariae and adult
worm
Parasitology
See also Filariasis.
5 mL serum separator
tube (SST) or pediatrics
use 2 mL red top tube
EIA
Parasitic Serology
Test performed at National Institute of Health, Bethesda,
Maryland, USA.
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Onychomycosis - See: Fungal Infections and Dermatophytes
Orchitis - See: Mumps
Orf - See: Poxvirus Infections
Orientia tsutsugamushi
(Scrub typhus)
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
(Risk Group 3)
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
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For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education ).
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Contact Microbiologist/Virologist On Call for molecular
testing.
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Ornithosis - See: Chlamydia Infections
Osteomyelitis, Acute
Staphylococcus aureus and
other bacterial species
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Purulent skin/lesion
discharge; aspirated pus;
lesion swab in plain
transport media (RTM)
Microscopy, culture
Bacteriology
Feces in SAF
Microscopy
preservative (see:
Diarrhea Parasitic for
collection details)
Panencephalitis (subacute sclerosing) (SSPE) – See: Measles
Ova and Parasites
Staphylococcus aureus is the most common agent.
Parasitology
Papillomavirus See: Human Papillomavirus
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MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Papovavirus Infections See: Human Papillomavirus, Progressive Multifocal Leukoencephalopathy, BK Virus
Paragonimiasis
Paragonimus westermani
Parainfluenza Virus
Infections
Parainfluenza viruses
(types 1-4)
See respiratory infections
Paralytic Illnesses, Viral
Several viruses especially
poliovirus* and other
enteroviruses, West Nile
Virus* and herpes viruses**,
and as part of
encephalomyelitis, or
ascending myelitis
syndromes.
Feces in SAF
preservative
Sputum; respiratory
secretions, aspirates or
biopsies in a sterile
screw cap container
Nasopharyngeal swab or
aspirate, or throat swab
in Universal Transport
Medium (UTM)
Microscopy for eggs
Parasitology
Adult parasite identification
Microscopy for eggs
Parasitology
NAT (RT-PCR) –
Respiratory Virus Panel
Virology
Molecular
Diagnostics
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
Aspirated material from
respiratory tract in
original collection device,
or bronchoscopy
NAT (RT-PCR) –
Respiratory Virus Panel
Virology
Molecular
Diagnostics
Note: Extended respiratory virus testing other than
influenza A/B will not be done on community patients
unless as part of an MOH-directed outbreak or after
consultation with Microbiologist/Virologist On Call.
Autopsy or biopsy
material (lung) in a sterile
container.
NAT (RT-PCR) –
Respiratory Virus Panel
Molecular
Diagnostics
If multiple PCR tests are
requested on a CSF,
submit at least 1 mL of
DEDICATED CSF to The
Laboratory and specify
the virus for PCR test
request.
Suspected enterovirus
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Emulsify feces in SAF preservative immediately after
collection.
Referred to National Reference Centre for Parasitology,
McGill University Centre for Tropical Disease/Centre for
Disease Control, Atlanta, Georgia, U.S.A.
Providing clinical information with the test request is
extremely helpful for the Laboratory.
If specimen can be received in the Laboratory within
24 hours of collection then ship on ice/cold packs.
If transportation might exceed 24 hours from collection
then freeze at -70°C and transport on dry ice.
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
In HIV infected patient*,
consider CMV-related
myelitis. Consult
Microbiologist/Virologist-On
Call at Calgary or
Edmonton before
submitting CSF for CMV
testing.
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
encephalitis:
See: Enterovirus
Infections
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
If poliovirus, West Nile virus, Herpes B Virus, Herpes
Simiae, Monkey B Virus or specimen is from HIV
infected (or suspected) patient:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Suspected HSV
Panel testing (enterovirus,
myelitis:
parechovirus,HSV-1/2 and
DEDICATED CSF
VZV)
*(Risk Group 3) sample in a sterile
container (at least 1 mL)
** (Herpes B Virus, for HSV PCR
Herpes Simiae and Suspected West Nile
Monkey B Virus are Risk Virus encephalitis:
Group 4) See: West Nile Virus
Infections
Paralytic Shellfish Poisoning - See: Shellfish Poisoning
Molecular
Diagnostics
Paratyphoid Fever - See: Typhoid Fever
Parvovirus Infections
Human parvovirus
Fifth Disease
For Immunity
Determination:
Collect 5 mL serum
separator tube (SST) or
pediatrics may use 2 mL
red top tube
Serology EIA: Parvovirus
IgG only
Virology
For Suspected Acute
Disease:
Provide clinical history on
Parvovirus IgG, IgM*
Virology
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*IgM will only be performed if clinical history of
suspected rash illness or acute infection is provided on
the requisition.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
requisition and collect 5
mL serum separator tube
(SST) or pediatrics may
use 2 mL red top tube
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Acute serum collected in the first 3 days of rash may test
as falsely negative. A follow-up sample should be sent
at least 5 days after onset to verify the initial negative
IgM, especially if the initial IgG is negative.
For immunocompromised patients, e.g. transplant
recipients, the IgM serological response may be absent.
Suspected parvovirus infection, usually in the form of
chronic anemia or neutropenia, can be diagnosed by
PCR testing of a bone marrow aspirate.
Pediculosis
Pediculus humanus capitis
Pediculus humanus
corporis
Phthirus pubis
Pemphigus
Staphylococcus aureus
Collect 1 – 2 mL bone
marrow or whole blood in
EDTA (lavender top)
tube or
5 mL serum separator
tube (SST). DO NOT
centrifuge.
Parvovirus PCR **
Virology
**Clinical history is required for Parvovirus PCR test.
Parvovirus PCR is referred to the National Microbiology
Laboratory, Winnipeg, Manitoba for testing. Consult
with the Microbiologist/Virologist On Call at Calgary or
Edmonton if molecular testing is required. Send
samples on Monday, Tuesday or Wednesday to allow
for shipping due to the time sensitive nature of the test
(unless it is a STAT holiday).
Parasites or eggs in hair
or underclothing
Microscopic identification
Parasitology
Submit lice or nits in a clear dry container (may be
submitted in 70% ethanol).
Vesicle fluid swab in
Microscopy, culture
plain transport media
(RTM)
Pericarditis, Viral - See: Myocarditis/Pericarditis, Viral
Bacteriology
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119
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Pertussis
Bordetella pertussis
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
One nasopharyngeal
swab collected with nylon
flocked/plastic shaft
swab placed into Regan
Lowe Transport Medium
(RLTM)
PCR
Molecular
Diagnostics –
Edmonton
Collect nasopharyngeal swab using nylon flocked swab
provided in collection kit. Gently insert swab straight
into nostril, near the septum and below the turbinates,
until it reaches the posterior nares. Leave in place for a
few seconds. Patient may cough from the tickling
sensation. If resistance is encountered, try the other
nostril.
Bacteriology Calgary
Check expiry date on
RLTM.
Place swab into RLTM; break shaft at the score mark to
insure that the cap can be securely tightened. If RLTM
is not available or expired, submit swab in charcoal
transport media. Refrigerate specimen if transport to the
Laboratory is to be delayed.
Please notify the Laboratory if an outbreak is
suspected.
Bordetella pertussis culture NOT routinely performed. If
required please contact the Microbiologist/Virologist On
Call at Calgary or Edmonton.
Bordetella parapertussis
As above
Culture
Bacteriology
Pharyngitis, Bacterial
Typically Streptococcus
pyogenes
Throat swab in plain
transport media (RTM)
Culture
Bacteriology
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Clearly indicate on the requisition “B. parapertussis
culture”.
Vigorously swab inflamed areas, both tonsillar areas and
posterior pharyngeal wall. Routinely cultured for betahaemolytic streptococci only.
Culture for Corynebacterium diphtheriae only on
request.
120
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Pharyngitis, Viral
Respiratory viruses e.g.
adenovirus, parainfluenza
virus, influenza virus, RSV,
rhinovirus and coronavirus.
Non-respiratory virus
including enteroviruses and
herpesvirus (usually
present with blister lesion)
Epstein-Barr virus (EBV)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Depending on clinical
picture, collect throat
swab in Universal
Transport Medium (UTM)
for: respiratory virus,
enterovirus or HSV.
HSV
NAT (PCR) – Respiratory
Virus Panel
Virology
Molecular
Diagnostics
Refrigerate but DO NOT freeze specimens. Specify
suspected viral pathogen for appropriate testing.
NAT (RT-PCR) –
Herpesvirus, VaricellaZoster virus
Molecular
Diagnostics
NAT (RT-PCR) –
enterovirus, parechovirus
Molecular
Diagnostics
For Suspected EBV:
Submit 5 mL serum
separator tube (SST) or
for pediatrics 2 mL (red
top tube)
EBV VCA IgM
Virology
Serum, 2 mL (red top
tube) or 5 mL serum
separator tube (SST)
EBV VCA IgM
Virology
Provide clinical history on requisition for CMV IgM
request.
