Form 0920-0978 FluSurv-NET Laboratory Survey 2019-2020 Season

Testing Facility Name:

Testing Facility ID (FluSurv-NET use only):

Name of person completing form:

Date:

FluSurv-NET Laboratory Survey 2019–2020 Season

Form Approved
OMB No. 0920-0978

Survey Introduction
Administer this survey to labs that serve FluSurv-NET hospitals. The questions in this survey refer to diagnostic testing ordered by healthcare
providers for routine clinical care of hospitalized and emergency department (ED) patients only. All questions relate to testing performed on-site
within the lab facility unless otherwise specified. If a FluSurv-NET hospital lab sends specimens to one or more labs (other than commercial or state
public health labs) for clinical influenza or RSV testing, please have each lab complete this survey.
• Do NOT administer this survey to commercial labs or to state public health labs
• Do NOT administer this survey to labs that are not affiliated with FluSurv-NET hospitals
• Do NOT include information on testing for the purposes of EIP influenza or RSV surveillance
• Do NOT include information on testing for outpatients
This survey should take 5-10 minutes to complete. Thank you for your time!
Common Abbreviations: RT-PCR=Reverse Transcriptase PCR, NAAT=Nucleic acid amplification test, RVP=Respiratory Viral Panel

Question
1. What is the role of the person completing this survey?
Laboratory staff at testing facility

FluSurv-NET staff

2. Please select the choice which best describes the laboratory type: (select one)
Hospital (private/public/community) laboratory

County public health laboratory

Federal government (military, IHS, Veteran’s Affairs) hospital laboratory

Other (specify):

University/medical school hospital laboratory

Influenza
3. Does the laboratory perform diagnostic testing for influenza on-site?
Yes  Answer question 4

No  Skip to question 9

4. Does the laboratory perform rapid influenza antigen diagnostic test (rapid test, RIDT)?
Yes, pediatric patients only  Answer questions 4a-4b
Yes, adult patients only  Answer questions 4a-4b

No, we confirm RIDT tests performed elsewhere in the hospital
(such as ED)  Skip to question 5

Yes, pediatric and adult patients  Answer questions 4a-4b

No  Skip to question 5

4a. Select the kit name(s) (manufacturer) for the rapid influenza antigen diagnostic test(s) performed at the laboratory: (Check all that apply)
(https://www.cdc.gov/flu/professionals/diagnosis/table-ridt.html)
BD Veritor™ System for Rapid Detection of Flu A+B (CLIA-waived),
(Becton Dickinson & Co.)

QuickVue® Influenza A+B Test (Quidel Corp.)

BD Veritor™ System for Rapid Detection of Flu A+B (Moderately Complex),
(Becton Dickinson & Co.)

Sofia® Analyzer and Influenza A+B FIA (Quidel Corp.)

Sofia® Analyzer and Influenza A+B FIA (CLIA-waived) (Quidel Corp.)

Binax NOW® Influenza A&B Card 2 (Abbott)
BioSign® Flu A+B or OraSure QuickFlu Rapid A+B Test or Polymedco Poly stat
Flu A&B Test or LifeSign LLC Status Flu A&B (Princeton BioMedtech Corp.)

XPECT™ Influenza A/B (Remel Inc./Thermo Fisher Scientific)
Other, specify:

4b. If more than one kit is selected above, please select the one kit that is (or will be) used most frequently for rapid influenza diagnostic testing at the
laboratory during the current influenza season:
BD Veritor™ System for Rapid Detection of Flu A+B (CLIA-waived),
(Becton Dickinson & Co.)

QuickVue® Influenza A+B Test (Quidel Corp.)

BD Veritor™ System for Rapid Detection of Flu A+B (Moderately Complex),
(Becton Dickinson & Co.)

Sofia® Analyzer and Influenza A+B FIA (Quidel Corp.)

Sofia® Analyzer and Influenza A+B FIA (CLIA-waived) (Quidel Corp.)

Binax NOW® Influenza A&B Card 2 (Abbott)
BioSign® Flu A+B or OraSure QuickFlu Rapid A+B Test or Polymedco Poly stat
Flu A&B Test or LifeSign LLC Status Flu A&B (Princeton BioMedtech Corp.)

XPECT™ Influenza A/B (Remel Inc./Thermo Fisher Scientific)
Other, specify:

5. Does the laboratory perform molecular assays (including rapid molecular, RT-PCR, RVPs) for influenza?
Yes  Answer questions 5a-5c

No  Skip to question 6

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/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30329; ATTN: PRA (0920-0978).

