Fact Sheet for Healthcare Providers: Interpreting Test Results Obtained With the CDC swH1N1 (Swine) Influenza Virus Real-Time RT-PCR Detection Panel on the Joint Biological Agent Identification and Diagnostic System (JBAIDS) Instrument (December 18, 2009)
The information previously contained on these webpages were authorized under the 2009 H1N1 Influenza Emergency Use Authorizations (EUAs). As of June 23, 2010, the EUAs have been terminated and this information is no longer current.
A public health emergency has been declared by the Secretary of Health and Human Services because of the outbreak of the 2009 H1N1 influenza virus which is also referred to as swine influenza (H1N1) virus. This Fact Sheet will refer to the virus as 2009 H1N1 influenza virus. The Food and Drug Administration (FDA) has authorized the emergency use of the CDC swH1N1 (swine) Influenza Virus Real-time RT-PCR Detection Panel on the Joint Biological Agent Identification and Diagnostic System (JBAIDS) Instrument (rRT-PCR Swine Flu Panel on JBAIDS) to test for the presence of the 2009 H1N1 influenza virus in clinical respiratory specimens and in viral culture under an Emergency Use Authorization (EUA). This authorization will terminate on April 26, 2010, unless (1) it is revoked sooner, (2) the declaration of emergency is terminated sooner, or (3) the declaration of emergency is renewed for a longer term. The information in this Fact Sheet is the minimum necessary to inform you of the significant known and potential risks and benefits of the emergency use of the rRT-PCR Swine Flu Panel on JBAIDS.
At this time, there are no FDA-approved or cleared tests that identify the existence of the 2009 H1N1 influenza virus in clinical specimens. Previously, the FDA granted Emergency Use Authorization for the Swine Influenza rRT-PCR Detection Panel provided by the CDC to be used on the Applied Biosystems (ABI) 7500 Fast Dx instruments. To augment existing testing capacity, to allow the use of additional specimen types, and provide 2009 H1N1 Influenza testing capability to Department of Defense (DoD) sites, most of which currently do not have PCR capability on the ABI 7500 Fast Dx instruments, but are currently equipped with the JBAIDS instruments, FDA has authorized the emergency use of the rRT-PCR Swine Flu Panel on JBAIDS to detect 2009 H1N1 influenza virus infections. Current information on 2009 H1N1 influenza virus, including case definitions and infection control guidelines, is available at http://www.cdc.gov/h1n1flu/ . All information and guidelines, including those on testing for 2009 H1N1 influenza A virus, may change as we continue to learn more about this disease. Please check CDC’s 2009 H1N1 influenza virus website regularly for the most current information.
The rRT-PCR Swine Flu Panel on JBAIDS should be ordered only to diagnose 2009 H1N1 influenza virus infection. This test is authorized for use with viral culture, upper respiratory tract specimens, such as nasopharyngeal swabs (NPS), nasal swabs (NS), throat swabs (TS), nasal aspirates (NA), nasal washes (NW), and dual nasopharyngeal / throat swabs (NPS/TS), and lower respiratory tract specimens, such as broncheoalveolar lavage (BAL), bronchial aspirate (BA), bronchial wash (BW), endotracheal aspirate (EA), endotracheal wash (EW), tracheal aspirate (TA), and lung tissue . Specimen collection should be conducted according to the manufacturer’s instructions for the specimen collection device and sent to a JBAIDS qualified DoD laboratory for analysis.
What does it mean if the specimen tests positive for the 2009 H1N1 influenza virus ?
A positive test for 2009 H1N1 Influenza virus using the rRT-PCR Swine Flu Panel on JBAIDS indicates that the patient is infected with the 2009 H1N1 influenza virus. The test does not indicate the stage of infection. Laboratory test results should always be considered in the context of clinical observations and epidemiologic data in making a final diagnosis. For guidelines on managing patients please refer to “Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Setting, Including Protection of Healthcare Personnel ” at http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm and “Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season” at http://www.cdc.gov/h1n1flu/recommendations.htm
The rRT-PCR Swine Flu Panel on JBAIDS has been designed to minimize the likelihood of false positive test results. However, in the event of a false positive result, the risks to patients could include any or all of the following: recommendations to limit contact with uninfected persons (including at home or at the workplace), a prescription of antiviral medication or other therapy, the impaired ability to detect and receive appropriate medical care for the true infection causing the flu like symptoms, or other unintended adverse effects.
What does it mean if the specimen tests negative for the 2009 H1N1 influenza virus?
Negative results do not preclude influenza virus infection and should not be used as the sole basis for treatment or other patient management decisions. The clinical features of the illness and the type and risk of exposure are the keys to making patient management and isolation decisions. A negative result from the rRT-PCR Swine Flu Panel on JBAIDS should not be interpreted as demonstrating that the patient does not have 2009 H1N1 influenza virus infection, if other aspects of the patient’s clinical presentation or recent epidemiologic exposures indicate 2009 H1N1 influenza virus infection is likely, and diagnostic tests for other causes of acute respiratory illness are negative.
JBAIDS Operators Help Line / Technical Assistance:
JBAIDS Training School
2507 Kennedy Circle
Brooks City Base, TX 78235
DSN: 240-3248 or Commercial: 210-536-3248
Healthcare providers will be contacted by the DoD’s Joint Project Management Office, Chemical Biological Medical Systems (CBMS), in the event of any significant new findings observed during the course of the emergency use of the rRT-PCR Swine Flu Panel on JBAIDS.