Picornavirus Infections – See: Enterovirus Infections, Rhinovirus Infections, and Hepatitis A Virus
Pinta
Treponema carateum
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Syphilis Serology:
EIA, RPR, INNO-LIA
Virology
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Antibodies to the treponema of pinta are
indistinguishable from those to the treponema of syphilis
by all the diagnostic tests in current use.
121
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Pinworm Disease - See: Enterobiasis - Pinworms (Cellophane Tape Test)
PJP (Pneumocystis jiroveci pneumonia) - See: Respiratory Infections, Acute Bacterial
Plague
See: Yersinia pestis
Pus from buboes;
sputum in sterile
container
Microscopy, culture
Bacteriology
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
1 - 2 mL sputum,
aspirated respiratory
secretions, auger
suction, bronchoscopy
specimens in sterile
container.
Microscopy, Culture
Bacteriology
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
(Risk Group 3)
Pneumonia, Bacterial
Several bacterial species
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Contact the Microbiologist/Virologist On Call before
collecting specimens or submitting suspected
Yersinia pestis isolates for confirmation. Please
indicate on requisition if plague is suspected.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
The quality of sputa is assessed on cell content. Deep
cough sputum and auger suction are best collected in
the early morning before eating. Saliva specimens are
not suitable.
122
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Pneumonia, Viral and Atypical Bacteria - See: Respiratory Infections, Viral and Atypical Bacteria.
Poliomyelitis – (Polioviruses types 1, 2, and 3) - See: Enterovirus Infections
Pontiac Fever - See: Legionnaires Disease
Post Perfusion Syndrome - See: Cytomegalovirus Infections
Powassan virus
(Risk Group 3)
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form.
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
Submit acute (at onset)
and convalescent (10 to
14 days) bloods
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Poxvirus Infections
Smallpox** and monkey
pox viruses*
* (Risk Group 3)
** (Risk Group 4)
Virology
Vesicle fluid; skin crusts;
scrapings from skin
Electron microscopy
Virology
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Immediately consult the Zone Medical Officer of
Health before collecting any specimens from
patients with suspected smallpox or monkey pox.
**Smallpox and *monkey pox viruses are to be
shipped as Category A.
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123
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Other poxviruses:
Cowpox, vaccinia, Orf,
Milker’s nodules, and
molluscum contagiosum
lesions on a microscope
slide (unfixed)
PCR
Progressive Multifocal
Leukoencephalopathy
JC virus (a human
papovavirus)
Biopsy or autopsy
material (brain) in sterile
container or
DEDICATED CSF
sample in sterile
container.
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
PCR test is referred to the National Microbiology
Laboratory, Winnipeg, Manitoba.
JC Virus PCR*
Virology
Please indicate on requisition if PML is suspected.
Specimen will be referred to National Microbiology
Laboratory, Winnipeg, Manitoba for PCR testing.
Contact Microbiologist/Virologist On Call at Calgary or
Edmonton before collecting this specimen.
Pseudomembranous Colitis - See: Diarrhea, Antibiotic Associated
Psittacosis - See: Chlamydial Infections
Puerperal Fever
Usually group A
streptococci
High vaginal swab in
charcoal transport media
(CTM)
Culture
Bacteriology
Nose swab and throat
swabs from mother in
plain transport media
(RTM)
Culture
Bacteriology
2 - 10 mL urine in sterile
container
Umbilical swab from
baby in plain transport
media (RTM)
Culture
Bacteriology
Microscopy, Culture
Bacteriology
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If streptococcal infection is suspected, take nose and
throat swabs from the mother and umbilical swab from
baby.
Include clinical information.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Pyoderma
Staphylococcus aureus
sometimes accompanied by
Streptococcus pyogenes or
Corynebacterium
diphtheriae
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Blood culture (see:
Blood Culture, Bacterial
for collection details)
Culture
Bacteriology
Swab in plain transport
media (RTM)
Microscopy, Culture
Bacteriology
Serology RFFIT
(rapid fluorescent focus
inhibition test)
Virology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Q Fever - See: Coxiella burnetii
Rabies
Rabies virus
(Risk Group 3)
5 mL serum separator
tube (SST)
or pediatrics may use 2
mL red top tube
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For the determination of immunity please include the
date of immunization and type of vaccine. Serology
(RFFIT) is referred to the National Microbiology
Laboratory, Winnipeg, Manitoba.
An adequate response after vaccination is >= 0.5 IU/mL.
Although there have been no cases of human rabies in
Alberta in the past 10 years, animal rabies does occur,
especially in skunks and insectivorous bats as the prime
reservoirs.
Consult the Microbiologist/Virologist On Call at Calgary
or Edmonton before sending human autopsy material or
if STAT testing for suspected rabies is required.
Con’t…
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Rat-bite Fever(Sodoku)
Spirillum minus (minor)
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
For suspected rabies:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
For examination of suspected rabid animals, contact
District Veterinarian, Health of Animals Branch, Canada
Agriculture.
Autopsy material (brain,
spinal cord, salivary
glands) in a sterile
container
Rat-bite Fever (Haverhill
Fever)
Streptobacillus moniliformis
CALGARY
Primary lesion exudate;
fluid from lymph glands;
pus in sterile container
Microscopy, Culture
Bacteriology
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Primary lesion exudate
Microscopy and animal
inoculation
Bacteriology
Blood smears in a slide
mailer
Microscopy
Bacteriology
Consult the Microbiologist/Virologist On Call at Calgary
or Edmonton prior to specimen collection.
Consult the Microbiologist/Virologist On Call at Calgary
or Edmonton prior to specimen collection.
Red Measles - See: Measles
Reiter’s Syndrome - See: Mycoplasma Infections
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Relapsing Fever, Tickborne
(Borrelia hermsii)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
(Risk Group 3)
Contact Microbiologist/Virologist On Call for molecular
testing.
Molecular Testing
(restricted availability)
Relapsing Fever, Louseborne
(Borrelia recurrentis)
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba.
(Risk Group 3)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Respiratory Infections,
Acute Bacterial
Several bacterial species,
especially Streptococcus
pyogenes,
Streptococcus
pneumoniae,
Haemophilus influenzae,
Moraxella catarrhalis
Legionella pneumophila
Pneumocystis carinii (PCP)
Sputum; aspirated
respiratory secretion in
sterile container
Microscopy, culture
Bacteriology
Throat swab in plain
transport media (RTM)
Culture
Bacteriology
Blood culture: (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
1-2 mL bronchial
specimen; BAL; bronch
brush/wash; induced
sputum; lung tissue in a
Microscopy
Parasitology
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For suspect diphtheria, page
Microbiologist/virologist On Call at Calgary or
Edmonton immediately.
Non-induced sputum specimens are NOT acceptable for
PCP.
Con’t…
127
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
sterile container. Specify
if PCP suspected.
Respiratory Infections,
Viral and Atypical
Bacteria
Numerous viruses including
classic respiratory virus
e.g., adenovirus, influenza
virus*, parainfluenza virus,
metapneumovirus,
coronaviruses*, respiratory
syncytial virus, entero/rhino
virus, varicella-zoster virus,
cytomegalovirus and
herpes simplex virus may
be found
in immunocompromised
hosts.
Nasopharyngeal (NP)
swab (rayon swab) or
aspirate or auger suction
in Universal Transport
Medium (UTM) (see:
Nasopharyngeal
Aspirates, Viral for
collection details.
RSV, Flu A
NAT (RT-PCR) –
Respiratory Virus Panel
Molecular
Diagnostics
Throat swab can also be
collected in Universal
Transport Medium UTM)
NAT (RT-PCR)–
Respiratory Virus Panel
Molecular
Diagnostics
Coxiella burnetii (Q fever)
Acute and convalescent
serum samples: 5mL
serum separator tube
(SST) or pediatrics may
use 2 mL red top tube.
EIA and IFA
Virology
5mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube.
EIA: IgM
* (Risk Group 3)
Mycoplasma pneumoniae
If suspected Influenza A,B, or C or coronavirus:
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Serology is referred to the National Microbiology
Laboratory, Winnipeg, Manitoba for testing.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Virology
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IgM may be falsely negative if collected within first 6
days of illness.
128
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
MERS (Middle East
Respiratory Syndrome) or
SARS (Severe Acute
Respiratory Syndrome)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
For cases where you suspect a MERS or SARS
infection, you must FIRST contact the Zone Medical
Officer of Health prior to sample collection. The
investigation will be coordinated with the Laboratory
by your local zone MOH.
(Risk Group 3)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Herpes Viruses (HSV,
CMV, VZV)
Respiratory Syncytial
Virus Infections, (RSV)
Respiratory syncytial virus,
bronchiolitis, croup,
pneumonia
NAT (PCR)
Molecular
Diagnostics
Nasopharyngeal swab or
aspirate or throat swab in
Universal Transport
Medium (UTM).
RT-PCR – Respiratory
Virus Panel
Molecular
Diagnostics
Aspirated material from
respiratory tract in
original collection device,
or bronchoscopy.
RT-PCR – Respiratory
Virus Panel
Virology
Molecular
Diagnostics
Autopsy or biopsy
material (lung) in a sterile
container.
RT-PCR – Respiratory
Virus Panel
Molecular
Diagnostics
Consult Microbiologist/Virologist On Call for additional
tests if required.
