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RESEARCH INSTITUTE FOR TROPICAL MEDICINE

Department of Health

FREQUENTLY ASKED QUESTIONS
(Laboratory FAQs as of January 13, 2014)

Q: What is the function of the laboratory in Measles surveillance?
A: The primary function of the laboratory in measles surveillance is confirming suspect
measles cases through testing of serum specimens for the presence of anti-measles IgM
antibodies..

Q: What sample is appropriate to collect in cases of Measles?
A: The recommendation is to collect either serum specimen within the first 28 days of rash
onset from all suspect measles cases. A single serum sample obtained at the first contact with
the patient at any time within 28 days after rash onset shall be taken from ALL suspected
measles cases.

The collection of Nasopharyngeal/Oropharyngeal (NP/OP) swab specimens for viral isolation
and genotyping must be within the first 7 days of rash onset.

Q: What is the use of collecting Dried Blood Spot (DBS) samples?
A: Dried blood spot samples shall ONLY be used as an alternative means of specimen
collection where there is difficulty in extracting blood (e.g. very young infants, no medical
technologist or certified phlebotomist), maintaining the specimen at 2-8C during storage and
transport (i.e. selected island barangays, municipalities or RHUs, and provinces, lack of
specimen storage facilities and no local courier). Collection shall be done by medical,
paramedical and other trained personnel (doctors, medical technologists, nurses, midwives,
etc).

Q: What is the timing of collection of DBS?
Obtain DBS at the first contact with a suspected case of measles or any time within 28 days
after onset of rash. [Refer to Updated Lab Guidelines for detailed method]

Q: Why do we need to take Nasopharyngeal/Oropharyngeal swab specimens from
Measles suspect cases?
A: NPS/OPS is used for Measles virus isolation. The isolate is further tested through
molecular methods to determine the Measles genotype.

Q: What is the reason for determining the Measles genotype?
A: Measles genotype information provides information on indigenous/endemic or imported
measles viruses circulating in the country, including outbreak source and transmission
pathways.

Q: How many NPS/OPS do we take from clusters/outbreaks?
In collecting NPS/OPS, the response team shall consider the guide below in collecting
samples of cases in a cluster/ outbreak:
3 cases - collect at least 1-2 samples
5 cases - collect a minimum of 3 samples
10 cases collect a minimum of 5 samples
>10 cases - collect a minimum of 10 samples
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Q: What is Virus Transport Medium (VTM)?
A: Virus Transport Medium or VTM is a special medium for transporting specimens for virus
isolation. It contains the necessary substances to maintain the viability of viruses in
specimens prior to testing at the laboratory. For purposes of the Measles surveillance,
OPS/NPS swabs are placed in the VTM.

Q: How do we transport OPS/NPS in VTM
A: Wrap VTM tubes with specimens in tissue paper or any absorbent material; place upright
in a separate 50 ml centrifuge tube or any leak/puncture proof container; place the 50 ml tube
or any container in a resealable plastic bag (Ziplock
TM
).
The laboratory request form shall be sealed in a separate plastic bag and enclosed within the
shipping box. Place the specimens in the transport box with at least 4 frozen ice packs fitted
around the specimens.

Q: How do we store serum samples prior to shipment to RITM?
A: Store serum at 4-8C and ship to RITM ensuring receipt will be within 3 days from
collection. If a delay in shipment is anticipated, freeze serum samples at -20C or lower.

Q: How do we transport the serum samples to RITM?
The appropriately labelled serum sample shall be placed in a sealable plastic bag or pouches
containing absorbent materials such as cotton wool to soak up any leakage that may occur.
Insulated containers shall be used to contain the sealed bags of specimen.
The case investigation form shall be sealed in a separate plastic bag and enclosed within the
shipping box. Place the specimens in the transport box with at least 4 frozen ice packs fitted
around the specimens.
Arrange shipment such that arrival of specimens at RITM does not fall on weekends or
holidays. Otherwise, make advance notice of such arrival via telephone, fax (NML Telefax
809-7120) or e-mail.

Q: To whom do we address the shipment of samples?
Address the shipment to: Department of Virology
Research Institute for Tropical Medicine
9001 Research drive, Filinvest Corporate Compound
Alabang, Muntinlupa City

Q: Is there a possibility that samples may not be tested?
A: The RITM National Measles Laboratory enforces rejection criteria for the following
situations:
Inadequate sample collection.
Samples without CIF.
Improperly labelled sample/ unlabelled sample.
Samples with visible contamination.
Spillage or breakage in transit.
Grossly hemolyzed sample
Improperly shipped ( no cold chain)

Q: What is the turn-around time for the laboratory tests?
A: The turn-around time for Measles Serology IgM testing is 5 working days. There may be
delays in exceptional circumstances, such as outbreaks.