Test ID RSVQL Respiratory Syncytial Virus, RNA, Qualitative Detection, Varies
Ordering Guidance
Due to the nonspecific clinical presentation of COVID-19, influenza A, influenza B, and respiratory syncytial virus infection during the early stages of flu-like illness, concurrent testing for these 4 respiratory tract viral pathogens may be warranted.
For the most up-to-date testing recommendations, visit:
www.cdc.gov/coronavirus/2019-ncov/index.html
www.cdc.gov/flu/professionals/diagnosis/index.htm
www.cdc.gov/rsv/clinical/index.html#lab
Shipping Instructions
Ship specimens refrigerated (if less than 72 hours from collection to arrive at Mayo Clinic Laboratories [MCL]) or frozen (if greater or equal to 72 hours from collection to arrive at MCL).
Specimen Required
Specimen Type: Nasopharyngeal (NP), oropharyngeal (OP ie, throat), nasal mid-turbinate, or nares/nasal swab
Supplies:
-Swab, Sterile Polyester, 10 per package (T507)
-Dacron-tipped swab with plastic shaft is acceptable
Container/Tube: Universal transport media, viral transport media, or equivalent (eg, Copan UTM-RT, BD VTM, MicroTest M4, M4-RT, M5)
Note: Media should not contain guanidine thiocyanate (GTC).
For more information on acceptable transport media, see www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2
Specimen Volume: Entire specimen with a minimum of 1.5 mL (maximum 3 mL) of transport media.
Collection Instructions:
1. Collect specimen by swabbing back and forth over nasal or pharyngeal mucosa surface to maximize recovery of cells. For more information on OP swab specimen collection, see COVID-19 Oropharyngeal Collection Instructions.
2. NP and OP swab specimens may be combined at collection into a single vial of transport media but only one swab is required for analysis.
3. Swab must be placed into transport medium. Swab shaft should be broken or cut so that there is no obstruction to the sample or pressure on the media container cap.
4. Do not send in glass tubes, vacutainer tubes, or tubes with push caps.
5. Do not overfill with more than 3 mL total volume of media.
Specimen Type: Nasopharyngeal aspirate or nasal washings
Container/Tube: Sterile container
Specimen Volume: Minimum of 1.5 mL
Additional Information: Do not aliquot into viral transport media, glass tubes, vacutainer tubes, or tubes with push caps.
Specimen Type: Lower respiratory tract
Sources: Bronchoalveolar lavage (BAL) fluid, bronchial washings, endotracheal aspirate, sputum
Container/Tube: Sterile container
Specimen Volume: Minimum of 1.5 mL
Additional Information: Do not aliquot into viral transport media, glass tubes, vacutainer tubes, or tubes with push caps.
Useful For
Detection of respiratory syncytial virus (RSV) in upper or lower respiratory tract specimens from individuals at risk for RSV infection with flu-like illness
See following website on indications and recommendations for testing: www.cdc.gov/rsv/clinical/index.html#lab
Highlights
This test provides qualitative detection of respiratory syncytial virus (RSV) RNA in upper and lower respiratory tract specimens from at-risk patients with flu-like illness caused by RSV. See Coronavirus Disease 2019 (COVID-19), Influenza, and Respiratory Syncytial Virus Testing Algorithm for the list of individuals at risk for RSV infection.
Testing Algorithm
For information see Coronavirus Disease 2019 (COVID-19), Influenza, and Respiratory Syncytial Virus Testing Algorithm.
Method Name
Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR)
Reporting Name
RSV RNA PCR Detect, VSpecimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Frozen (preferred) | 14 days | |
Refrigerated | 72 hours |
Reject Due To
Calcium alginate-tipped swab, wooden shaft swab, or swab collection tubes containing gel or charcoal additive. | Reject |
Transport media tubes containing the entire swab (shaft and knob attached) | Reject |
Glass transport media tubes | Reject |
Thawed | Cold OK; Warm reject |
Clinical Information
Respiratory syncytial virus (RSV) is an infectious pathogen that infects the human respiratory tract causing an influenza-like illness. Most healthy people spontaneously recover from RSV infection in 1 to 2 weeks, but infection can be severe in infants, young children, and older adults. The virus is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under 1 year of age in the United States. .It is recognized increasingly as a frequent cause of respiratory illnesses in older adults.