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
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129
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Rheumatic Fever
Sequelae to upper
respiratory tract infections
with Streptococcus
pyogenes
Throat swab in plain
transport media (RTM)
Culture
Bacteriology
Rhinovirus Infections
Rhinoviruses (over 100
different types), common
cold, coryza
Nasopharyngeal swab or
aspirate or throat swab in
Universal Transport
Medium (UTM).
PCR – Respiratory Virus
Panel
Molecular
Diagnostics
Rhinoviruses and
enteroviruses are members
of the picornovirus family.
Aspirated material from
respiratory tract in
original collection device
or bronchoscopy.
Autopsy or biopsy
material (lung) in sterile
container.
PCR – Respiratory Virus
Panel
Molecular
Diagnostics
PCR – Respiratory Virus
Panel
Molecular
Diagnostics
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Refrigerate but DO NOT freeze specimens. Send
immediately to the Laboratory.
The Laboratory uses an assay that detects both
rhinoviruses and enteroviruses and reports them as
entero-rhinovirus.
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130
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Rickettsial Infections
Global distribution caused
by various Rickettsia sp
common ones listed below
Rickettsia rickettsii
(Rocky Mountain Spotted
Fever [RMSF]
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Submit acute (at onset)
and convalescent (14 to
21 days) blood
For a comprehensive listing of Rickettsial Infections,
distribution and vectors refer to the Zoonotic Testing
Supplement (Posted on the ProvLab website:
www.provlab.ab.ca\education ).
Contact Microbiologist/Virologist On Call for molecular
testing
Rickettsia africae
(African tick bite fever)
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba.
Rickettsia australis
(Queensland tick typhus)
Rickettsia conorii & sub spp
(Mediterranean spotted
fever, Boutonneuse fever,
etc)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Rickettsia felis
(Flea-borne spotted fever)
Rickettsia typhi
(Murine typhus)
Rickettsia prowazekii
(Epidemic typhus or sylvatic
typhus)
(Risk Group 3)
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131
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Electron microscopy
Virology
Refrigerate at 4 C if transport will exceed 2 hours.
Electron microscopy by request only.
Optimal samples are those collected within the first 48
hours after onset of symptoms. Formed stools are of no
diagnostic value.
Serology EIA Rubella IgG
only
Virology
*IgM will only be performed if clinical history of
suspected rash illness or acute infection is provided on
the requisition.
Ringworm - See: Dermatomycosis
Roseola Infections - See: Human Herpesvirus Type 6 (HHV6)
Rotavirus Infections
Rotavirus (at least 2 types)
Feces in a Closed
Container
0
RSV - See: Respiratory Syncytial Virus
Rubella
abortion, congenital rubella
syndrome, rubella virus,
German measles
For immunity
determination:
Collect 5 mL serum
separator tube (SST) or
pediatrics may use 2 mL
red top tube
For suspected acute
disease:
Contact Zone Medical
Officer of Health, provide
clinical history on
requisition, and collect:
5 mL serum separator
Rubella IgG, IgM*
Virology
tube (SST) or pediatrics
may use 2 mL red top
tube
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For enhanced provincial surveillance for rash illness,
parvovirus IgG and IgM and rubella IgG and IgM will be
performed on request for measles IgG and IgM in the
presence of acute illness.
Acute serum collected in the first 3 days of rash may test
as falsely negative. A follow-up sample should be
sent at least 5 days after onset to verify the initial
negative IgM, especially if the initial IgG is negative.
Con’t…
132
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Nasopharyngeal (NP)
swab in Universal
Transport Medium (UTM)
**
Urine in sterile
container**
Molecular testing
Virology
** NP swab and urine will be referred to National
Microbiology Laboratory, Winnipeg, Manitoba if the
serological test result is indicative of acute infection.
Aborted material,
placenta,
autopsy/biopsy material
(all organs and in
particular lens removal
for cataract) in sterile
container***
Molecular testing
Virology
Molecular testing
Virology
*** Tissue, biopsy/autopsy material may also be referred
to National Microbiology Laboratory for further testing.
Please consult with Microbiologist/Virologist On Call at
Calgary or Edmonton.
Rubeola - See: Measles
Salmonellosis - See: Typhoid Fever; Diarrhea Bacterial; Food-borne Bacterial Disease/Syndrome
Salpingitis - See: Genital Infections
SARS - (Severe Acute
Respiratory Syndrome)
PCR
Molecular
Diagnostics
SARS Coronavirus (SARSCoV)
(Risk Group 3)
For cases where you suspect a SARS infection, you
must FIRST contact the Zone Medical Officer of
Health prior to sample collection. The investigation
will be coordinated with the Laboratory by your local
zone MOH.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Scabies
(Sarcoptes scabiei)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Scrapings of skin at edge
of tracks collected in
sterile container,
envelope with black
paper to contain
specimen or specimen
placed between two
glass slides and secured
together at the ends with
tape.
Microscopy for mites
Parasitology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Scarlet Fever, Scarlatina - See: Streptococcal Infections
Schistosomal Dermatitis,
(Swimmer’s Itch)
Larvae of blood flukes of
water birds
No satisfactory test
Parasitology
Schistosomiasis
30 mL urine, final voiding
in sterile container
Microscopy for eggs
Parasitology
Schistosoma haematobium
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA
Parasitic Serology
Schistosoma japonicum,
Schistosoma mansoni
Feces in SAF
preservative (see:
Microscopy for eggs
Parasitology
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Peak egg excretion occurs between 1200 Hours and
1500 Hours.
Culture performed only by prior arrangement with
Microbiologist/Virologist.
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Diagnostic titre: EIA 1:128
Con’t…
134
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
Diarrhea, Parasitic for
collection details)
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Serology EIA
Parasitic Serology
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Diagnostic titre: EIA 1:128
Scrub typhus - See: Orientia tsutsugamushi
Septicaemia
Numerous bacteria, and
fungus
Blood culture, (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Fungus culture is accepted on BACTEC vials. Please
indicate fungus culture on requisition.
Contact the Canadian Food Inspection Agency at
(ph)604-666-3737, (fax)604-666-4440 or (email)
PacificShellfish@inspection.gc.ca
Shellfish Poisoning
Shigellosis - See: Diarrhea Bacterial and Foodborne Bacterial Disease / Syndrome
Shingles - See: Varicella Zoster Virus Infections
Sinusitis
Various bacteria including
Streptococcus pyogenes
and Staphylococcus aureus
Aspirated fluid under
aseptic conditions in a
sterile container
Microscopy, culture
Bacteriology
Also See: Fungal Infections.
Smallpox - See: Poxvirus Infections
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Snowshoe Hare virus
(Risk Group 3)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Serology
Virology
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
For epidemiologic information refer to the Zoonotic
Testing Supplement (Posted on the ProvLab website:
www.provlab.ab.ca/education ).
Submit acute (at onset)
and convalescent (14 to
21 days) blood
Testing performed at National Microbiology Laboratory,
Winnipeg, Manitoba.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens
Spore Strips – See: Biological Indicators
Sporotrichosis - See: Fungal Infections
Sputum Culture
5 – 10 mL in a sterile
container
Microscopy, culture
Fungal culture
AFB (Acid Fast Bacilli)
culture*
Bacteriology
Mycology
Mycobacteriology
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Send specimens promptly to ensure viability of
pathogens. Refrigerate if transport is delayed, DO NOT
freeze. Collect samples in the early morning, before
eating (highest concentration of disease causing
organisms present). If possible have patient gargle with
water (not mouthwash), to reduce oral contamination.
Saliva is not a suitable sample.
Bacteriology specimens will be Q (quality) scored to
determine validity prior to culturing. Repeat specimens
will be requested by telephone. One specimen per 72
hours will be processed unless approved by the
Microbiologist. Gram stains are done on all culture and
sensitivity specimens.
*See: Mycobacteria for collection of sputum for AFB
culture.
136
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Throat swab; infected
area exudate in plain
transport media (RTM)
Culture
Bacteriology
Blood culture (see Blood
Culture, Bacteriology for
collection details)
Culture
Bacteriology
CSF in sterile container
Microscopy, culture
Bacteriology
Isolate in charcoal
transport media OR
isolate on a blood agar
slant (BAS).
Serotyping of invasive
groups A, B,
Streptococcus pneumoniae
Bacterial Typing
Unit
Group B strep
Streptococcus agalactiae
(prenatal screen)
Combined vaginal/ rectal
swab in plain transport
media (RTM)
Culture
Bacteriology
Prenatal screen recommended at
35 – 37 weeks gestation. Culture performed only on
specimens with clinical information indicating pregnancy.
Submit swab of the distal vagina and the rectum.
Strongyloidiasis
Strongyloides stercoralis
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details).
Microscopy for larvae
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
St. Louis Encephalitis - See: Arbovirus Infections
Sterilization Test – See: Biological Indicators
Streptococcal Infections
Streptococcus pyogenes
(Group A streptococcus)
and other groups of
streptococci, especially
groups B, C, and G and
Streptococcus pneumoniae
Con’t…
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Unpreserved FRESH
feces in a Closed
Container.