Revised 06/2019

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5a. Select kit name(s) (manufacturer) for all molecular assays performed at the laboratory: (Check all that apply)
(https://www.cdc.gov/flu/professionals/diagnosis/table-nucleic-acid-detection.html)
ID Now™ Influenza A&B (CLIA Waived), (Abbott)†
Accula Flu A/Flu B (Mesa Biotech,

FilmArray® Respiratory Panel, EZ (BioFire Diagnostics, LLC)*

Inc.)†

Idylla Respiratory IFV-RSV Panel, (Biocartis)*

ARIES® Flu A/B & RSV Assay, (Luminex)

IMDx Flu A/B and RSV for Abbott m2000, (IMDx)

CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel (Influenza

Lyra Influenza A+B Assay, (Quidel)

A/B Typing Kit4), (CDC Influenza Division)

Nx-TAG Respiratory Pathogen Panel, (Luminex Molecular Diagnostics Inc)*

CDC Human Influenza Virus Real-Time RT-PCR Detection and

Panther Fusion® Flu A/B RSV, (Assay Hologic)

Characterization Panel, (CDC Influenza Division)

Prodesse PROFLU™, (GenProbe/Hologic)

CDC Influenza A/H5 (Asian Lineage) Virus Real-Time RT-PCR Primer and
Probe Set, (CDC Influenza Division)

Prodesse ProFAST™, (GenProbe/Hologic)*
Silaris Infuenza A & Btg, (Sekisui Diagnostic)†

CDC Influenza 2009 A(H1N1)pdm Real-Time RT-PCR Panel,

Solana Influenza A+B Assay, (Quidel)

(CDC Influenza Division)

Simplexa™ Flu A/B & RSV, (Focus Diagnostics, 3M)

Cepheid Xpert Flu Assay, (Cepheid)

Simplexa™ Flu A/B & RSV Direct, (Focus Diagnostics, 3M)

Cepheid Xpert Flu/RSV XC Assay, (Cepheid)

Simplexa™ Influenza A H1N1 (2009), (Focus Diagnostics, 3M)

Cepheid Xpert Express Flu Assay, (Cepheid)

Verigene® Respiratory Virus Nucleic Acid Test, (Nanosphere, Inc)

Cepheid Xpert Express Flu/RSV Assay, (Cepheid)

Verigene® Respiratory Virus Plus Nucleic Acid Test (RV+), (Luminex)

Cobas Liat Influenza A/B, (Roche Diagnostics)†

Verigene® Respiratory Pathogen Nucleic Acid Test (RP Flex)*, (Luminex)

Cobas Liat Influenza A/B & RSV, (Roche Diagnostics)†

x-TAG® Respiratory Viral Panel Fast (RVP FAST)*,

ePlex Respiratory Pathogen Panel (GenMark Diagnostices)*
eSensor® Respiratory Viral Panel (RVP), (GenMark Diagnostics)*

(Luminex Molecular Diagnostics Inc)
In-house developed PCR assay

FilmArray Respiratory Panel, (BioFire Diagnostics, LLC)*
®

Other, specify:
†

= Rapid Molecular

*= can detect subtype

5b. If more than one kit is selected above, please select the one kit that is (or will be) used most frequently for molecular assay at the laboratory during
the current influenza season:
ID Now™ Influenza A&B (CLIA Waived), (Abbott)†

FilmArray® Respiratory Panel, EZ (BioFire Diagnostics, LLC)*

Accula Flu A/Flu B (Mesa Biotech, Inc.)†

Idylla Respiratory IFV-RSV Panel, (Biocartis)*

ARIES® Flu A/B & RSV Assay, (Luminex)

IMDx Flu A/B and RSV for Abbott m2000, (IMDx)

CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel (Influenza

Lyra Influenza A+B Assay, (Quidel)

A/B Typing Kit4), (CDC Influenza Division)

Nx-TAG Respiratory Pathogen Panel, (Luminex Molecular Diagnostics Inc)*

CDC Human Influenza Virus Real-Time RT-PCR Detection and

Panther Fusion® Flu A/B RSV, (Assay Hologic)

Characterization Panel, (CDC Influenza Division)

Prodesse PROFLU™, (GenProbe/Hologic)

