TESTING DIRECTORY
LABORATORY TESTING SERVICES
This section outlines investigations offered by all the departments of the laboratory. These guidelines are applicable for routine specimen referrals.
Please note - Potential outbreaks are managed on a case by case basis following contact with the Laboratory and Epidemiology divisions for further guidance.
Note:
All specimens referred for serological testing assays should:
- Have a minimum volume of 1.0 ml.
- Be maintained at temperatures within the range of 4oC to -20oC.
- Be contained in appropriate vials that do not exceed the dimensions of 1.5 cm diameter and 4.7 cm in height e.g. Nunc vial. Only vials with external threads should be used.
Please check the EPI field guide or the EPI manager in-country for further information for the following vaccine preventable diseases covered under the EPI elimination or eradication programme
- Congenital rubella syndrome
- Measles
- Poliomyelitis
- Rubella (German measles)
Matrix of Disease/Etiology Specimen Type/s Diagnostic Method and Turnaround Times
Disease/Aetiologic Agent | Comment | Specimen | Method | Turnaround Time (Days) |
---|---|---|---|---|
Campylobacter |
Performed at CARPHA for countries without testing capability |
Isolate in Cary Blair media; Stool |
Culture and biochemical tests |
7 |
Chlamydia infection |
Please contact CARPHA before submission of specimens (Sent to CARPHA's Reference Laboratory) |
Vaginal discharge in transport media |
PCR |
14 - 21 |
Chicken pox (varicella) |
Please contact CARPHA before submission of specimens (Sent to CARPHA's Reference Laboratory) |
Vesicle swab Serum |
PCR IgG ELISA |
14 - 21 |
Chikungunya |
Performed at CARPHA for outbreaks |
Acute serum (collected 1-4 days from onset); |
PCR |
7 |
Cholera |
Initial laboratory testing in country, CARPHA: referral for further testing |
Isolate in maintenance media Stool in Cary Blair media |
Serotyping Confirmation |
7 |
Ciguatera poisoning |
Please contact carpha for discussion and decision making |
- |
- |
- |
Diphtheria |
Performed at CARPHA for countries without testing capability |
Throat swab in transport media |
Culture Biochemical tests and gram staining |
14 |
Dengue Fever; Dengue haemorrhagic fever Dengue shock syndrome |
Performed at CARPHA for countries without testing capability |
Acute serum (collected 1-4 days from onset); |
PCR |
7 |
Convalescent serum (collected 7-15 days from onset) |
IgM ELISA |
7 |
||
E. coli (pathogenic) |
Performed at CARPHA for countries without testing capability |
Isolate in maintenance media; Stool in Cary Blair media |
EIA assay; Serotyping; Confirmation |
7 |
EBV |
Not routinely tested CARPHA to be contacted for discussion and assistance prior to submission of specimens |
Serum |
IgM ELISA |
7 |
Neisseria Gonococcal Infection |
Performed at CARPHA for countries without testing capability |
Isolate in BHI with glycerol or on chocolate agar |
Culture; Antimicrobial Resistance (AMR) testing |
7 - 14 |
Influenza and other Respiratory syncytial, Parainfluenza 1 - 4, Metapneumovirus, Adenovirus, Rhinovirus |
Performed at CARPHA for countries without testing capability |
Nasopharyngeal or oropharyngeal swabs, aspirate or washes; Broncheoalveolar lavage, tracheal aspirates (collected within 1 -7 days of onset) |
PCR Virus isolation |
7 |
Leptospirosis |
Performed at CARPHA for countries without testing capability |
Serum (collected > 5 days after onset) |
IgM ELISA |
7 |
Malaria (indigenous and imported) |
Laboratory testing: in-country CARPHA: to be contacted for discussion if necessary |
Thick and thin slides |
Microscopy |
2 |
Meningitis infection (due to Neisseria meningitidis) |
Performed at CARPHA for countries without testing capability Isolates to be submitted to CARPHA for further characterization. |
Isolate in BHI with glycerol or on chocolate agar |
Culture; Antimicrobial Resistance (AMR) testing; Serotyping |
7 - 14 |
Meningitis/Pneumonia (due to Streptococcus pneumoniae) |
||||
Meningitis/Pneumonia (due to Haemophilus influenzae) |
||||
Norovirus |
Performed at CARPHA for countries without testing capability |
Stool |
PCR; IgM ELISA |
7 |
Opportunistic infections (e.g. cryptosporidium, CMV, toxo, pnuemo,etc)* |
Performed at CARPHA for countries without testing capability |
Toxoplasma: Serum |
IgM ELISA |
7 |
CMV:serum |
IgM ELISA |
7 |
||
Cryptosporidium: Stool |
Microscopy: Stool staining |
7 |
||
Cryptococus neoformans: CSF |
Microscopy: India ink staining |
7 |
||
Pertussis |
Performed at CARPHA for countries without testing capability |
Nasopharyngeal or throat swab |
Culture; Referred for PCR testing |
7 |
Plague |
Sent to CARPHA's Reference Laboratory |
Blood; Biopsy material from bubo |
Blood culture; Microscopy; Culture; Antimicrobial Resistance (AMR) testing |
14 |
Rabies (in humans) |
CARPHA: to be contacted for discussion if necessary (Sent to CARPHA's Reference Laboratory) |
- |
- |
- |
Rotavirus |
