1. COLLECTION AND TRANSPORT OF VIROLOGICAL SPECIMENS.
In the investigation of viral infections, reliable laboratory results can only be obtained if the specimens are collected, preserved and transported correctly to the Virology laboratory.
When to collect virological specimens?
Specimen for detection of viruses should be collected as soon as possible after the appearance of the symptoms that is when the concentration of the virus is at its highest.
Blood for antibody testing should be collected as early in the disease as possible and also days later.
Two serum specimens (paired sera) are necessary to detect a rise in the titre of the Ab. A four fold rise in titre between paired sera establishes a positive result.

2. Collection of virological specimens:
The type of the specimen required will depend on:
1. The viral infection suspected.
2. The laboratory technique to be used.
District and local laboratories must obtain information about the collection of specimen from their Virology Reference Laboratory.

3. The following information is intended only as a general guide:
Faeces:
1. Place about 4-8 g of faeces (small spoon) in a clean, dry, leak-proof container (not a waxed carton).
2. Deliver to the laboratory as soon as possible.
3. If there is likely to be a delay to more than few hours in the specimens reaching the laboratory, suspend about one gram of faeces in 9 ml of phosphate buffered saline. If possible centrifuge at 2000g for 15 minutes, and then transfer the supernatant fluid to a clean leak- proof container.
4. Label and keep at -20 OC.
5. Send to the virology laboratory in a cold box.

4. 6. If a faeces sample can not be obtained, rectal swab should be collected and transported in buffered saline.
7. The isolation of viruses from rectal swab however, is less satisfactory than from faeces.
8. Faeces specimens are required to diagnose viral gastroenteritis specially that caused by rotaviruses, and to investigate poliomyelitis and other diseases caused by enteroviruses.

5. 2. Nasopharyngeal secretions:
A.Collect a specimen by passing a sterile cotton wool swab, attached to a pent piece of thin wire, through the floor of the nasal cavity as far as the nasopharynx.
B. After few seconds, slowly withdraw the swab and immerse the swab in a container of sterile VTM, cutting off swab wire to allow the bottle cap to be replaced tightly.
C. A specimen of nasopharyngeal secretion can also be obtained by using a sterile mucus extractor.
D. Respiratory viruses can also be recovered from a throat swab preserved in VTM but a pernasal swab is usually easier to obtain and has been found very satisfactory for the isolation of influenza viruses, measles virus, and respiratory syncytial viruses.

6. E. A throat swab is unsuitable if the specimen is to be tested by a fluorescence antibody technique.
F. Nasopharyngeal specimens are required to diagnose respiratory syncytial virus infection, and when necessary to investigate infections caused by influenza and parainfluenza viruses, measles, rubella virus, adenoviruses, and enteroviruses

7. 3. Cerebrospinal fluid:
Collect ml of fluid in a dry, sterile, leak-proof container. Refrigerated immediately at 4 OC.
Transport in an insolated cold box.
Cerebrospinal fluid is required to investigate some arbovirus infections. When meninges are infected, the CSF will contain lymphocytes and the CSF total protein will be raised.
4. Skin and ulcer specimens:
Collect skin scrapings in a dry sterile container.
Refrigerate immediately at 4OC, and then transport in a cold box.
If measles or rubella is suspected, the virus is more likely to be isolated from a per nasal swab.
Skin specimens are required to investigate infections caused by herpes simplex viruses, rabies viruses….

8. 5. Blood for serological tests:
Two serum specimens are required to diagnose an infection serologically.
Collect the sample within 5 days of the onset of the symptoms, and the second sample 5-10 days later.
Collect 5-10 ml of venous blood in a dry sterile, screw-cup glass tube or bottle.
A single sample is required for investigating newborn infant with congenital defects, determining immunity to rubella or other viruses…
A single serum sample is required when testing for hepatitis B surface Antigen (HBsAg) and HIV-1 and HIV-2.
After the blood collected, collect in leak-prove container, refrigerate at 4C until transport it in ice box to the virology lab.

9. 6. Anticogulated blood for culture:
Collect 7-10 ml of blood into a sterile tube or bottle which contains heparin, gently mix the blood with the anticoagulant.
Viruses which can be cultured from blood include dengue viruses and some arboviruses.
7. Specimens such as urine and sputum are generally unsuitable for viruses' isolation.
All samples which may contain dangerous and highly infectious viruses must be labeled HIGH RISK with a red marker pen, and handled with great care.

10. Labeling of specimens:
This should be including:
Patient's name and number.
Hospital or health centre.
Type of specimen.
Date and time of collection.
Container tops should be sealed with adhesive tape to prevent slacking during transit.

11. Information to accompany specimens:
A request form should include the fallowing information:
1. Name, place, age, number of the patient, and details of any recent travel.
2. Type of specimen, if two, mention as the first of second.
3. Investigation required.
4. Full clinical information: nature duration, and severity of disease.
5. Details about immunization and antimicrobial therapy.
6. Name and address of the hospital or health centre.

12. *IF THE SAMPLE IS HIGH RISK, THE SAME SENTENSE SHOULD BE WRITTEN IN THE FORM BY THE RED COLOR PEN.
The form should not be wrapped around the specimen container but placed separate it, inside the outer container where it will be found immediately when the package is opened.
Transporting of specimens to the Virology laboratory:
Viruses are unable to survive temperature over 50 C, freezing or fluctuatings in temperature.
Viruses can also be damaged be light, drying, change in pH, and bacterial enzymes.
The usage of VTM will prevent specimens from drying out and help to preserve viral activity.
All virological specimens should be transported in ice box with the warning label.