CDC Influenza A/H5 (Asian Lineage) Virus Real-Time RT-PCR Primer and
Probe Set, (CDC Influenza Division)

Prodesse ProFAST™, (GenProbe/Hologic)*
Silaris Infuenza A & Btg, (Sekisui Diagnostic)†

CDC Influenza 2009 A(H1N1)pdm Real-Time RT-PCR Panel,

Solana Influenza A+B Assay, (Quidel)

(CDC Influenza Division)

Simplexa™ Flu A/B & RSV, (Focus Diagnostics, 3M)

Cepheid Xpert Flu Assay, (Cepheid)

Simplexa™ Flu A/B & RSV Direct, (Focus Diagnostics, 3M)

Cepheid Xpert Flu/RSV XC Assay, (Cepheid)

Simplexa™ Influenza A H1N1 (2009), (Focus Diagnostics, 3M)

Cepheid Xpert Express Flu Assay, (Cepheid)

Verigene® Respiratory Virus Nucleic Acid Test, (Nanosphere, Inc)

Cepheid Xpert Express Flu/RSV Assay, (Cepheid)

Verigene® Respiratory Virus Plus Nucleic Acid Test (RV+), (Luminex)

Cobas Liat Influenza A/B, (Roche Diagnostics)†

Verigene® Respiratory Pathogen Nucleic Acid Test (RP Flex)*, (Luminex)

Cobas Liat Influenza A/B & RSV, (Roche Diagnostics)†

x-TAG® Respiratory Viral Panel Fast (RVP FAST)*,

ePlex Respiratory Pathogen Panel (GenMark Diagnostices)*
eSensor® Respiratory Viral Panel (RVP), (GenMark Diagnostics)*

(Luminex Molecular Diagnostics Inc)
In-house developed PCR assay

FilmArray Respiratory Panel, (BioFire Diagnostics, LLC)*
®

Other, specify:
†

= Rapid Molecular

*= can detect subtype

5c. Does the laboratory perform influenza A subtyping?
Yes  Answer questions 5d

No  Skip to question 6

5d. What testing kit does the testing facility use (or will it use) most often to perform influenza A sub-typing during the current influenza season?
(Select one)
Verigene® Respiratory Pathogen Nucleic Acid Test (RP Flex),
(Nanosphere, Inc)

ePlex Respiratory Pathogen Panel (GenMark Diagnostics)
eSensor® Respiratory Viral Panel (RVP), (GenMark Diagnostics)

x-TAG® Respiratory Viral Panel Fast (RVP FAST),
(Luminex Molecular Diagnostics Inc)

FilmArray Respiratory Panel, (BioFire Diagnostics, LLC)
Idylla Respiratory IFV-RSV Panel, (Biocartis)
Nx-TAG Respiratory Pathogen Panel (Luminex Molecular Diagnostics Inc)
Prodesse ProFAST™, (GenProbe/Hologic)

FluSurv-NET Laboratory Survey 2018–2019 Season

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In-house developed PCR assay
Other, specify:

6. Does the laboratory perform any of the following additional tests to detect influenza (other than RT-PCR or RIDT)? (Check all that apply)
Viral culture

Serology (IgG or IgM)

Indirect fluorescent antibody (IFA) stain

No

Direct fluorescent antibody (DFA) stain
7a. Which influenza test method does the laboratory perform most frequently for pediatric patients (aged 0-17 years)? (Select one)
Standard Molecular assay (e.g. RT-PCR, NAAT) – singleplex or duplex

Viral culture
Indirect fluorescent antibody (IFA)/direct fluorescent antibody stain (DFA)

Standard Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory
viral panel (RVP)
Not applicable (no pediatric testing)

Rapid influenza diagnostic test (rapid test, RIDT)
Rapid Molecular assay – singleplex or dualplex†

=Rapid Molecular assays include following kits: IDNow™, Cobas® Liat Influenza A/B Assay, Cobas® Liat Influenza A/B & RSV Assay, Accula Flu A/Flu B, Silaris Influenza A&B

†

7b. Which influenza test method does the laboratory perform most frequently for adult patients (aged ≥18 years)? (Select one)
Viral culture

Standard Molecular assay (e.g. RT-PCR, NAAT) – singleplex or duplex

Indirect fluorescent antibody (IFA)/direct fluorescent antibody stain (DFA)
Rapid influenza diagnostic test (rapid test, RIDT)

Standard Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory
viral panel (RVP)

Rapid Molecular assay – singleplex or duplex†

Not applicable (no adult testing)