RSV can be detected by polymerase chain reaction in upper and lower respiratory tract specimens. Nasopharyngeal swabs or aspirates are the preferred specimen types for detection of RSV RNA. Nasal swabs may not yield as high detection rate as those of nasopharyngeal specimens for molecular detection of RSV RNA. Bronchoalveolar lavage fluid, bronchial washings, endotracheal aspirate, and sputum are suitable specimens for detection of RSV infection of the lower respiratory tract.
Reference Values
Undetected
Interpretation
A "Detected" result indicates that respiratory syncytial virus (RSV) RNA is present and suggests the presence of RSV infection in the symptomatic patient.
An "Undetected" result indicates that RSV RNA is absent in the patient's specimen.
An "Inconclusive" result indicates that the presence or absence of RSV RNA in the specimen could not be determined with certainty after repeat testing in the laboratory, possibly due to inhibition of polymerase chain reaction from interfering substances present in the respiratory tract specimen. Submission of a new specimen for testing is recommended when clinically indicated.
Cautions
The sensitivity of the assay is dependent on the timing of the specimen collection (in relation to symptom onset), quality, and type of specimen submitted for testing. This test should not be performed unless the patient meets clinical and epidemiologic criteria for testing.
The test is specific for detection of respiratory syncytial virus (RSV), and positive test results do not exclude the possibility of concurrent infection with other respiratory viruses, such as SARS-CoV-2, influenza A and B viruses.
Undetected (ie, negative) results do not rule out RSV infection in patients and should not be used as the sole basis for treatment or other patient management decisions. Results should be correlated with patient's history and clinical presentation. This assay detects both viable (ie, replicating) and nonviable virus.
Clinical Reference
1. Mammas IN, Drysdale SB, Rath B, et al: Update on current views and advances on RSV infection (review). Int J Mol Med. 2020; Aug;46(2):509-520
2. Griffiths C, Drews SJ, Marchant DJ: Respiratory syncytial virus: infection, detection, and new options for prevention and treatment. Clin Microbiol Rev. 2017; Jan;30(1):277-319
3. Hall CB, Simoes EAF, Anderson LJ: Clinical and epidemiologic features of respiratory syncytial virus. Curr Top Microbiol Immunol. 2013;372:39-57
4. National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases, Centers for Disease Control and Prevention (CDC). Respiratory syncytial virus infection (RSV). Updated December 2020. Accessed September 8, 2022. Available at www.cdc.gov/rsv/clinical/index.html
Method Description
This assay is a laboratory-developed, TaqMan probe-based, real-time, reverse transcription polymerase chain reaction (PCR) assay using a commercially available assay with the cobas 6800 / 8800 Systems for qualitative detection of respiratory syncytial virus (RSV) in human upper and lower respiratory tract specimens. Clinical samples undergo automated sample preparation (nucleic acid extraction and purification), during which viral nucleic acid in patient samples and added internal control RNA molecules are simultaneously extracted. Nucleic acid is released by the addition of proteinase and lysis reagent to the sample, and purified nucleic acid is eluted from the magnetic glass particles with the elution buffer. Known positive and negative controls are processed in the same way in each assay run. Viral target-specific forward and reverse primers and TaqMan probe are used to amplify and detect the matrix protein (M)-encoding sequences of RSV. Selective amplification of reaction internal control is achieved by the use of heterologous target sequence-specific forward and reverse primers that have no homology with the RSV genome. Amplified viral target sequences are detected by cleavage of the fluorescently labeled TaqMan probe.(Unpublished Mayo method)
Day(s) Performed
Tuesday, Friday
Report Available
1 to 7 daysTest Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87634
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
RSVQL | RSV RNA PCR Detect, V | 85479-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
616200 | RSV RNA PCR | 85479-4 |
RSVQS | RSV Specimen Source | 31208-2 |