Culture
Parasitology
Test performed by prior arrangement ONLY. Please
consult the Microbiologist/Virologist On Call at the
Edmonton site.
Duodenal aspirate in a
Closed Container
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube.
Culture, Microscopy
Parasitology
Serology EIA
Parasitic Serology
Specimens containing strongyloides larvae may be
infectious upon contact with unprotected skin.
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease
Subacute Sclerosing Panencephalitis (SSPE) – See: Measles
Swab Test
See Notes
Environmental
Swimmer’s Itch - See: Schistosomal Dermatitis
Syphilis
Treponema pallidum
Swab of lesion, rash or
serous exudate sent in
Culture
Bacteriology
Consult the Microbiologist/Virologist On Call prior to
collecting samples.
Molecular testing
Virology
Avoid sending swabs of lesions with significant oral or
fecal contamination, such as rectal or buccal lesion.
Universal Transport
Medium.
CSF (min volume 1mL) in
sterile container
VDRL
Virology
5 mL serum separator
tube (SST) or for
pediatrics patients – 2
mL red top tube
Serology:
EIA, RPR, INNO-LIA
Virology
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Consult the Laboratory prior to collecting tissues or
samples from autopsies or in a suspected congenital
infection.
The subspecies of T. pallidum i.e., pallidum,
endemicum, carateum and pertenue causing syphilis,
bejel, pinta and yaws, cannot be discriminated from
each other by the above serologic and molecular
assays.
138
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Taeniasis (Tape Worm)
Taenia saginata
Taenia solium
See: Cysticercosis
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Worm or segments in
sterile saline in a Closed
Container
Microscopy for eggs
Parasitology
Submit segments in sterile saline. Please note: it is
important that segments are NOT preserved.
Microscopy for eggs and
identification of segments
Parasitology
Microscopy, culture
Bacteriology
Antitoxin determination
Bacteriology
Tape Worm - See: Taeniasis
Tetanus
Clostridium tetani
Wound swab; lesion
swab in Cary Blair
(anaerobic) transport
media
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Tick-Borne Encephalitis virus (TBEV) – No testing available
Tick-Borne Relapsing Fever – See: Borrelia hermsii
Ticks
Tick for identification in
Closed Container
Tick Speciation
Parasitology
The tick will be speciated if clinically indicated. Consult
the Microbiologist/Virologist On Call if further testing is
necessary under specific circumstances.
For details on tick collection from environmental sources
(NOT clinical samples),see: www.health.alberta.ca/ticks
Con’t…
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
For more information on Lyme disease and tick
surveillance see: Alberta Government “Surveillance of
Ticks On Humans and in the Environment”
Tinea Versicolor (Malassezia furfur), Tinea corporis, Tinea cruris - See: Fungal Infections (Dermatophytes)
TORCH – See: Congenital Infections
Toxic Shock Syndrome
(TSS)
Staphylococcus aureus
Toxic Shock-like
Syndrome (TSLS)
Streptococcus pyogenes
(Group A)
Vaginal swab and/or
cervical swab in plain
transport media (RTM)
Focal skin lesion swab;
anterior nare swab in
plain transport media
(RTM)
Culture
Bacteriology
Microscopy, culture
Bacteriology
Isolate in charcoal
transport media (CTM) or
on a blood agar slant
(BAS)
PCR for Staphylococcus
enterotoxins and toxic
shock syndrome toxin
Bacteriology
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Throat swab; focus of
infection swab in plain
transport media (RTM)
Culture
Bacteriology
Not all cases are associated with menstruation and use
of tampons. It has occurred in males and after
staphylococcal infection in a variety of sites.
PCR for Staphylococcus toxins referred to the National
Microbiology Laboratory, Winnipeg, Manitoba
Con’t…
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Toxocariasis
(Visceral larva migrans)
Toxocara canis
Toxocara cati
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Isolate in charcoal
transport media (CTM) or
on a blood agar slant
(BAS)
Serotyping
Bacteriology
Submit isolates to ProvLab with the required clinical
information.
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA
Parasitic Serology
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Diagnostic titre: EIA 1:64.
Toxoplasmosis
Toxoplasma gondii
Trace Metal Testing,
Water
CSF in a sterile container
Microscopy, PCR
Parasitology
Biopsy material in a
sterile container
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Microscopy, PCR
Parasitology
Serology;
IgG, IgM, IgA
(Other tests as required)
Parasitic Serology
Carried out only by prior arrangement with
Microbiologist/Virologist On Call.
Special specimen transport conditions apply.
Serology performed 1/week.
Consult a public health inspector in your zone.
Trachoma - See: Chlamydial Infections
Treponematoses - See: Pinta and Syphilis
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Trichinosis
(Trichinellosis)
Trichinella spiralis
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Biopsy of muscle
Microscopy
Parasitology
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology EIA
Parasitic Serology
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Diagnostic titre EIA: 1:128.
Feces in SAF
preservative (see:
Diarrhea, Parasitic for
collection details)
Feces in SAF
preservative (se:
Diarrhea, Parasitic for
collection details)
Microscopy for eggs
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
Microscopy for eggs
Parasitology
Emulsify feces in SAF preservative immediately after
collection.
For suspected classic
Whipple’s disease
(gastroenteritis),
acceptable and reliable
samples for testing are
duodenal, gastric, or
colonic biopsy. For
suspected neurologic
infection, acceptable
samples for testing are
CSF, brain tissue, and in
some rare cases blood.
Blood has the potential
PCR
Bacteriology
Microbiologist/Virologist On Call consult required.
Trichomoniasis - See: Genital Infections
Trichostrongyliasis
Trichostrongylus species
Trichuriasis
Trichuris trichiura
(whipworm)
Tropheryma whipplei
(Whipple’s Disease)
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PCR testing referred to the National Microbiology
Laboratory, Winnipeg, Manitoba.
Con’t…
142
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
Blood films, thick and
thin, (unstained) in a
slide mailer
Microscopy
Parasitology
Fluid aspirated from
lymph nodes
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Microscopy
Parasitology
Serology
Virology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
for positive detection but
is NOT considered a
reliable specimen for
Whipple’s disease. Send
tissues in sterile screw
top culture bottles/jars. A
minimum of 2mL is
required for a fluid
specimens in a sealed
screw top tube. For blood
samples, a minimum of
1mL of unspun whole
blood in a sealed EDTA
collection vial is required.
Glass slides, serum,
plasma, saliva, throat
specimens, and stool
are not acceptable
samples and will not be
tested.
Trypanosmiasis, African
Trypanosoma rhodesiense,
Trypanosoma gambiense
American(Chagas
disease)
Trypanosoma cruzi
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Serology performed at National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease/Centre for Disease Control, Atlanta, Georgia,
U.S.A.
143
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Serology
Virology
Transport specimens at room temperature
(22ºC ± 5º C) to the laboratory within 16 hours. DO
NOT refrigerate or freeze the blood sample.
Tuberculosis - See: Mycobacteria
Tuberculosis – Latent
Infection
(LTBI)
Mycobacterium tuberculosis
(Risk Group 3)
QuantiFERON® –TB
Gold IT (In-Tube
Method) requires 1 ml of
blood into each of the
following
QuantiFERON®
specific blood collection
tubes:
1. NIL control (grey cap)
2. TB antigen (red cap)
3. Mitogin Control (purple
cap)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
DO Mix tubes [shaking
vigorously (10x)] for at
least five seconds to
ensure that the entire
inner surface of the tube
has been coated with
blood
Tularemia
Francisella tularensis
(Risk Group 3)
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Serology, Agglutination
Virology
A 4-fold rise in the agglutination test on serial samples is
considered diagnostic. A single titre of 1:40 or more
may indicate either current or past infection.
Con’t…
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Blood culture (see:
Blood Culture,
Bacteriology for
collection details)
Culture
Bacteriology
Contact the Microbiologist/Virologist On Call before
collecting specimens or submitting suspected F.
tularensis isolates for confirmation. Please indicate
on requisition if Tularemia is suspected.
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Typhoid Fever,
Paratyphoid Fever,
Enteric Fever
Salmonella typhi
Salmonella paratyphi
A, B or C
Feces in a Closed
Container; fill container
1/3 full or at least 1
tablespoon (minimum)
Do not contaminate with
water or urine.
Send feces containing
blood or mucus if these
are present. If transport
of fecal sample exceeds
24 hours, submit in
enteric transport media
(Enteric transport media
is not supplied by the
Laboratory)
Culture
Bacteriology
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The organism must be isolated, preferably from blood.
In patients who have received antibiotics before
specimens are collected, bone marrow culture may be
the most successful specimen.
Con’t…
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
15 mL urine in a sterile
container
Culture
Bacteriology
Bone marrow in a sterile
container
(see: Bone Marrow,
Bacteriology for
collection)
Culture
Bacteriology
Blood culture
(see: Blood Culture,
Bacteriology for
collection)
Culture
Bacteriology
Culture
Bacteriology
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Typhus Fever - See: Rickettsial Infections
Tzank Smear - See: Herpes Simplex Virus Infections
Undulant Fever - See: Brucellosis
Ureaplasma - See: Mycoplasma/Ureaplasma Infections
Urethritis - See: Genital Infections
Urinary Tract Infections
(Edmonton site only)
Urine inoculated into BD
Vacutainer® Urine C&S
Preservative Plus Plastic
Tube (Grey Top).