=Rapid Molecular assays include the following kits: IDNow™, Cobas® Liat Influenza A/B Assay, Cobas® Liat Influenza A/B & RSV Assay, Accula Flu A/Flu B, Silaris Influenza A&B

†

8. Based on tests that were performed during the 2018-2019 influenza season, approximately what percent of the time are each of these test types used
to test for flu overall? (Answers should add to 100%)
% Viral culture
% Indirect fluorescent antibody stain (IFA)/direct fluorescent antibody stain (DFA)
% Rapid influenza diagnostic test (rapid test, RIDT)
% Rapid Molecular assay – singleplex or dualplex†
% Standard Molecular assay (e.g. RT-PCR, NAAT) – singleplex or dualplex
% Standard Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory viral panel (RVP)
=Rapid Molecular assays include, but is not limited to the following kits: IDNow™, Cobas® Liat Influenza A/B Assay, Cobas® Liat Influenza A/B & RSV Assay, Silaris Influenza A&B

†

9. Does the lab send specimens to other labs for clinical testing of influenza:
Yes  Answer question 9a

No  Skip to question 10

9a. Select all that apply:
Commercial lab(s): List names of all labs:
Public Health lab(s): List names of all labs:
Other lab(s): List names of all labs:
10. Laboratory comments:

RSV
Question
11. Does the laboratory perform diagnostic testing for RSV on-site?
Yes  Answer question 12

No  Answer question 11a

11a. What are the reasons that the laboratory does not perform testing for RSV? (Select all that apply) (Then skip to Question 20)
Cost prohibitive

Inadequate staffing (not enough staff or lack of staff training)

Send out to another laboratory

Other (specify):

12. Does the laboratory perform rapid antigen detection tests (RADT)† for RSV?
Yes, pediatric patients only  Answer questions 12a-12b

Yes, pediatric and adult patients  Answer questions 12a-12b

Yes, adult patients only  Answer questions 12a-12b

No  Skip to question 13

†

=Rapid antigen detection tests includes, but is not limited to the following kits: BinaxNOW RSV Card, Clearview RSV, Quick Vue RSV Test, Sofia RSV F/A, Directigen EZ RSV Kit,
TRU RSV Kit, RAMP Rapid Detection RSV Test Kit, SAS RSV Alert, Xpect RSV Test, BD Veritor System for Rapid Detection of RSV.

12a. Select the kit name(s) (manufacturer) for the RSV rapid antigen detection test(s) performed at the laboratory: (Check all that apply)
BinaxNOW® RSV Card (Abott)

RAMP™ Rapid Detection RSV Test Kit (Response Biomedical Corp.)

Clearview® RSV (Alere Scarborough, Inc.)

SAS™ RSVAlert (SA Scientific, Inc.)

QuickVue RSV Test (Quidel Corp.)

Xpect™ RSV Test (Remel Inc./Thermo Fisher Scientific)

Sofia RSV FIA (Quidel Corp.)

BD Veritor System for Rapid Detection of RSV (Becton-Dickinson & Co.)

Directigen™ EZ RSV Kit (Becton-Dickinson & Co.)

Other, specify:

TRU RSV® Kit (Meridian Bioscience, Inc.)
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12b. If more than one kit is selected above, please select the one kit that is (or will be) used most frequently for RSV rapid antigen detection testing at the
laboratory during the current RSV season: (Select one)
BinaxNOW® RSV Card (Abott)

RAMP™ Rapid Detection RSV Test Kit (Response Biomedical Corp.)

Clearview® RSV (Alere Scarborough, Inc.)

SAS™ RSVAlert (SA Scientific, Inc.)

QuickVue RSV Test (Quidel Corp.)

Xpect™ RSV Test (Remel Inc./Thermo F+isher Scientific)

Sofia RSV FIA (Quidel Corp.)

BD Veritor System for Rapid Detection of RSV (Becton-Dickinson & Co.)

Directigen™ EZ RSV Kit (Becton-Dickinson & Co.)

