PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
Diagnostic Virology
NV020v6
07/06/07
Ninewells Hospital
Dundee
REPORTING TO HEALTH PROTECTION SCOTLAND (HPS) AND
NHS TAYSIDE HEALTH PROTECTION TEAM (HPT)
SOP No. / VERSION No.
NV020v6
WRITTEN BY
Paul McIntyre
AUTHORISED BY
Paul McIntyre
SIGNED
DATE
REVIEW PERIOD
2 Years
COPY
1 of 2
LOCATION OF COPIES
1.
Virology General Laboratory Manual
2.
HPT, Kings Cross
NB Authorised copies of SOPs have a blue footer
Unauthorised amendments and production of copies is not permitted
Amendments
Date
Page
Section
Page 1 of 9
Written by
Authorised by
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
NV020v6
07/06/07
1.0
REPORTING TO HPS
1.1
All positive reports are sent via Ecoss to HPS and interpreted in accordance with guidance in
appendix 1.
2.0
REPORTING TO HPT
2.1
Extracts of Ecoss data are made available to HPT by HPS. The conditions of greatest interest are
listed below:
Disease
Code
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
Disease Name
Anthrax
Bacilliary dysentery
Campylobacter
Chickenpox
Cholera
Continued fever
Diphtheria
Erysipelas
Food poisoning: Cryptosporidium
Food poisoning: E. coli
Food poisoning: Salmonella spp.
Food poisoning: Other
Influenza
Legionellosis
Leptospirosis
Lyme disease
Malaria
Measles
Membranous group
Meningococcus
Mumps
Norwalk (Norovirus)
Paratyphoid A
Paratyphoid B
Plague
Poliomyelitis: paralytic
Poliomyelitis: non-paralytic
Psittacosis
Puerperal fever
Q-fever
Rabies
Relapsing fever
Rotavirus
Rubella
Scarlet fever
Smallpox
Tetanus
Toxoplasmosis
Tuberculosis: pulmonary
Tuberculosis: non-pulmonary
Typhoid
Typhus
Viral Haemorrhagic Fever
Notes
See section 2.2 re phoned results*
See section 2.2 re phoned results*
Borrelia recurrentis/parkeri/hermsii
See section 2.2 re phoned results*
See section 2.2 re phoned results*
Page 2 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
2.2
39
Viral hepatitis
40
Whooping cough
NV020v6
07/06/07
See section 2.2 re phoned results*
Reporting by phone to HPT (extension 36987)
*Hepatitis A IgM positive serology needs to be phoned since the window of opportunity for
post exposure prophylaxis is so tight. This should be done by the duty Consultant when the
sample is shown to be repeatedly reactive in our assay rather than waiting for the results of a
second assay performed in another lab for confirmation. A note should be added in Request
Notes to confirm that the report has been made.
Patients confirmed to be HBsAg positive for the first time in Tayside should be reported to the
Health Protection Tayside team by phone. Where a prior HBsAg positive sample has been
analysed and reported a repeat report is not required, except ante-natal HBsAg positives which
should also be phoned on the first positive of every pregnancy. The Consultant on duty
should make the telephone report when the markers are ready for issuing, and a note added in
Request Notes to confirm that the telephone report has been made.
Drs McIntyre or Yirrell will additionally telephone details of other confirmed cases to HPT,
where information is likely to be required urgently. Examples will include (but not be limited to)
confirmed rabies, avian influenza, Lassa fever, Congo Crimean Haemorrhagic Fever,
Marburg, Ebola, polio and Q-fever and unusual cases or clusters of cases of any of the
conditions listed at 2.1 above. HPT would normally take the lead if liaison with HPS or Health
Protection teams in other Health Boards is required. Reporting is by phoning extension 36987.
The Consultant on duty should make the telephone, and a note added in Request Notes to
confirm that the telephone report has been made.
HPT should also be phoned on the basis of clinical suspicion alone for the following
conditions:
Rabies, avian influenza, Lassa fever, Congo Crimean Haemorrhagic Fever, Marburg,
Ebola and polio
.
Page 3 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
NV020v6
07/06/07
Appendix to NV020:
Reporting to ECOSS
A handbook for Virologists
Version 1.1
Date: 17 January 2006
Health Protection Scotland
Page 4 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
Introduction
NV020v6
07/06/07
Reports by virologists to Health Protection Scotland (HPS) constitute the foundation of the national surveillance of
communicable disease in Scotland.
The three main objectives of communicable disease surveillance are:

The detection of outbreaks and longer term trends in the incidence of infections, including with organisms
resistant to specific antimicrobials, to enable early preventive action when appropriate

The evaluation of control measures

The provision of data for health service planning
In addition to these operational objectives, routine surveillance provides a baseline for enhanced surveillance,
informs research priorities, and provides research opportunities.
In order to meet its objectives, it is essential that laboratory reporting is comparable over time and space, so that
one time period is comparable with another, and one geographical area with another. A common set of rules is
therefore necessary for all reporting laboratories.
It is also vital, however, that these rules do not lead to unusual, unspecified but important episodes being missed. It
is therefore assumed throughout this document that as well as laboratories reporting in a standard fashion to
ECOSS, virologists will always be alert to, and report immediately to HPS, any identification or incident which they
think is of importance. Reporting of these occurrences is not addressed further here, because, while it is vital, it
does not fulfil the most widely accepted definition of surveillance:
“ongoing systematic collection, collation, analysis and interpretation of data; and the
dissemination of information to those who need to know in order that action be taken”
(World Health Organisation (WHO))
www.who.int/suveill/index.html
Page 5 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
Protocol
NV020v6
07/06/07
Participating laboratories should report to ECOSS all identifications of organisms and inferences of infection or
microbiological intoxication, unless they are known to be of no clinical or public health importance.




