Patients with mild clinical disease should not be tested as a routine
Laboratory testing for pandemic (H1N1) 2009 to assist with clinical management is indicated for those who meet the case definition and are:
symptomatic patients with moderate to severe disease
symptomatic patients in a group vulnerable to severe outcomes (see list above)
Laboratory testing for public health surveillance may be done for:
cases in areas where the disease is newly introduced, to allow control measures to be instituted if appropriate
representative samples of acute respiratory illness (ARI) cases from existing sentinel surveillance systems
in outbreaks in ‘closed’ environments where individuals are at increased risk fro severe influenza. The number of patients needing testing to determine the cause of an outbreak is generally low (this will depend on the clinical situation, but five or less samples should suffice).
They should be tested for respiratory viruses using nose and throat swabs, with the staff performing the test wearing personal protective equipment (PPE). This should include surgical mask, eye protection, and disposable gloves + disposable gown.
Nasopharyngeal aspirates are not recommended unless the specimen can be collected safely in a controlled clinical setting.
Specimens should be tested for H1N1 09 and/or influenza A. Any test positive for influenza A by PCR (or other methods) should be subtyped and specific PCR H1N1 09 tests conducted.
Blood, rather than swabs, should be collected for future serologic testing for suspect cases where presentation is more than 7 days after onset, and may also be collected at the same time as swabs are collected in other cases, depending on circumstances.
