Montana Department of Public Health and Human Services Surveillance Testing for Influenza, 2022-23 Season Laboratory Guidance

The following guidelines have been developed to allow for geographic monitoring of the circulating strains of influenza and anti-viral resistance trends using existing clinical laboratory testing in addition to Montana Public Health Laboratory testing.

Fee-Waived Testing
Select Hospital Laboratories	For the week ending October 8, 2022, fourteen (14) designated hospital laboratories will begin submitting two (2) fee-waived specimens each week.
Other Clinical Laboratories	Thirty-three (33) additional clinical laboratories from around the state have been designated to provide specimens for confirmation of rapid tests or ILI. Five (5) fee-waived tests throughout the season will be provided to each lab.
Sentinel Providers	Sentinel providers, designated by DPHHS CDEpi, will submit up to five (5) fee-waived sentinel specimens throughout the season.
Clusters/Outbreaks	Consultation with MT DPHHS-CDEpi (406-444-0273) is required prior to specimen submission. Up to three (3) fee-waived specimens may be tested to determine the cluster type and subtype. Note: A cluster of influenza is defined as 2-3 cases who have onset of influenza-like illness (ILI) within 72 hours of each other AND are associated with the same institution, activity, or event (i.e., school, travel, or work).
Special Circumstances	Consultation with MT DPHHS-CDEpi (406-444-0273) is required prior to specimen submission. Approval is on a case-by-case basis.

Laboratory Surveillance specimens will be screened for both Influenza A and Influenza B by PCR. All Influenza A positive specimens will be subtyped and all influenza B specimens will be genotyped to identify the lineage. A representative sample of these specimens will be referred to the Centers for Disease Control and Prevention for further characterization and anti-viral resistance testing. All influenza surveillance testing is fee-waived.

Specimen Collection

Specimens should be collected within 3 days of onset of symptoms. After 3 days, the viral shedding is reduced, and may be harder to detect.
Respiratory specimens (nasopharyngeal swab, throat swab, nasal swab, or combination NP/Throat swab) must be submitted in Universal Transport Media (UTM) or Viral Transport Media (VTM) in a cold condition. Flocked nasopharyngeal and regular swabs are provided in the UTM/VTM kit
Do not submit a swab or residual fluid that has been used for Rapid testing; these will be rejected as an unsatisfactory specime A second swab must be collected and submitted in UTM.

Most Transport Media can be stored at room temperature before specimen collection, but be sure to check to make sure media is being stored properly. After the specimen has been introduced to the transport media, the specimen should be stored at refrigerator temperature and transported to the MTPHL in a cold condition. Please freeze if there is going to be a delay in transport >3 days.

Specimens can be transported via courier or the mail as a Biologic Substance, Category B, and should be received within 48 hours of collection.

Online Ordering

For designated sites and pre-approved sites, please select “Inf PCR Surv”.
In addition to the regular information, please answer the clinical information questions that pop up on the screen, as appropriate. Questions include results of Rapid or PCR Testing (if performed), whether the patient is hospitalized, vaccination status, and other pertinent information.

Turn Around Time

Turnaround time is expected to be less than 72 hours from specimen receipt, although this time may vary.

If you have any questions, call the Montana Public Health Laboratory at 1-800-821-7284.