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Collect midstream urine in BD Vacutainer® Urine
Collection Cup and replace blue lid tightly onto cup.
Peel back protective sticker on blue lid to expose rubber
covered cannula. Push C&S Preservative Plus Plastic
Con’t…
146
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Tube (Grey Top) onto the cannula. Remove tube after it
has filled (approximately 3mL draw) and invert 10 times
to mix well. Place protective sticker back over the
transfer port, and dispose of urine cup and lid
appropriately. Label the filled Vacutainer® tube with
patient name, ID number (ULI, PHN), date and time of
collection. Initial requisition. Transport Vacutainer®
tube and requisition to the Laboratory as soon as
possible (up to 48 hours after collection). If insufficient
volume (less than 10 mL in the blue cup) of urine is
collected, phone the Laboratory at 780-407-7121 for
instructions.
Inoculate urine direct from Foley Catheter using LuerLok™ Access Device into BD Vacutainer® Urine C&S
Preservative Plus Plastic Tube (Grey Top).
Vaccinia - See: Poxvirus Infections
Vaginitis - See: Genital Infections
Valley Fever, (Coccidiomycosis) – See: Fungal Infections
Varicella Zoster Virus
Infections
Chickenpox – varicella,
herpes zoster, shingles
Lesion swab* in
Universal Transport
Medium (UTM)
NAT (PCR)
Molecular
Diagnostics
Bronchoscopy,
NAT (PCR)
Molecular
Diagnostics
For suspected
encephalitis:
DEDICATED CSF
NAT (PCR)CSF panel
(HSV, VZV, enterovirus,
parechovirus )
Molecular
Diagnostics
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*Unroof a fresh blister and vigorously swab base of
lesion and place swab in Universal Transport Medium
(UTM). Refrigerate but DO NOT freeze specimens.
Providing clinical information with the test request is
extremely helpful for the Laboratory for PCR test. If
Con’t…
147
LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
sample (at least0.5-1mL)
in a sterile container for
VZV PCR
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
specimen can be received in the Laboratory within 24
hours of collection then ship on ice/cold packs. If
transportation might exceed 24 hours from collection
then freeze at -70°C and transport on dry ice.
5 mL serum separator
tube (SST)** or
pediatrics may use 2 mL
red top tube – Provide
clinical history.
Serology EIA,: VZ IgM***,
IgG
Virology
**Swab of lesion (blister) for NAT (PCR) request is more
specific and a more appropriate specimen than
serology. IgM can be falsely negative in the first three
days of rash in primary infection.
***IgM will only be performed if clinical history of
suspected rash illness or acute infection is provided on
the requisition.
For visceral
disseminated disease of
the immunodeficient
1 – 2 mL blood in EDTA
(lavender top )tube
NAT (PCR)for VZV
Molecular
Diagnostics
Do not centrifuge. Ship on ice or cold pack within
24 hours.
Biopsy/autopsy material
in a sterile container.
NAT (PCR)
Molecular
Diagnostics
Microbiologist/Virologist On Call consult required.
Variola, Smallpox - See: Poxvirus Infections
VDRL - See: Syphilis
Venezuelan Equine Encephalitis - See: Arbovirus Infections
Vibrio – See: Diarrhea Bacterial and Cholera
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Viral Hemorrhagic Fever
Congo-Crimean hemorrhagic
fever virus
Ebola virus
Lassa fever virus
Marburg virus
Argentinian hemorrhagic fever
(Junin)
Bolivian hemorrhagic fever
(Machupo)
Other South American
hemorrhagic fever viruses
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Virology
Immediately consult the Zone Medical Officer of
Health before collecting any specimens from
patients with suspected Viral Hemorrhagic Fever.
Immediately consult the Microbiologist/Virologist On
Call before collecting samples.
Only if advised by the MOC/VOC to collect
specimens; follow this link for instructions:
http://www.albertahealthservices.ca/topics/Page10597.aspx
(Risk Group 4)
Ship as Category A.
For Dengue hemorrhagic
fever See: Arbovirus
Infections
Virus B of Monkeys - See: B Virus Infections
Visceral Larva Migrans
Toxocara species
Ascaris species
2 mL serum (red top
tube)
Serology EIA
Parasitic Serology
Serology referred to the National Reference Centre for
Parasitology, McGill University Centre for Tropical
Disease, Montreal, Quebec.
Voriconazole Levels - See: Antifungal Levels
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
VRE
Vancomycin Resistant
Enterococci
(Edmonton site only)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
Rectal Swab in plain
transport media (RTM)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
NOTES
Bacteriology
Insert the swab approximately 2-3 cm into the rectum in
adults, pediatrics as per size assessment (may lubricate
by dipping the swab in the culture media prior to
collecting the specimen).
Please write “VRE Screen” on the Microbiology
requisition.
Environmental
Microbiology
Samples must be submitted with coolant (not loose ice)
and be received at the Laboratory within 24 hours of
collection.
Warts – See: Human Papillomavirus (HPV)
Water: Bottled (Public
Health Inspector
approved) and Packaged
Ice
Packaged Ice:
Fill a 1 litre ice collection
jar provided by the
Laboratory
Presence/absence or
quantitative defined
substrate culture methods
for E. coli and total
coliforms.
Culture for HPC.
Samples also tested for the
presence of Pseudomonas
aeruginosa
Samples of bottled water and ice should be submitted
for public health monitoring on finished product only.
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.) and Health Canada
Microbiological Standards for Bottled Water and
Packaged Ice.
Bottled water (Public
Health Inspector
approved):
200 mL of water
collected in sterile
sample bottles provided
by the Laboratory
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MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Water: Distilled /
Deionized / Clinical Lab
Reagent Water (CLRW)
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
200 mL of water
collected in sterile
Culture for HPC
Environmental
Microbiology
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.) and Preparation and Testing
of Reagent Water in the Clinical Laboratory; Approved
Guideline (Current Ed.)
Samples must be submitted with coolant (not loose ice)
and be received at the Laboratory within 24 hours of
collection.
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.).
Test results conform to full requirements for
microbiological water quality outlined in the latest edition
of the Guidelines for Canadian Drinking Water Quality.
Samples must be submitted with coolant (not loose ice)
and be received at the Laboratory within 24 hours of
collection.
Instructions for sampling will be provided upon approval
of testing.
sample bottles provided
by the Laboratory
Water: Drinking
(e.g. municipal drinking
water, private homeowners
drinking water)
200 mL water collected
in sterile sample bottles
provided by the
Laboratory
Presence/absence or
quantitative defined
substrate culture methods
for E. coli and total
coliforms
Environmental
Microbiology
Water: Enteric Bacteria
Shig-toxin producing E. coli
including E. coli 0157
Campylobacter spp.
Salmonella spp.
Prior to sampling, contact
the Environmental
Microbiology Laboratory
in Edmonton (780-4078925 ext 4) to obtain
approval for testing.
Culture and molecular –
based testing methods
Environmental
Microbiology
Water: Legionella
Contact Microbiologist/
Virologist On Call at
Calgary or Edmonton to
discuss requirements for
testing.
Bacteriology
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Water: Natural
Recreation (beach)
200 mL of water
collected in sterile
sample bottles provided
by the Laboratory
Membrane filtration
method for thermotolerant
coliforms
Environmental
Microbiology
Water: Parasites and
Enteric Pathogens
(Cryptosporidium and
Giardia)
Prior to sampling, contact
the Environmental
Microbiology Laboratory
in Calgary (403-9441215 ext 5) to obtain
approval for testing.
United States
Environmental Protection
Agency (U.S. EPA) Method
1623.1
Environmental
Microbiology
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.).
Test results conform to full requirements for the
Alberta Public Health Act – Nuisance and General
Sanitation Regulation.
Samples must be submitted with coolant (not loose ice)
and be received at Laboratory within 24 hours of
collection.
Instructions for sampling will be provided upon approval
of testing.
Water: Raw
(i.e. lake, river, pond, etc.)
200 mL of water
collected in sterile
sample bottles provided
by the Laboratory
Membrane filtration
method for thermotolerant
coliforms, total coliforms,
and/or E. coli
Environmental
Microbiology
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.).
Samples must be submitted with coolant (not loose ice)
and be received at the Laboratory within 24 hours of
collection.
Water: Sewage Effluent
200 mL of water
collected in sterile
sample bottles provided
by the Laboratory
Membrane filtration
method for thermotolerant
coliforms and total
coliforms
Environmental
Microbiology
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.). Samples must be submitted
with coolant (not loose ice) and be received at the
Laboratory within 24 hours after collection.
Molecular speciation and
genotyping for human
health risk assessment.
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LABORATORY CONTACT INFORMATION
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PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Water: Swimming Pool or
Whirlpool
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
200 mL of water
collected in sterile
sample bottles provided
by the Laboratory
Presence/absence using
defined substrate culture
methods for total coliforms.
