If possible select a recently developed vesicle. Using a scalpel or needle gently incise/remove skin or crust over the top. Moisten the swab in virus transport medium and then rub the fluid exuding from the vesicle. Snap off the swab into virus transport medium.
Diagnosis of viral pharyngitis and streptococcal pharyngitis depends on the culture of a throat swab.
virology – moisten the swab in virus transport medium before taking the specimen. Follow procedures as for the bacteriology throat swab. Snap off the swab into transport medium. If a respiratory virus is suspected a nose swab can also be taken
bacteriology – See Bacteriology section
Serology Test Profiles
Rubella – we screen by looking for IgG using an ELISA technique. It is important to remember that re-infection can occur, and may rarely cause foetal damage, so pregnant contacts should be followed up even if previously reported as immune. If sending specimens from pregnant contacts please give the gestation and date of contact, as this will influence the investigations performed.
Hepatitis B – post-vaccination screening is by measuring anti-HBs. A level >100 IU will provide protection for at least 5 years; levels between 10-100 are protective for an indeterminate period.
Varicella – we are regularly asked to check the immune status of pregnant contacts, and a rapid (though expensive) method is available for this. If the patient has had an antenatal screen at Plymouth, we can test the stored serum and provide the result within hours. Zoster immune globulin will be issued if required.
See the latest copy of the Needlestick Injury Policy, which is available on all wards, and is also on the Trust’s intranet under clinical guidelines/communicable diseases.
The tables below summarise the investigations that may be performed for various clinical syndromes. They are open for modification depending upon clinical information provided.