Get the free Specimen Submittal Form for Suspect Avian Influenza A (H5N1) - smchealth

This form is used for the submission of specimens suspected of containing Avian Influenza A (H5N1) to the San Mateo County Public Health Laboratory for testing.

How to fill out specimen submittal form for

How to fill out Specimen Submittal Form for Suspect Avian Influenza A (H5N1)

1. Begin with the header of the Specimen Submittal Form, enter the date of submission.
2. Fill in the contact information section with your name, position, and contact details.
3. Provide the identification data of the specimen, including species, breed, and age of the bird.
4. Indicate the clinical signs observed in the suspect bird before submission.
5. Include details about the sample type (e.g., swab, tissue) and collection method.
6. Record the location where the specimen was collected, including GPS coordinates if available.
7. Ensure to mark if the submission is part of a broader surveillance program or incident investigation.
8. Review the form for completeness and accuracy before final submission.

Who needs Specimen Submittal Form for Suspect Avian Influenza A (H5N1)?

1. Veterinarians suspecting Avian Influenza in birds.
2. Wildlife biologists monitoring bird populations.
3. Laboratories performing diagnostic testing for avian diseases.
4. Government agencies involved in animal health surveillance.

People Also Ask about

What is the diagnostic test for H5N1?

The MN assay remains the gold standard for serological diagnosis of H5N1 infection in humans.

What is the specimen for avian influenza?

The sample type will also depend on the type of birds that are being tested; oropharyngeal swabs from gallinaceous poultry and cloacal swabs from waterfowl are the preferred specimens for most diagnostic tests, although it is optimal to collect swabs from both locations, if possible.

What kind of test is used to detect H5N1?

Commercial PCR tests for influenza can be used to rule out influenza A (and therefore H5N1) infection in symptomatic people less likely to be infected with influenza A(H5N1) (e.g., symptomatic people with limited animal exposure, or no known exposure to infected animals or humans).

What is the diagnostic tool for avian influenza?

Serological tests: As all influenza A viruses have antigenically similar nucleocapsid and matrix antigens, agar gel immunodiffusion tests are used to detect antibodies to these antigens. Concentrated virus preparations containing either or both type of antigens are used in such tests.

Is avian influenza virus H5N1 a threat to human health?

The highly pathogenic avian influenza virus subtype H5N1 is already panzootic in poultry, with attendant economic consequences. It continues to cross species barriers to infect humans and other mammals, often with fatal outcomes.

Is H5N1 the same as avian flu?

H5N1 avian influenza (bird flu) refers to the disease caused by infection with avian influenza Type A viruses. These viruses naturally spread among wild aquatic birds worldwide and can infect domestic poultry and other bird and animal species. Bird flu viruses do not normally infect humans.

What is the PCR test for H5N1?

H5N1-specific influenza PCR As the name suggests, this test is specifically for H5N1 influenza, and we can be more confident in the result if that's the strain for which we're looking. The downside is that it won't detect co-infections with multiple flu strains.

What is the confirmatory test for the bird flu?

To diagnose bird flu, a healthcare professional takes a sample of fluid from your nose and throat to test for evidence of bird flu infection. They also may take a sample of fluid from your eye if you have pink eye.

For pdfFiller’s FAQs

What is Specimen Submittal Form for Suspect Avian Influenza A (H5N1)?

The Specimen Submittal Form for Suspect Avian Influenza A (H5N1) is a document used to collect and submit samples suspected of containing the H5N1 virus for testing and analysis.

Who is required to file Specimen Submittal Form for Suspect Avian Influenza A (H5N1)?

Individuals or organizations that suspect avian influenza A (H5N1) in poultry or other birds, including veterinarians, lab personnel, and wildlife authorities, are required to file the form.

How to fill out Specimen Submittal Form for Suspect Avian Influenza A (H5N1)?

To fill out the form, provide accurate details about the specimen, including the species, symptoms observed, date of collection, and the submitter's contact information, ensuring all fields are completed clearly.

What is the purpose of Specimen Submittal Form for Suspect Avian Influenza A (H5N1)?

The purpose of the form is to facilitate the proper identification and testing of suspect H5N1 cases, aiding in surveillance and control measures for avian influenza outbreaks.

What information must be reported on Specimen Submittal Form for Suspect Avian Influenza A (H5N1)?

The form must report information such as the specimen type, the source of the specimen, clinical signs observed in the birds, date of collection, location, and details of the submitter.