Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

Table A-3: Specimens for laboratory confirmation for priority diseases at the district levelSuspected disease orconditionDiagnostic test Specimen When to collect How to prepare, storeand transportAcute flaccid paralysis(polio)REFERENCE:WHO global action plan forlaboratory containment ofwild polio viruses. WHO/V&B/99.32, Geneva, 1999Manual for the virologicalinvestigation of polioWHO/EPI/GEN/97.01Geneva, 1997Isolation of polio virus fromstoolStoolNote: If no specimen iscollected, re-evaluatepatient after 60 days toconfirm clinical diagnosis ofpolio (AFP).Collect a sample from everysuspected AFP case.Collect the first specimenwhen the case is investigated.Collect a second specimenon the same patient 24hours later. Place stool in clean,leakproof container andlabel clearly. Immediately place inrefrigerator or cold boxnot used for storingvaccines or othermedicines. Transport specimens sothey will arrive atdesignated poliolaboratory within 72hours of collection. When there is a delay,and specimen will notbe shipped within 72hours, freeze specimenat -20°C or colder.Then transport frozenspecimen with dry iceor cold packs alsofrozen at -20°C orcolder.Buruli ulcer Isolation of MycobacteriumUlcerans from ulcer.Wound swabORTissue from the ulcerCollect the specimen for onecase if diagnosis uncertain.If sending directly to thelab, place swab ortissue in a dry cleantest tube and transportat room temperature.If sending to lab within 6hrs of collection, placeswab or tissue in about2 mls of saline in aclean test tube.When there will be adelay of about 2 ormore days, keep inthe refrigerator at 4-8°C.ResultsPreliminary test resultsare usually available 14-28 days after receipt ofspecimen by the laboratory.If wild polio virus isdetected, the nationalprogramme will planappropriate actions.Zeihl-Neelsen (ZN)staining and microscopyshould be completedwithin 24 hours of arrivalof specimen in thelaboratory.Culture and sensitivityresults should be ready in6-9 weeks of arrival at thelaboratory.130Technical Guidelines for Integrated Disease Surveillance and Response in Ghana