Influenza Annual Survey

U.S. WHO Influenza Collaborating Laboratories

Testing Methods Assessment

Lab Name:

Lab ID Number:

1. What types of samples does your lab receive for influenza virus testing and what is the relative proportion of each? Please exclude proficiency testing samples. (check all that apply and give the approximate percent for each type checked)

• Original patient specimens _____ %

• Viral isolates _____ %

• Other _____ %

Specify: _________________________

2. What influenza testing methods does your lab offer? (check all that apply)

   • Commercial rapid diagnostic

   • Viral culture

   • Immunofluorescent antibody testing

• RT-PCR

• Other

Specify: _________________________

3. 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

Specify: _________________________

4. Approximately what proportion of the test results you report to CDC are obtained using PCR?

   • None

   • 1-24%

   • 25-29%

   • 50-74%

   • 75-99%

   • All

5. Is your laboratory currently testing all specimens for both influenza A and B viruses?

   • Yes, all specimens are tested for both influenza A and B

   • No, we are testing only for influenza A

   • All specimens are tested for influenza A and only influenza A negative samples are tested for influenza B

   • Other

Specify: _________________________

6. Are you fully subtyping all influenza A viruses identified by your laboratory?

   • Yes, we are subytping all influenza A viruses to identify both 2009 influenza A (H1N1) and seasonal influenza A viruses.

   • No, we identify only 2009 influenza A (H1N1) but don’t further subtype those which are influenza A positive.

   • No, we identify 2009 influenza A (H1N1) and test only a subset of influenza A positive and 2009 influenza A (H1N1) negative viruses for seasonal influenza subtypes

   • No, we attempt subtyping on only a subset of influenza A viruses.

   • No, we are not currently subtyping any influenza A viruses.

   • Other

Specify: _________________________

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