MERS-CoV PCR to CDC (Sendout)

Interpretation

Guidelines

• Washington DOH Notifiable Conditions

Method

Polymerase Chain Reaction (PCR)

Reference Range

References

Resources:

• CDC MERS-CoV Molecular Detection test (refer to "CDC Pre-Approval" section for points of contact).
• CDC Middle East Respiratory Syndrome (MERS)
• CDC Managing MERS Cases and Contacts
• Seattle King Co. Public Health Epidemiologist: 206-296-4774
• For residents outside of King County, use the WA State Interactive Map of LHJ Websites

Ordering & Collection

Specimen Type

Nasopharyngeal and/or Oropharyngeal swabs, sputum, and lower respiratory tract aspirates/washes.

Collection

Collection Recommendations: CDC recommends collecting and testing multiple specimens for the rRT-PCR assay, including lower (bronchoalveolar lavage, sputum and tracheal aspirates) and upper (nasopharyngeal and oropharyngeal swabs) respiratory specimens. For patients with possible MERS-CoV pneumonia, lower respiratory specimens are the preferred specimen type, because they have higher test sensitivity.

Nasopharyngeal or Oropharyngeal Swab:

• After swabbing the site, place the swab into a sterile tube containing 2-3 mL of transport media.
• Use only synthetic fiber swabs with thin plastic or wire shafts. Do not use calcium alginate swabs or swabs with wooden shafts, as they may contain substances that inactivate some viruses and inhibit PCR testing.
• NP and OP specimens can be combined, placing both swabs in the same vial.

Bronchoalveolar lavage, Tracheal aspirate: Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container.

Sputum: Have the patient rinse the mouth with water and then expectorate deep cough sputum directly into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container. A minimum of 200 µL is required for testing.

Label all specimens with at least two matching patient identifiers, the specimen site, and collection date/time.

Additional Resource: CDC Laboratory Testing for MERS

Forms & Requisitions

• WA PHL Specimen Pass Through Form (for sending samples through WAPHL to CDC only. Direct CDC submissions must be ordered in the CDC Specimen Test Order and Reporting [CSTOR] web portal.)

Approval Required

Lab Medicine Resident or Microbiology Fellow approval required.

Handling Instructions

Outside Laboratories: Clients outside of the UW Medicine system should arrange for testing directly with WA DOH or CDC.

Quantity

Requested: 3 mL BAL/tracheal aspirate; swab in 3 mL of viral transport media; 200 µL sputum
Minimum: 0.5 mL BAL/tracheal aspirate; swab in 2 mL of viral transport media; 200 µL sputum

Processing

Receiving Instructions

Refrigerate specimens while awaiting shipment. Specimens can be stored at 2-8°C for up to 72 hours after collection.

SPS: At order entry, include the modifier comment "Possible MERS" for all other Virology tests being requested along with MERS. Accession a separate order for each specimen type received.

Login: SPMSND-;REFRIG, POSSIBLE MERS

• MSNDTO: CDC
• MSPTYP: [Enter the appropriate specimen code below]
• MTSTRQ: ;MERS CoV Molecular Detection (CDC Test CDC.10488)

Specimen Type:

ETC	Translation
SPUT	Sputum
SWAB	Swab
NPS	Nasopharyngeal Swab
ORPH-SWAB	Oropharyngeal Swab
TASP	Tracheal Aspirate
BAL	Bronchoalveolar Lavage

Sendouts: Samples may be sent to WPHL or directly to the CDC, depending on instruction from the LMR/Micro Fellow.

To CDC via Washington State Public Health Lab:

• Complete the WPHL Pass-Through Serology Requisition and include the name of the approving public health official in the Comment section. Add the CAST fax number to the form to ensure proper result routing.
• Send sample(s) refrigerated with the DLMP or STAT courier.

Direct Submission to CDC:

• CDC Test: CDC-10488
• Prepare a FedEx shipment to the CDC. Ship Monday through Thursday only (Saturday Delivery is not available). Do not ship before holidays.
• Send a high priority HC1 task to CAST (Subcategory: Request for Electronic Requisitions) for assistance with online ordering and requisition printing. Include the FedEx tracking number in the task.
  • Effective 10/30/2026, the CDC no longer accepts the 50.34 Specimen Submission Form. All orders must be placed electronically in the CDC Specimen Test Order and Reporting (CSTOR) web portal.
• Once the order is placed, CAST will attach a separate requisition form for each sample and a CSTOR packing slip to the HC1 Task.
  • Package the samples in a biohazard bag with the requisitions in the back pocket.
  • Affix the first page of the packing slip (no PHI) to the outside of the shipping box.
  • Include the second page of the packing slip (containing patient name/DOB) inside the package.
• There must be two matching patient identifiers present on the samples and on the CDC requisitions. One identifier must be the name, the other identifier can be the MRN, specimen ID, or date of birth.
  • Note that because Sunquest CID labels do not contain the DOB, then either or the MRN or specimen ID must be included on the requisition or the date of birth added to the specimen label.
• Ship sample refrigerated via FedEx Priority Overnight.

Stability: Refrigerated: 72 hrs. Samples 72 hours or older: Freeze at -70°C. Samples should be shipped frozen.

Misc Sendout

Performance

Lab Department

Frequency

Turnaround Time: 2 Weeks from sample receipt at CDC Laboratories.

Available STAT?

No

Performing Location(s)

Sendout	Centers for Disease Control and Prevention 855-612-7575 1600 Clifton Road NE Atlanta, GA 30333

Billing & Coding