Culture for HPC. For pools
> 30ºC, water sample is
also tested for the
presence of Pseudomonas
aeruginosa.
Environmental
Microbiology
Analysis performed based on protocols described in
Standard Methods For the Examination of Water and
Wastewater (Current Ed.).
Samples must be submitted with coolant (not loose ice)
and be received at the Laboratory within 24 hours of
collection.
Weil’s Disease - See: Leptospirosis
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form.
West Nile Virus (WNV)
Infections
(Risk Group 3)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
Acute:
At least 3 mL in a 5 mL
serum separator tube
(SST) or pediatrics may
use 2 mL red top tube
AND
At least 3 mL/tube in two
4 mL EDTA (lavender
top) tubes.
WNV EIA: IgM*
Virology
*WNV IgM can still be negative during the first week of
illness and repeat serology may be advisable.
NAT (RT-PCR)**
Molecular
Diagnostics
**PCR detects approximately 50% of cases during the
first week of illness, but is rarely positive after that time.
Both WNV and enterovirus are seasonal and may
present with similar clinical picture. See: Enterovirus.
Con’t…
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
OR
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
NOTES
Enterovirus and parechovirus are tested automatically
along with all WNV PCR requests.
DO NOT spin. DO NOT freeze. Transport on ice/cold
Packs. Must be received within 48 hours of collection.
At least 3 mL/tube in two
PPT (Plasma Preparation
Tubes)
(5 mL tube).
OR
Centrifuge, DO NOT pour off, refrigerate until transport.
DO NOT freeze. Transport on ice/cold packs, must be
received within 48 hours of collection. (For outside
Calgary Zone and Edmonton Zone, PPT may be
ordered from the Laboratory)
For pediatric collection:
at least one 2 mL EDTA
(lavender top) tube.
Centrifuge, DO NOT pour off, refrigerate until transport.
DO NOT freeze. Transport on ice/cold packs, must be
received within 48 hours of collection. (For outside
Calgary Zone and Edmonton Zone, PPT may be
ordered from the Laboratory)
WNV Encephalitis:
DEDICATED CSF
sample (at least 0.5-1mL)
in a sterile container.
Convalescent:
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
NAT(RT-PCR) ***
Molecular
Diagnostics
WNV EIA: IgM, IgG
Virology
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*** West Nile Virus PCR has low sensitivity in CSF.
CSF panel tests are automatically included along with all
WNV PCR requests on CSF
If specimen can be received in the Laboratory within 24
hours of collection then ship on ice/cold packs. If
transportation might exceed 24 hours from collection
then freeze at -70°C and transport on dry ice.
Specify “Convalescent” on the requisition.
Convalescent serology is usually unnecessary if acute
IgM and blood PCR/NASBA are both negative (95%
sensitivity)
Con’t…
154
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SECTION
Transplant:
NOTES
Transplant clinics are asked to refer to Laboratory
Bulletin “ProvLab West Nile Virus Screening', dated
June 4, 2013
Western Equine Encephalitis - See: Arbovirus Infections
Whipple’s Disease - See: Tropheryma whipplei
Whipworm – (Trichuris trichuria) See: Diarrhea, Parasitic
Whooping Cough - See: Pertussis
Worm Infections
Wound Infections
Various species of aerobic
and anaerobic bacteria
Rapidly growing
Mycobacteria for example:
M. fortuitum
M.abscessus
M. chelonae
M. marimun
Entire worm, proglottids
in sterile saline in a
sterile container
Wound swab in plain
transport media (RTM)
OR Cary Blair
(anaerobic) transport
media
Identification
Parasitology
Please note: it is important that tapeworm segments are
NOT preserved when submitted for identification.
Microscopy, culture
Bacteriology
If the lesion is dry, moisten the swab before use in
sterile water or saline. DO NOT submit dry swabs.
Include site of wound, clinical details and antibiotic
usage on the requisition.
Pus in sterile screw cap
container
Pus; biopsy of involved
area in dry sterile screw
cap container
Microscopy, culture
Bacteriology
Microscopy, culture
Mycobacteriology
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Swabs are not recommended for mycobacterial
examination.
155
LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
SPECIMEN
COLLECTION
REQUIREMENTS
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
TESTS AVAILABLE
SECTION
NOTES
Syphilis Serology:
EIA, RPR, INNO-LIA
Virology
Antibodies to the treponema of yaws are
indistinguishable from those to the treponema of syphilis
by all the diagnostic tests in current use.
Serology for vaccination
response
Virology
MUST NOTIFY Zone MOH in suspected cases prior to
sample collection, who will notify ProvLab
Microbiologist/Virologist On Call if testing is indicated.
Wuchereria bancrofti – See: Filariasis
Yaws
Treponema pallidum ssp.
pertenue
Yellow Fever
(Risk Group 3)
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
5 mL serum separator
tube (SST); pediatrics
may use 2 mL red top
tube
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Testing performed at the National Microbiology
Laboratory, Winnipeg, Manitoba.
Samples for serologic and molecular testing in
suspected cases are considered Risk Group 3 and
must be shipped as Category A.
Yersiniosis
Yersinia enterocolitica
Yersinia
pseudotuberculosis
Feces in a Closed
Container
Abscess swab in plain
transport media (RTM)
Culture
Bacteriology,
Microscopy, culture
Bacteriology
Indicate request for Yersinia culture on the requisition.
See also: Diarrhea
Bacterial and
Lymphadenopathy
mesenteric.
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LABORATORY CONTACT INFORMATION
GUIDE TO SPECIMEN COLLECTION
PRIMARY INQUIRIES
MICROBIOLOGIST/VIROLOGIST ON CALL( MOC or VOC)
DISEASE / TEST /
SYNDROME
CAUSAL AGENTS
Yersinia pestis
[See: Plague]
(Risk Group 3)
Zika virus
CALGARY
EDMONTON
Ph: 403-944-1200 Fax: 403-270-2216
Ph: 780-407-7121 Fax: 780-407-3864
Ph: 403-944-1200 (ask for MOC or VOC)
Ph: 780-407-8822 (UAH Switchboard) or
780-407-7121 (Laboratory)
(ask for MOC or VOC)
SPECIMEN
COLLECTION
REQUIREMENTS
TESTS AVAILABLE
SECTION
NOTES
Excised mesenteric
lymph nodes in a sterile
container
Blood culture (see Blood
Culture, Bacteriology for
collection details)
5 mL serum separator
tube (SST) or pediatrics
may use 2 mL red top
tube
Culture
Bacteriology
Culture
Bacteriology
Contact the Microbiologist/Virologist On Call before
collecting specimens or submitting suspected Y.
pestis isolates for confirmation. Please indicate on
requisition if plague is suspected.
Serology
Serology Agglutination
Serology referred to the Public Health Ontario
Laboratories, Ontario.
Use the Zoonotic Serology Requisition when ordering.
(Posted on the ProvLab website:
www.provlab.ab.ca/requisition_history_form ).
Acute Infection –
symptom onset < 7 days
prior to testing
5 mL EDTA (lavender
top) AND 10-20 mL urine
AND 5 mL SST (Gold
top)
Onset date unknown or
>7 days before testing–
5 mL serum separator
tube (SST Gold top)
Ship as Category A: if cultures only.
Ship as Category B: if patient specimens.
RT-PCR for EDTA blood
and urine
Zika virus IgM serology for
SST
Zika virus IgM serology
Refer to the Bulletins posted on the ProvLab and AHS
websites for current advisories and laboratory testing
guidelines.
Serologic testing for asymptomatic infections is NOT
recommended due to the lack of serology assays to
determine past exposure and the significant serologic
cross-reactivity between members of the Flavivirus
genus.