Other, specify:

TRU RSV® Kit (Meridian Bioscience, Inc.)
13. Does the laboratory perform molecular assays (e.g., RT-PCR) for RSV?
Yes, pediatric patients only  Answer questions 13a-13b

Yes, pediatric and adult patients  Answer questions 13a-13b

Yes, adult patients only  Answer questions 13a-13b

No  Skip to question 14

13a. Select kit name(s) (manufacturer) for all molecular assays used at the laboratory: (Select all that apply)
ARIES® Flu A/B & RSV Assay (Luminex)

Simplexa™ Flu A/B & RSV (Focus Diagnostics, 3M)

Alere™ i RSV (Alere)

Simplexa™ Flu A/B & RSV Direct (Focus Diagnostics, 3M)

Cepheid Xpert Flu/RSV XC Assay (Cepheid)

Verigene® Respiratory Virus Nucleic Acid Test (Luminex)

Cepheid Xpert Xpress Flu/RSV Assay (Cepheid)

Verigene® Respiratory Virus Plus Nucleic Acid Test (RV+) (Luminex)

Cobas® Liat® Influenza A/B and RSV Assay (Roche Molecular Systems, Inc.)

Verigene® Respiratory Pathogen Nucleic Acid Test (RP Flex)
(Luminex)

eSensor® Respiratory Viral Panel (RVP) (GenMark Diagnostics)

x-TAG® Respiratory Viral Panel Fast (RVP FAST)
(Luminex Molecular Diagnostics Inc)

FilmArray Respiratory Panel (BioFire Diagnostics LLC)
FilmArray Respiratory Panel EZ (BioFire Diagnostics LLC)

In-house developed PCR assay

IMDx Flu A/B and RSV for Abbott m2000 (IMDx)

CDC Respiratory Syncytial Virus Real-Time RT-PCR Assay

Prodesse PROFLU™+ (GenProbe/Hologic)

Other, specify:

13b. If more than one kit is selected above, please select the one kit that is (or will be) used most frequently for molecular assays at the laboratory during
the current RSV season: (Select one)
ARIES® Flu A/B & RSV Assay (Luminex)

Simplexa™ Flu A/B & RSV (Focus Diagnostics, 3M)

Alere™ i RSV (Alere)

Simplexa™ Flu A/B & RSV Direct (Focus Diagnostics, 3M)

Cepheid Xpert Flu/RSV XC Assay (Cepheid)

Verigene® Respiratory Virus Nucleic Acid Test (Luminex)

Cepheid Xpert Xpress Flu/RSV Assay (Cepheid)

Verigene® Respiratory Virus Plus Nucleic Acid Test (RV+) (Luminex)

Cobas® Liat® Influenza A/B and RSV Assay (Roche Molecular Systems, Inc.)

Verigene® Respiratory Pathogen Nucleic Acid Test (RP Flex)
(Luminex)

eSensor® Respiratory Viral Panel (RVP) (GenMark Diagnostics)

x-TAG® Respiratory Viral Panel Fast (RVP FAST)
(Luminex Molecular Diagnostics Inc)

FilmArray Respiratory Panel (BioFire Diagnostics LLC)
FilmArray Respiratory Panel EZ (BioFire Diagnostics LLC)

In-house developed PCR assay

IMDx Flu A/B and RSV for Abbott m2000 (IMDx)

CDC Respiratory Syncytial Virus Real-Time RT-PCR Assay

Prodesse PROFLU™+ (GenProbe/Hologic)

Other, specify:

14. Does the laboratory perform any of these additional tests to detect RSV (apart from rapid antigen detection tests and molecular assays) for pediatric
patients (aged 0–17 years)? (Select all that apply)
Viral culture

Serology (IgG or IgM)

Indirect fluorescent antibody (IFA) stain

No

Direct fluorescent antibody (DFA) stain

Not applicable (no pediatric testing)

15. Does the laboratory perform any of these additional tests to detect RSV (apart from rapid antigen detection tests and molecular assays) for adult
patients (aged ≥ 18 years)? (Select all that apply)
Viral culture

Serology (IgG or IgM)

Indirect fluorescent antibody (IFA) stain

No

Direct fluorescent antibody (DFA) stain

Not applicable (no adult testing)

16. Which RSV test method does the laboratory perform most frequently for pediatric patients (aged 0–17 years)? (Select one)
Viral culture

Molecular assay (e.g. RT-PCR, NAAT) – singleplex (RSV only)

Indirect fluorescent antibody stain (IFA)/direct fluorescent antibody stain (DFA)

Molecular assay (e.g. RT-PCR, NAAT) – dualplex (RSV/influenza)

Serology (IgG or IgM)

Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory viral panel (RVP)

Rapid antigen detection test (rapid test, RADT)†

Not applicable (no pediatric testing)

†=

Rapid antigen detection tests includes, but is not limited to the following kits: BinaxNOW RSV Card, Clearview RSV, Quick Vue RSV Test, Sofia RSV F/A, Directigen EZ RSV Kit,
TRU RSV Kit, RAMP Rapid Detection RSV Test Kit, SAS RSV Alert, Xpect RSV Test, BD Veritor System for Rapid Detection of RSV.