Performed for countries without testing capability in outbreak situations. - Please contact CARPHA for discussion |
Stool |
Antigen ELISA PCR |
7 |
Salmonellosis |
Performed at CARPHA for countries without testing capability Isolates to be submitted for further characterization |
Isolate in maintenance media |
Serotyping; Phage Typing of S. enteritidis |
7 - 14 |
Shigellosis |
Serotyping |
Serotyping |
7 |
|
*Tuberculosis (Pulmonary) |
Performed at CARPHA for countries without testing capability Selected specimens sent to CARPHA's Reference Laboratory |
Sputum |
Identification (PCR) Drug Sensitivity Testing (PCR) |
4 |
Tuberculosis (Extra-pulmonary) |
Please contact CARPHA submission of specimens |
- |
- |
- |
Typhoid and paratyphoid fever |
Performed at CARPHA for countries without testing capability |
Stool, Isolate in maintenance media |
Identification Serotyping |
7 |
Viral Encephalitis/Meningitis |
Performed at CARPHA for countries without testing capability |
1 -2 mL acute CSF; nasopharyngeal swab in viral transport media, unpreserved stool |
PCR (Enterovirus, HSV1 and HSV 2) |
7 |
Viral Hepatitis A, E |
Performed at CARPHA for outbreak investigation |
Single serum |
IgM ELISA |
7 |
Viral Hepatitis B |
Performed at CARPHA for countries without testing capability |
Single serum |
ELISA (surface antigen HBsAg) |
7 |
Yellow fever |
CARPHA for testing: (Sent to CARPHA's Reference Laboratory) |
Single serum Viral Isolation (when BSL3 facility is available |
ELISA; PCR |
21 |
Entomology Specimen Referrals
The following table lists information relevant to the collection and testing of specimens for Entomology investigations.
NOTE: All specimens sent to the Entomological unit must be accompanied by the following information:
- Method of specimen collection
- Date and time of specimen collection
- Name of specimen collector
- Country and location
- Type of habitat (from which collection was made)
Test | Specimen recommended | Notes | Turnaround time (calendar days) |
---|---|---|---|
Insecticide resistance |
Aedes aegypti mosquito eggs |
On removal from ovitraps, the paper containing eggs should be placed in a container lined with damp paper towels. After 2-3 days, the paper should be removed from the container and left to air-dry for 1-2 days. Fold paper in two with the side containing the eggs on the inside. |
42 |
Mosquito identification (larval specimen) |
Specimen collected and killed in hot but NOT boiling water |
Specimen should be sent in vials containing 70% ethanol. |
7 |
Mosquito identification (adult specimen) |
Specimen killed with chloroform, ether, carbon dioxide or rapidly frozen in a domestic refrigerator |
The specimen should be packaged and sent in a small vial or cardboard box lined with grease-proof paper or paper towels. |
7 |
Virus isolation:
|
Live adult mosquitoes:
|
Individual vials should contain a pool of 20 adults. These vials should be lined with grease-proof paper and stored in a -700C freezer until ready for shipment.
Overseas laboratories:
Local Laboratories: |
28 |
SUBMISSION OF SPECIMENS TO CARPHA
Specimens must be routed through the relevant National Reference/ Public Health Laboratory or the Ministry of Health.
The following minimum information must accompany each specimen
1. A labelled specimen container with the following information:
- National Patient ID/Laboratory Number
- Date of collection
- Specimen type
2. Completed CARPHA Laboratory Investigation form (Refer to page. 8) or Country’s Laboratory form with similar information
General Information for Transportation of Specimens
Referred specimens must always be prepared, packaged and transported in accordance with current international shipping guidelines and IATA (International Air Transport Association) regulations.
1. Incoming Receipt Notifications (including baggage tags, airway bill number) should be sent to the Laboratory using the following means of communication –
Data Entry and Reporting Unit
Fax: 1-868-628-9302,
Telephone: 1-868-622-4261/2
Email: customerservice@carpha.org
2. All packages must be addressed in the following manner:
The Director of CARPHA
The Caribbean Public Health Agency (CARPHA)
16-18 Jamaica Boulevard
Federation Park
PORT of SPAIN
TRINIDAD, W.I.
SPECIMEN COLLECTION GUIDELINES
PURPOSE
To describe methods for the collection and transport of the following specimens (most commonly submitted specimens are italicised):
A. Blood
- Venous Blood Samples
- Serum from Blood
- Capillary Blood Samples
B. Respiratory Tract Samples
-
Upper Respiratory Tract Specimens
- Throat Swab
- Pre-Nasal and Post Nasal Swab
- Aspirates
- Lower Respiratory Tract Specimens
C. Cerebrospinal Fluid
D. Faecal Specimens
- Stool Specimen
- Rectal Swab from Infants
E. Eye Specimen
F. Samples From For Skin Lesions
- Vesicular or Vesiculo-Pustular Rash
- Crusting Stage
- Aspiration of Abscesses
G. Urine Specimens
H. Post- Mortem Specimens
- Collection of Tissue Specimens
I. Sputum Specimens for TB Testing