Zygomycosis - See: Fungal Infections
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157
INDEX FOR GUIDE TO SPECIMEN COLLECTION
A
Acanthamoebae, 27
Acid Fast Bacilli. See Mycobacteria
Acquired Immune Deficiency Syndrome (AIDS). See
Human Immunodeficiency Virus
Actinomycosis, 27
Adenovirus Infections, 27
AFB. See Mycobacteria
AIDS. See Human Immunodeficiency Virus
Algal Toxins, 28
Amoebic Dysentery. See Diarrhea, Parasitic
Amoebic Encephalitis, Primary, 28
Amoebic Hepatitis, 29
Anaerobic Infections, 29
Anaplasma phagocytophilum, 30
Ancylostomiasis. See Hookworm Disease
Anisakiasis, 30
Anthrax, 30
Antifungal Levels, 31
Arbovirus Infections, 31
Ascariasis, 32
Aseptic meningitis, 32
Aspergillosis. See Fungal Infections
Aspergillus antigen detection, 33
Astrovirus Infections, 33
Attest ™. See Biological Indicators
B
B Virus Infection, 34
Babesiosis, 34
Bacterial Antigen Detection. See Meningitis, Bacterial
Balanitis, 34
Balantidiasis. See Diarrhea, Parasitic
Bartonella henselae, 35
Bilharziasis. See Schistosomiasis
Biological Indicators, 36
BK Virus, 36
Blastocystis, 36
Blastomycosis. See Fungal Infections, Fungal Serology
Blood Culture, Bacteriology, 37
Blood Culture, TB. See Mycobacteria
Bone Chips, 37
Bone Marrow Culture, Bacteriology, 37
Bone Marrow Culture, Mycology, 37
Bone Marrow Culture, TB. See Mycobacteria
Bone Marrow,, 38
Bordetella Infections. See Pertussis
Bornholm Disease. See Enterovirus Infections
Borrelia burgdorferi, afzelii & garinii. See Lyme disease
Borrelia hermsi, 38
Borrelia spp. See Borrelia hermsii
Borreliosis. See Lyme Disease
Botulism, 39
Brills Disease. See Rickettsial Infections
Bronchiolitis of Infants, 40
Bronchitis, 41
Brucellosis, 41
Brugia sps. See: Filariasis
Burkholderia pseudomallei. See: Melioidosis
C
Calicivirus Infections. See Diarrhea, Viral
Campylobacter. See Diarrhea Bacterial and Food-borne
Bacterial Disease Syndrome
Candidiasis. See Fungal Infections and Genital Infections
Cat Scratch Disease/Fever. See Bartonella henselae
Cervicitis. See Genital Infections
Chagas Disease. See Trypanosomiasis
Chancroid. See Genital Infections, Chancroid
Chickenpox, Varicella and Zoster (shingles). See
Varicella Zoster Virus Infections
Chikungunya virus, 43
Chinese Liver Fluke Disease. See Clonorchiasis
Chlamydial Infections, Chlamydia trachomatis, 45
Chlamydophila Infections, Chlamydia psittaci, 44
Chlamydophila pneumonia, Atypical pneumonia, 45
Cholera. See Diarrhea Bacterial/ Also See Vibrio
Clonorchiasis, 47
Clostridium Difficile Toxin. See Diarrhea Antibiotic
Associated
CMV. See Cytomegalovirus Infections
Coccidioidomycosis. See Fungal Infections
Colitis, Haemorrhagic, 48
Colorado tick fever virus, 48
Congenital Infections, 48
Congo – Crimean Hemorrhagic Fever. See: Viral
Hemorrhagic Fever
Conjunctivitis. See Eye Infections
Coronavirus Infections. See: Respiratory Infections,
Viral and Atypical Bacteria
Corynebacterium diphtheriae. See Diphtheria
Cowpox. See Poxvirus Infections
Coxiella burnetii. See Rickettsial Infections
Coxsackie Virus Infections. See Enterovirus Infections
Creutzfeldt-Jakob Disease, 52
Croup. See Bronchiolitis of Infants
Cryptococcal Antigen Detection, 52
Cryptococcus. See Fungal Infection
Cryptosporidiosis, 52
Cyclospora, 53
Cysticercosis, 53
Cytomegalovirus Infections (CMV), 53
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158
D
Dengue virus/Dengue Fever, 54
Dermatophytes, 54
Diarrhea Antibiotic Associated, 55
Diarrhea Bacterial, 56
Diarrhea Parasitic, 57
Diarrhea Viral, 58
Diphtheria, 58
Diphyllobothriasis, 59
Dirofilaria immitis. See Filariasis
Dracunculiasis, 59
Dysentery, Amoebic. See Diarrhea Parasitic
Dysentery, Bacillary. See Diarrhea Bacterial
E
E. coli. See Diarrhea Bacterial or Food-borne Bacterial
Disease/Syndrome
Ear Infections, Otitis Externa, 59
Ear infections, Otitis Media, 59
Eastern Equine Encephalitis, 60
Ebola Virus. See Viral Hemorrhagic Fever
EBV. See Epstein-Barr Virus Infections
Echinococcosis, 61
Echovirus. See Enterovirus Infections
Ectoparasites, 61
Ehrlichia chaffeensis (Human monocytic ehrilichiosis
[HME], 61
Encephalitis, Viral, 62
Endocarditis, Bacterial, 64
Entamoebae. See Diarrhea Parasitic
Enteric Fever. See Typhoid Fever
Enterobiasis - Pinworms, 64
Enterovirus Infections, 65
Epiglottitis, Acute, 67
Epstein-Barr Virus Infections, 67
Erlichiosis. See Rickettsial Infections
Erysipelas. See Streptococcal Infections
Erysipeloid, 68
Eye Infections. See Genital Infections - Gonorrhea
Eye Infections, Bacterial/ Fungal/Parasitic, 68
Eye Infections, Chlamydial, 68
Eye Infections, Viral, 69
F
Fascioliasis, 69
Fasciolopsiasis, 69
Favus. See Dermatomycosis
Fifth Disease. See Parvovirus Infections
Filariasis, 70
Flea-borne spotted fever. See Rickettsia felis
Food Poisoning Organisms. See Diarrhea Bacterial or
Food-borne Bacterial Disease/Syndrome
Food-borne Bacterial Disease/Syndrome, 71
Francisella. See Tularemia
Fungaemia, 72
Fungal Infections, 72
G
Galactomannan. See Aspergillus Antigen Detection
Gas gangrene, 29
Gas Gangrene. See Anaerobic Infections
Gastritis, 73
Gastroenteritis. See Food-borne Bacterial
Disease/Syndrome, Diarrhea-Parasitic, Diarrhea, Viral
Genital Infections - Bacterial Vaginosis, 74
Genital Infections - Candidiasis, 74
Genital Infections - Chancroid (soft chancre), 74
Genital Infections - Chlamydia, Mycoplasma &
Ureaplasma Infections, 75
Genital Infections - Gonorrhea, 75
Genital Infections - Herpes Simplex Virus, 78
Genital Infections - Trichomoniasis, 78
German Measles. See Rubella
Giardiasis, 79
Gnathosomiasis, 79
Granuloma Inguinale (venereum), 79
Guinea-Worm Disease. See Dracunculiasis
H
Haemolytic Uremic Syndrome (HUS), 79
Haemophilus ducreyii. See Genital Infections - Chancroid
Haemophilus influenzae. See Meningitis, Bacterial and
Epiglottitis
Hand-foot-and-mouth Disease. See: Enterovirus
Infections
Hantavirus, 81
Helicobacter pylori. See Gastritis
Hepatitis A Virus (Infectious Hepatitis, HAV), 81
Hepatitis B Virus (Quantitation of Surface Antigen),
83
Hepatitis B Virus (Serum Hepatitis, HBV), 82
Hepatitis B Virus (Viral Load), 83
Hepatitis C Virus (Genotyping), 85
Hepatitis C Virus (HCV), 84
Hepatitis C Virus (Viral Load), 84
Hepatitis D Virus (Delta Hepatitis, Delta Agent, HDV,
Hepatitis Delta Virus, 86
Hepatitis Delta Virus. See Hepatitis D Virus
Hepatitis E Virus (HEV), 86
Herpangina. See Enteroviruses
Herpes Simiae Virus Infections. See B Virus Infections
Herpes Simplex Virus Infections (HSV), 87
Herpes Zoster Virus. See Varicella Zoster Virus
Infections
Heterophile Negative Mononucleosis. See
Cytomegalovirus Infections
Heterophyiasis, 88
Histoplasmosis (Histoplasma capsulatum)-. See
Fungal Infections
HIV. See Human Immunodeficiency Virus
Hookworm Disease, 88
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159
HPV. See Human Papilloma Virus
HSV. See Herpes Simplex Virus Infections
HTLV I/II. See Human T-Cell Leukaemia/Lymphoma Virus
HTLV III. See Human Immunodeficiency Virus
Human granulocytic ehrlichiosis [HGE. See
Anaplasma phagocytophilum
Human granulocytic ehrlichiosis [HGE], 30
Human Herpesvirus Type 6 (HHV6), 89
Human Immunodeficiency Virus 1, 90
Human Immunodeficiency Virus 1 and 2, 91
Human Immunodeficiency Virus 1 Resistance
Testing, 92
Human Immunodeficiency Virus HIV 1 and 2, HTLV
III, LAV, AIDS, ARC, 89
Human Metapneumovirus. See: Respiratory Infections,
Viral and Atypical Bacteria
Human monocytic ehrlichiosis [HME. See Ehrlichia
chaffeensis
Human Papilloma Virus, 92
Human T Cell Leukemia/Lymphoma Virus Type I
HTLV I, Virus Type II – HTLV I, 93
Hydatid Disease. See Echinococcosis
Hymenolepiasis, 93
I
Ice. See Water: Bottled and Packaged Ice
