Specimen PIDSR

NOTIFIABLE
DISEASES
Philippine Integrated Disease
Surveillance and Response
(PIDSR)
Republic of the Philippines

Department of Health
Center for Health Development-CAR
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SPECIMEN
COLLECTION

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Quality of Laboratory Result
SPECIMEN TYPE SHIPMENT

CONDITION
QUALITY
TIMING
AMOUNT
OF
COLLECTED
COLLECTION
©RITM

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Vaccine Preventable
Diseases (VPD)
1. Diphtheria
2. Measles-Rubella
3. Acute Flaccid Paralysis (AFP)
4. Pertussis
5. Neonatal Tetanus – No Specimen Required

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Diphtheria
Handling/Storage:
Specimen:
• Unpreserved: Transport as soon as possible;
1. Throat Swab (TS) ≤ 2 hours, RT (Room Temparature)
• Preserved: Amies Transport Medium / Blood Agar Plate:
2. Nasopharyngeal swab (NPS)
≤ 24 hours, RT (if BAP only is submitted,
3. Pseudomembrane include the remaining pseudomembrane)
Note: plate or tube must be wrapped with sealing film or any

adhesive tape.
Time of Collection: Collection:

1. TS: 2 swabs (Place swabs in sterile test tube or Amies TM)
2 Throat swabs; 2. NPS: 1 swab (Place swabs in sterile test tube or Amies TM)
As soon As the suspicion arises, preferably 3. Pseudomembrane: can be removed or swab beneath
prior to antimicrobial therapy the membrane or the inner portion.
Place in sterile tube or any sterile container or
Piece/s of swabs from pseudomembrane inoculate/ rub the inner portion of the
membrane onto Blood Agar plate

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Measles-Rubella
Specimen: Handling/Storage
• Transport on ice packs
1. OPS/NPS Storage: Freeze (-20°C) prior to transport
2. Serum • Immediately refrigerate at 2-8 degree
Celsius while awaiting transport
• Transport in ice to be received at RITM
within 72 hours

• OPS/NPS: within 7 days from rash onset ▪ 1 -2 swabs OPS/NPS
• Serum: within 4-28 days - Use Dacron or rayon swabs with
plastic shafts Suspend in VTM/UTM
▪ 1 ml serum (aliquot sample into cryotube)

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Acute Flaccid Paralysis (AFP)
Specimen: Handling/Storage;
• Immediately refrigerate at 2-8 degree Celsius
while awaiting transport
Stool • Transport in ice to be received at RITM within 72
hours
• Place container in a ziplock/leakproof plastic
bags

2 Stool
• Place in a clean screw- capped container
Within 14 days onset of paralysis
• 24 hours interval
• 1 adult thumb size; diarrheic: 5-10 ml

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Pertussis
Specimen: Handling/Storage:
A. Samples for Culture Testing
• Unpreserved: Transport as soon as possible, RT
1. NPS • Preserved: Regan Lowe< 24 hours, RT; > 24 hours, on ice packs
2. Nasopharyngeal B. Samples for Molecular Testing
• Storage: Refrigerate (2-8°C) prior to transport
Aspirate (NPA) • Transport on ice packs
• Storage: Freeze (-20°C) prior to transport
Collection:
Culture Testing:
Time of Collection: • NPS: 1-2 swabs; Place the 2 swabs (NPS/NPA) in Regan-
Lowe TM
As soon as the suspicion arises, • NPA: 1 ml; