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Get the free VZV Specimen Collection Form - dhhr wv

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This form is used for the collection and submission of specimens related to varicella (chickenpox) and zoster (shingles) diagnoses as part of the ARRA School-Based Varicella Project.
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How to fill out vzv specimen collection form

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How to fill out VZV Specimen Collection Form

01
Obtain the VZV Specimen Collection Form from the appropriate healthcare provider or laboratory.
02
Fill in patient identification information including name, date of birth, and contact details.
03
Indicate the date and time of specimen collection.
04
Specify the type of specimen being collected (e.g., blood, swab).
05
Document the clinical information relevant to the specimen collection, such as symptoms or diagnosis.
06
Include any previous laboratory results if applicable.
07
Ensure all required signatures are completed, including that of the healthcare provider.
08
Review the form for accuracy and completeness before submission.

Who needs VZV Specimen Collection Form?

01
Patients suspected of having varicella-zoster virus infections.
02
Healthcare providers who require laboratory confirmation for diagnosis.
03
Laboratories responsible for analyzing specimens for VZV.
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You will need to provide a sample of blood from your vein or from the fluid in one of your blisters. Blood tests check for antibodies to the VZV. Blister tests check for the virus itself. For a blood test from a vein, a health care professional will take a blood sample from a vein in your arm using a small needle.
Vesicular lesions or scabs, if present, are the best for sampling. Adequate collection of specimens from maculopapular lesions in vaccinated people can be a challenge.
Scabs are excellent samples for PCR detection of VZV DNA. Whenever present, lift scabs off the skin (a glass slide can be used for this purpose). Then transfer directly into break-resistant, snap-cap or screw-top tubes.
Collection: Blood should be collected aseptically by venipuncture and placed in a plain, red top tube or other plain sterile tube without anticoagulant and allowed to clot at room temperature.
Vesicular lesions or scabs, if present, are the best for sampling. Adequate collection of specimens from maculopapular lesions in vaccinated people can be a challenge.
Scabs are excellent samples for PCR detection of VZV DNA. Whenever present, lift scabs off the skin (a glass slide can be used for this purpose). Then transfer directly into break-resistant, snap-cap or screw-top tubes.
A PCR (polymerase chain reaction) test. It is most often done on a sample of fluid taken by swabbing open blisters (a swab test). In some cases, other fluids may be used, but the results may not always be as accurate. The PCR test can get results quickly and is the most useful test for confirming a VZV infection.
Collection instructions Polyester swab method-vesicular lesions. Use a sterile needle to unroof the top of the vesicle. Vigorously swab the base of the lesion, applying enough pressure to collect epithelial cells without causing bleeding-and collect vesicular fluid. Place swab into labeled tube.

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The VZV Specimen Collection Form is a document used to collect and report data related to samples taken for laboratory testing of Varicella-Zoster Virus (VZV), which causes chickenpox and shingles.
Healthcare providers who collect specimens for VZV testing are required to file the VZV Specimen Collection Form.
To fill out the VZV Specimen Collection Form, provide patient information, specimen details, and clinical history as requested in the form, ensuring accuracy and completeness.
The purpose of the VZV Specimen Collection Form is to facilitate the accurate collection, labeling, and tracking of specimens for VZV testing, ensuring proper diagnosis and treatment.
The information that must be reported on the VZV Specimen Collection Form includes patient demographics, clinical history, specimen type, collection date, and details of the healthcare provider.
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