Impetigo, 93
Infectious Mononucleosis. See Epstein-Barr Virus
Infections
Influenza, 93
Itraconazole Levels. See Antifungal Levels
J
Lyme Disease, 99
Lymphadenopathy, Mesenteric, 101
Lymphocytic Choriomeningitis, (LCM), 102
Lymphogranuloma venereum (LGV). See Chlamydial
infections, Chlamydia trachomatis
Lymphogranuloma Venereum (LGV), 46
M
Malaria, 102
Mansonella sps. See: Filariasis
Marburg Virus Disease. See: Viral Hemorrhagic Fever
Measles, 103
Melioidosis, 105
Meningitis, Bacterial, 105
Meningitis, Viral or Aseptic. See Aseptic Meningitis and
Encephalitis Viral
MERS (Middle East Respiratory Syndrome), 106
Metapneumovirus. See Respiratory Infections, Viral
and Atypical Bacteria
Metorchiasis, 107
Microsporidia, 107
Molluscum Contagiosum. See Poxvirus Infections
Mononucleosis, Infectious. See Epstein-Barr Virus
Infections
Monospot. See Epstein-Barr Virus Infections
MRSA Screen, 107
Mumps, 108
Murine Typhus. See Rickettsia typhi
Mycobacteria, 109
Mycoplasma Infections, Respiratory, 111
Mycoplasma Infections, Ureaplasma Infections,
Genital and Non-Respiratory Sites, 112
Myiasis, 113
Myocarditis/Pericarditis, Viral, 113
Jamestown Canyon virus (JCV), 94
Japanese encephalitis virus (JEV), 95
K
Kala Azar. See Leishmaniasis
Kaposi’s Varicelliform Dermatitis. See Herpes Simplex
Virus Infections
Keratomycosis. See Fungal Infections
N
Nasopharyngeal Aspirate, Viral Upper Respiratory
Infections, 114
NGU - (non-gonococcal urethritis. See Genital
Infections, Chlamydia (trachomatis), Mycoplasma
Infections
Nocardiosis, 115
Norovirus. See Diarrhea, Viral
L
Laryngitis, Viral, 96
Lassa Fever. See Viral Hemorrhagic Fever
Legionnaires Disease, 96
Leishmaniasis, Cutaneous Form, 97
Leishmaniasis, Mucocutaneous Form, 97
Leishmaniasis, Visceral Form (Kala Azar), 98
Leprosy, 98
Leptospirosis, 98
Listeriosis, 99
Loiasis. See Filariasis
Lung Abscess, 99
O
Onchocerciasis, 115
Onychomycosis. See Fungal Infections, Dermatophytes
Orchitis. See Mumps
Orf. See Poxvirus Infections
Orientia tsutsugamushi (Scrub typhus), 115
Ornithosis. See Chlamydia Infections
Osteomyelitis, Acute, 116
Ova and Parasites, 116
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160
P
Panencephalitis (subacute sclerosing) (SSPE). See
Measles
Papillomavirus. See Human Papillomavirus
Papovavirus Infections. See Human Papillomavirus ;
Progressive Multifocal Leukoencephalopathy; BK Virus
Paragonimiasis, 117
Parainfluenza Virus Infections, 117
Paralytic Illnesses, Viral, 117
Paralytic Shellfish Poisoning. See Shellfish Poisoning
Paratyphoid Fever. See Typhoid Fever
Parvovirus Infections, 118
Pediculosis, 119
Pemphigus, 119
Pericarditis, Viral). See Myocarditis/Pericarditis, Viral
Pertussis, 120
Pharyngitis, Bacterial, 120
Pharyngitis, Viral, 121
Picornavirus Infection. See Enterovirus Infections,
Rhinovirus Infections, and Hepatitis A Virus
Pinta, 121
Pinworm Disease. See Enterobiasis
PJP (Pneumocystis jiroveci pneumonia). See
Respiratory Infections, Acute Bacterial
Plague, 122
Pneumonia, Bacterial, 122
Pneumonia, Viral and Atypical Bacteria. See
Respiratory Infections, Viral and Atypical Bacteria
Poliomyelitis. See Enterovirus Infections
Pontiac Fever. See Legionnaires Disease
Post Perfusion Syndrome. See Cytomegalovirus
Infections
Powassan virus, 123
Poxvirus Infections, 123
Progressive Multifocal Leukoencephalopathy, 124
Pseudomembranous Colitis. See Diarrhea, Antibiotic
Associated
Psittacosis. See Chlamydial Infections
Puerperal Fever, 124
Pyoderma, 125
Q
Q Fever. See Coxiella burnetii
Respiratory Infections, Viral and Atypical bacteria,
128
Respiratory Syncytial Virus Infections, (RSV), 129
Rheumatic Fever, 130
Rhinovirus Infections, 130
Rickettsial Infections, 131
Ringworm. See Dermatomycosis
Roseola Infections. See Human Herpes Virus 6
Rotavirus Infections, 132
RSV. See Respiratory Syncytial Virus
Rubella, 132
Rubeola. See Measles
S
Salmonellosis. See Typhoid Fever; Diarrhea Bacterial;
Food-borne Bacterial Disease/Syndrome
Salpingitis. See Genital Infections
SARS (Severe Acute Respiratory Syndrome), 133
Scabies, 134
Scarlet Fever, Scarlatina. See Streptococcal Infections
Schistosomal Dermatitis, (Swimmer’s Itch), 134
Schistosomiasis, 134
Scrub typhus. See Orientia tsutsugamushi
Septicaemia, 135
Shellfish Poisoning, 135
Shigellosis. See Diarrhea Bacterial and Foodborne
Bacterial Disease/Syndrome
Shingles. See Varicella Zoster Virus Infections
Sinusitis, 135
Smallpox. See Poxvirus Infections
Snowshoe Haer virus, 136
Spore Strips. See Biological Indicators
Sporotrichosis. See Fungal Infections
Sputum Culture, 136
St. Louis Encephalitis. See Arbovirus Infections
Sterilization Test – see
Biological Indicators, 137
Streptococcal Infections, 137
Strongyloidiasis, 137
Subacute Sclerosing Panencephalitis (SSPE). See
Measles
Swab Test, 138
Swimmer’s Itch. See Schistosomal Dermatitis
Syphilis, 138
T
R
Rabies, 125
Rat-bite Fever (Haverhill Fever), 126
Rat-bite Fever(Sodoku), 126
Red Measles. See Measles
Reiter’s Syndrome. See Mycoplasma Infections
Relapsing Fever, Louse-borne, 127
Relapsing Fever, Tick-borne, 127
Respiratory Infections - , SARS, 129
Respiratory Infections - MERS, 129
Respiratory Infections, Acute Bacterial, 127
Taeniasis (Tape Worm). See Cysticercosis
Tape Worm. See Taeniasis
Tetanus, 139
Tick-Borne Encephalitis virus (TBEV). No testing
available
Tick-Borne Relapsing Fever. See: Borrelia hermsii
Ticks, 139
Tinea Versicolor(Malassezia furfur), Tinea corporis,
Tinea cruris. See Fungal Infections, (Dermatophytes)
TORCH. See Congenital Infections
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Toxic Shock Syndrome (TSS), 140
Toxic Shock-like Syndrome (TSLS), 140
Toxocariasis, 141
Toxoplasmosis, 141
Trace Metal Testing, Water, 141
Trachoma. See Chlamydial Infections
Treponematoses. See Pinta and Syphilis
Trichinosis (Trichinellosis), 142
Trichomoniasis. See Genital Infections
Trichostrongyliasis, 142
Trichuriasis, 142
Tropheryma whipplei, 142
Trypanosmiasis, 143
Tuberculosis. See Mycobacteria
Tuberculosis – Latent Infection, 144
Tularemia, 144
Typhoid Fever, Paratyphoid Fever, Enteric Fever,
145
Typhus Fever. See Rickettsial Infections
Tzank Smear. See Herpes Simplex Virus Infections
U
Undulant Fever. See Brucellosis
Ureaplasma. See Mycoplasma/Ureaplasma Infections
Urethritis. See Genital Infections
Urinary Tract Infections, 146
Visceral Larva Migrans, 149
Voriconazole Levels. See Antifungal Levels
VRE Vancomycin Resisitant Enterococci, 150
W
Warts. See Human Papillomavirus (HPV)
Water
Bottled and Packaged Ice, 150
Distilled / Deionized / Clinical Lab Reagent Water
(CLRW), 151
Drinking, 151
Legionella, 151
Natural Recreation (beach), 152
Parasites and Enteric Bacteria, 152
Raw, 152
Sewage Effluent, 152
Swimming Pool or Whirlpool, 153
Weil’s Disease. See Leptospirosis
West Nile Virus (WNV) Infections, 153
Western Equine Encephalitis. See Arbovirus Infections
Whipple’s Disease. See Tropheryma whipplei
Whipworm. See Diarrhea, Parasitic
Whooping Cough. See Pertussis
Worm Infections, 155
Wound Infections, 155
Wuchereria bancrofti. See: Filariasis
V
Vaccinia. See Poxvirus Infections
Vaginitis. See Genital Infections
Valley Fever. See Fungal Infections
Varicella Zoster Virus Infections, 147
Variola, Smallpox. See Poxvirus Infections
VDRL. See Syphilis
Venezuelan Equine Encephalitis. See Arbovirus
Infections
Vibrio. See Diarrhea Bacteria and Cholera
Viral Hemorrhagic Fever, 149
Virus B of Monkeys. See B Virus Infections
Y
Yaws, 156
Yellow Fever, 156
Yersinia pestis, 157
Yersiniosis, 156
Z
Zika virus, 157
Zygomycosis. See Fungal Infections
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