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Label the specimen container(s) with the patient’s first and last name, date of collection, and one other unique identifier such as the patient’s date of birth or health card number. Failure to provide this information may result in rejection or testing delay.

Complete all fields of the PHO’s General Test Requisition Form, including:

1. Tests requested and reason for test
2. Patient setting, specimen types and sites
3. Travel history, exposure history and clinical information
4. Ct value for Influenza A if available

Serology testing is not recommended for influenza diagnosis, including avian influenza, and is not available for clinical testing in Canada.

For Avian Influenza testing:

1. Prior to specimen submission for Avian Influenza testing, contact PHO’s Laboratory Customer Service Centre at 416-235-6556 or 1-877-604-4567 or after-hours Emergency Duty Officer at 416-605-3113 for further instructions and testing approval. Weekend testing is available and must be approved by a PHO microbiologist or designate.
2. Under Tests Requested include all the following Avian Influenza, COVID-19 PCR, and Multiplex Respiratory Virus PCR/MRVP
3. In the Outbreak field of the requisition include ONT-2022-00001 (see special instruction below)
4. Upper respiratory tract samples, including nasopharyngeal (NP) swab and throat swab in universal or viral transport medium (UTM/VTM) are recommended for all symptomatic patients being investigated for avian influenza.
5. Lower respiratory tract samples - e.g. bronchoalveolar lavage (BAL), bronchial wash, and/or lung tissue if obtained (e.g. biopsy, post-mortem) are recommended for severe cases with lower respiratory tract infection
6. Sample types other than respiratory, such as swabs from other potentially infected anatomical sites (e.g. conjunctival swabs from patients with conjunctivitis and potential occupational exposure), require approval by a PHO microbiologist.
7. Stool and blood are not routinely tested for avian influenza but may be tested if avian influenza is detected in respiratory specimens. Contact PHO for approval by a PHO microbiologist before you submit these specimens.

For Influenza A Subtyping:

1. Under Tests Requested indicate Influenza A Subtyping
2. Include the Ct value for Influenza A if available
3. A minimum of 0.5ml of the primary specimen is required for influenza A subtyping