U.S. WHO Influenza Collaborating Laboratories
Address Update and Testing/Reporting Methods Assessment
Name: ________________________________Title:____________________________
Address Update
Please supply the following contact information for your laboratory.
Lab ID #: 83 Contact Name: ______________________________________________
Institution: ___________________________________________________________________
Department: ___________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________________________
City: __________________________________ State: _________ Zip: ____________________
E-mail address: _________________________________________________________________
Phone number: ___________________________ Fax number: __________________________
Influenza Testing Methods
What type of influenza testing does your lab perform? Check all that apply AND indicate method used most frequently by circling.
Antigen detection from original clinical material
Culture
PCR
Other, please specify: ______________
_________________________________
If your lab is culturing virus, how is the virus type identified?
HAI
Using WHO kit reagents? Yes No
Fluorescent antibody test
Using WHO kit reagents? Yes No
Using commercially available reagents?
Yes No
PCR
Other, please specify: ______________
_________________________________
Does your lab subtype influenza A viruses?
Yes (approximate percentage of isolates subtyped ________)
No
4. If your lab subtypes influenza A viruses, which method is used?
HAI
Using WHO kit reagents? Yes No
Fluorescent antibody test
Using WHO kit reagents? Yes No
PCR
Other, please specify: ____________ ______________________________
5. If your lab does not routinely subtype influenza A viruses, why not?
Lack of staff
Lack of resources (other than staff)
Not a lab priority
Other, please specify: ______________
_________________________________
What determines if an isolate is subtyped?
Characteristics of the patient (i.e., age, immune status etc.)
Time of influenza season (i.e., early, peak)
Extenuating Circumstances (i.e., work load of lab, part of an outbreak, etc.)
All influenza A viruses are subtyped
Other, please specify:________________
How confident are you that your lab would recognize an unusual subtype of influenza A?
Very confident
Somewhat confident
Not at all confident
Does your lab conduct year-round influenza surveillance?
Yes
No
If your lab does not conduct year round surveillance, why not?
Lack of necessary personnel
Lack of necessary supplies
No requests submitted
Other, please specify: __________
_____________________________
10. What is the highest bio-safety level available at your lab?
BSL 2
BSL 3
BSL 3+
11. What best describes the origin of specimens your lab receives? Please rank order the following sources from 1 (source from which you obtain the most specimens) to 6 (source from which you receive the least specimens).
____ Sentinel surveillance sites
____ Local health departments
____ Managed care
____ Private physicians
____ Hospitals
____ Other, please specify: ______________
________________________________
12. During which weekly reporting period does your lab report specimens tested to CDC?
Week the specimen was collected
Week specimen was received
Week test result was determined
Other, please specify: ________ ___________________________
13. During which weekly reporting period does your lab report isolates (positive) to CDC?
Week the specimen was collected
Week specimen was received
Week test result was determined
Other, please specify: ___________ ______________________________
14. Does your lab report positive isolates during the same weekly reporting period as the corresponding specimen (are the positives reported for a given week a subset of the reported specimens tested for that same week)?
Yes
No
15. Does your lab maintain a computerized database of specimens received and tested?
Yes
No
16. Does your lab report influenza surveillance data to CDC electronically (PHLIS)?
Yes
No
a. If no, why not: ____________________
________________________________
________________________________
17. If an Internet data entry site for influenza surveillance were created, would your lab use it to report influenza surveillance?
Yes
No, because: ______________________
______________________________
______________________________
CDC 55.31A 9-95 Public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC, Reports Clearance Officer, 1600 Clifton Rd., MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0004).
Please fax completed survey to 1-888-232-1322 by October 18, 2002.
File Type | application/msword |
File Title | Influenza Testing Methods |
Author | azz0 |
Last Modified By | zre2 |
File Modified | 2006-10-25 |
File Created | 2006-10-25 |