Guidelines for selecting respiratory virus testing

A variety of options are available for respiratory virus testing. Test selection should be made on the basis of clinical setting and facility. Several of the options provide testing for combinations of viruses, particularly Influenza A and B, RSV, and SARS-CoV-2 (COVID-19). Additional information is available by following links to individual tests.

Additional clinical recommendations are also available for University of Washington providers on OCCAM.

Additional information on viruses circulating in the Seattle area can be found on the Pacific Northwest Respiratory Virus Dashboard.

Ambulatory Settings

• SARS-CoV-2 and Influenza A&B Qual PCR [NCVFLU] is intended for routine Influenza A and B and SARS-CoV-2 testing in the outpatient setting.
• Order SARS-CoV-2 (COVID-19) Qualitative PCR [NCVQLT] for routine testing for SARS-CoV-2 only, including for Fred Hutch community sites.
• If testing for RSV is needed, order Influenza A, B & RSV PCR Panel [FLURSV] for routine testing for RSV and Influenza A and B.
  • This panel does not test for SARS-CoV-2. If testing for SARS-CoV-2 is also necessary, collect a second sample for SARS-CoV-2 (COVID-19) Qualitative PCR [NCVQLT].
• For symptomatic outpatients at FHCC South Lake Union, use COVID/FLU/RSV Respiratory Panel, Rapid PCR [FABRCV].
  
  • COVID/FLU/RSV Respiratory Panel, Rapid PCR [FABRCV] can also be used for symptomatic outpatients at clinics located on the HMC, UWMC-Montlake, or UWMC-NW hospital footprints only if test results would change immediate patient disposition.

Emergency Department and Inpatient Areas

• COVID/FLU/RSV Respiratory Panel, Rapid PCR [FABRCV] is intended for symptomatic ED and inpatients at UWMC-NW, UWMC-Montlake, and HMC. Testing is performed onsite at all main hospital sites (HMC, UW-NW, and UW-MT) and FHCC South Lake Union with an expected turnaround time of ~2 hours.
• For rapid onsite testing of SARS-CoV-2 alone, use SARS CoV 2 (COVID 19) Qualitative Rapid PCR (ED & Inpatients only) [NCVRPD].

Other Testing

Influenza A H5 Subtyping

• UW now offers Influenza A H5 subtyping Influenza A H5 Subtyping by PCR [FLUH5]. This test should only be performed on patients with a known influenza A infection and is primarily intended for hospitalized patients. Outpatients with an influenza A infection should only have H5 subtyping performed if there is an appropriate exposure history.
• The ordering process for H5 subtyping Influenza A H5 Subtyping by PCR [FLUH5] depends on where a patient's original influenza A test was performed:
  • For patients whose initial influenza A test was performed at a UW Medicine Laboratory (not on a point-of-care platform) - this applies to ED patients, inpatients, and any outpatients whose samples were sent to the lab for testing:
    • Influenza A H5 subtyping Influenza A H5 Subtyping by PCR [FLUH5] should be ordered as a LADDON test with "Influenza A H5 Subtyping, FLUH5" listed as the lab test requested.
  • For patients whose initial influenza A test was performed at an outpatient clinic on a point-of-care platform - this applies to our UWPC locations that are running the Abbott ID Now platform:
    • Influenza A H5 subtyping Influenza A H5 Subtyping by PCR [FLUH5] will require collection of a new sample and should be ordered as a LABUND test with "Influenza A H5 Subtyping, FLUH5" listed as the lab test requested.
• Clients outside of UW Medicine can order H5 subtyping for Influenza A positive patients using standard ordering processes. Please contact the Clinical Virology Laboratory (206-685-6656) with any questions.

Additional Respiratory Virus Test Options

• We also offer the Respiratory Virus PCR Panel (no SARS-CoV-2) [REVSQF] extended respiratory virus panel. This panel does not test for SARS-CoV-2. It is recommended for symptomatic patients with negative COVID/FLU/RSV Respiratory Panel, Rapid PCR [FABRCV] for whom identification of a viral cause is clinically important (e.g. chemotherapy timing, severe illness, etc.) or for symptomatic severely immunocompromised patients (e.g. BMT, high-dose chemotherapy, etc.). This panel is performed daily, but is not available STAT.
• To order testing for subsets of the viruses tested in the extended panel, we offer the RSV and Influenza panels described above as well as panels for Adeno/Metapneumo/Rhino Virus PCR Panel [FUSAMR], Parainfluenza PCR Panel [FUSPIV], and Coronavirus (Non SARS CoV2) PCR Panel [FUSCOV].