17. Which RSV test method does the laboratory perform most frequently for adult patients (aged ≥ 18 years)? (Select one)
Viral culture

Molecular assay (e.g. RT-PCR, NAAT) – singleplex (RSV only)

Indirect fluorescent antibody stain (IFA)/direct fluorescent antibody stain (DFA)

Molecular assay (e.g. RT-PCR, NAAT) – dualplex (RSV/influenza)

Serology (IgG or IgM)

Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory viral panel (RVP)

Rapid antigen detection test (rapid test, RADT)†

Not applicable (no adult testing)

†=

Rapid antigen detection tests includes, but is not limited to the following kits: BinaxNOW RSV Card, Clearview RSV, Quick Vue RSV Test, Sofia RSV F/A, Directigen EZ RSV Kit,
TRU RSV Kit, RAMP Rapid Detection RSV Test Kit, SAS RSV Alert, Xpect RSV Test, BD Veritor System for Rapid Detection of RSV.
FluSurv-NET Laboratory Survey 2018–2019 Season

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18. Based on tests that were performed during the 2018-2019 RSV season, approximately what percent of the time are each of these test types used to
test for RSV in pediatric patients (aged 0–17) years? (Answers should add to 100%)
% Viral culture
% Indirect fluorescent antibody stain (IFA)/direct fluorescent antibody stain (DFA)
% Serology (IgG or IgM)
% Rapid antigen detection test (rapid test, RADT)†
% Molecular assay (e.g. RT-PCR, NAAT) – singleplex (RSV only)
% Molecular assay (e.g. RT-PCR, NAAT) – dualplex (RSV/influenza)
% Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory viral panel (RVP)
Not applicable (no pediatric testing)
†=

Rapid antigen detection tests includes, but is not limited to the following kits: BinaxNOW RSV Card, Clearview RSV, Quick Vue RSV Test, Sofia RSV F/A, Directigen EZ RSV Kit,
TRU RSV Kit, RAMP Rapid Detection RSV Test Kit, SAS RSV Alert, Xpect RSV Test, BD Veritor System for Rapid Detection of RSV.

19. Based on tests that were performed during the 2018-2019 RSV season, approximately what percent of the time are each of these test types used to
test for RSV in adult patients (aged ≥ 18 years)? (Answers should add to 100%)
% Viral culture
% Indirect fluorescent antibody stain (IFA)/direct fluorescent antibody stain (DFA)
% Serology (IgG or IgM)
% Rapid antigen detection test (rapid test, RADT)†
% Molecular assay (e.g. RT-PCR, NAAT) – singleplex (RSV only)
% Molecular assay (e.g. RT-PCR, NAAT) – dualplex (RSV/influenza)
% Molecular assay (e.g. RT-PCR, NAAT) – multiplex/respiratory viral panel (RVP)
Not applicable (no adult testing)
†=

Rapid antigen detection tests includes, but is not limited to the following kits: BinaxNOW RSV Card, Clearview RSV, Quick Vue RSV Test, Sofia RSV F/A, Directigen EZ RSV Kit,
TRU RSV Kit, RAMP Rapid Detection RSV Test Kit, SAS RSV Alert, Xpect RSV Test, BD Veritor System for Rapid Detection of RSV.

20. Does the lab send specimens to other labs for clinical testing of RSV:
Yes  Answer question 20a

No  Skip to question 21

20a. Select all that apply:
Commercial lab(s): List names of all labs:
Public Health lab(s): List names of all labs:
Other lab(s): List names of all labs:
21. Laboratory comments:

FluSurv-NET site use only
22. List all in - catchment FluSurv-NET hospital IDs (hosp_TX) associated with this testing facility.
Hospital ID 1 (Required):

Hospital ID 6:

Hospital ID 2:

Hospital ID 7:

Hospital ID 3:

Hospital ID 8:

Hospital ID 4:

Hospital ID 9:

Hospital ID 5:

Hospital ID 10:

(Do not include names - CDC receives this info)

End of survey. Thank you for participating in this survey!

Revised 06/2019

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