Some viruses we want to know about regardless of what site they came from. These are summarised
in Table 1.
Other viruses are generally only found in certain, specified sites. These are in Table 2.
Some viruses are identified by serology and these are found in Table 3.
Although not viruses, many bacteria can be identified using the same serology techniques that are used
to identify viruses. It is recognised that much of this bacterial serology testing is done within virology
laboratories so they have been included in Table 4 of this handbook.
Conversely, viruses that do not appear in any list should nevertheless be reported at the discretion of the virologist if
they are suspected of being of clinical or public health importance. The lists therefore represent default positions,
which can be overridden on the basis of the reporters’ knowledge and expertise. If these rules result in the
exclusion of many items we ask to be reported, or the reporting of many items we have not asked for, then our lists
will require revision.
Page 6 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
NV020v6
07/06/07
Table 1
Viruses from all sites
Virus
Specimen
All
Adenovirus
Congo-Crimean HF virus
HTLVI
HTLVII
Lassa fever virus
Poliovirus
Rabies virus
Rubella virus
Smallpox
Reportable Result
PCR, Ag (IF, EIA or latex), culture
CF>=128 or >= four-fold rise in
titre
All
PCR, seroconversion
PCR, seroconversion
All
Neutralising antibody, culture,
PCR
All
IgM, PCR
All
All
Blood
All
All
All
All
All
All
All
All
All
Yellow fever virus
Table 2
Viruses from specified sites
Virus
Astrovirus
Coronavirus (not SARS)
Coronavirus (SARS)
Cytomegalovirus
Specimen
Faeces
Respiratory sample
Respiratory sample,
Blood
Amniotic fluid, urine, tissue,
swab, respiratory sample.
Reportable Result
PCR, EM
PCR
PCR, serology
PCR, culture
Blood
Enteroviruses
(Poliovirus, Coxsackie A, Coxsackie
B, Echovirus)
Epstein-Barr virus
Erythrovirus B19
Herpes simplex type 1 or 2
Human metapneumovirus
Influenza viruses
Measles virus
CSF, swab, faeces, urine,
tissue, respiratory sample,
blood.
Blood, CSF
CSF, amniotic fluid, tissue,
swab
IgM or CF>=128
or >= 4-fold rise in titre or
seroconversion, culture
PCR, culture, IgM, neutralising
antibody.
IgM, PCR
PCR
Blood
Swab, tissue, CSF
PCR, IgM, seroconversion
PCR, culture
Blood
IgM, or CF>=128
or >= 4-fold rise in titre.
PCR, IF
PCR, IF, culture
Swab, respiratory sample
Swab, respiratory sample,
tissue
Blood
CFS, swab
CF >=128 or >= 4-fold rise in titre.
PCR, IF, culture
Blood
IgM, CF >=128 or >= 4-fold rise in
Page 7 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
Molluscum contagiosum
Mumps virus
NV020v6
Tissue
CSF, swab
Blood
Norovirus
Orf virus
Parainfluenza
Polyomavirus BK
Polyomavirus JC
Respiratory syncytial virus
07/06/07
titre.
EM
PCR, culture
Faeces
Tissue
Respiratory sample, CSF
Urine, blood
CSF, blood
Swab, respiratory sample
IgM, CF >=128 or >= 4-fold rise in
titre.
PCR, EM, EIA
EM
PCR, IF, culture
PCR
PCR
PCR, IF, EIA, culture
Blood
Rhinovirus
Rotavirus
Respiratory sample
Faeces
Sapovirus
Varicella-zoster virus
Faeces
Swab, vesicle fluid, CSF,
respiratory sample
Blood
IgM, seroconversion, EM, CF
>=128 or >= 4-fold rise in titre.
IgM, PCR
Blood, CSF
West Nile virus
CF >=128 or >= 4-fold rise in titre.
PCR, culture
EM, PCR, Ag (EIA or latex),
PAGE
PCR, EM
PCR, IF, culture
Table 3
Viruses from serum only
Virus
Specimen
Serum
Reportable Result
IgM, PCR
Serum
Serum
All
HAV IgM
HBsAg positive
Anti-HCV (new cases)
HCV PCR (if anti-HCV negative)
HEV IgM
Serum
All
Dengue
Ebola/Marburg viruses
A
Hepatitis B
C
D
E
(note: new HCVs only
reported through HCV
Register in Edinburgh and
Glasgow)
Rift Valley virus
Table 4
Bacteria/parasites from specified sites
Page 8 of 9
PAPER NSG 6
Virology - Reporting to HPS and HP Tayside
Bacteria/Parasite
Borrelia burgdorferi
Chlamydia spp.
NV020v6
Site
Blood, CSF
Respiratory sample, swab,
urine
07/06/07
Reportable Result
IF, ELISA, PCR, IgG, IgM
SDA positive detected, IF, PCR
CF >=128 or >= 4-fold rise in titre
Coxiella burnetti (Q fever)
Mycoplasma spp.
Blood
Blood
Respiratory sample, swab
CF >=128 or >= 4-fold rise in titre.
PCR
Blood
Pneumocystis jiroveci
Rickettsiae
Strept Anti-Streptolysin O
Toxoplasma spp.
Tissue, respiratory sample
Blood
Blood
Blood, faeces bone
marrow, tissue, CSF
Page 9 of 9
IgM or CF>=128 or >=4-fold rise
in titre.
PCR, IF
Reference laboratory tests
ASO titres > 200
Dye test, EIA, PCR, IgM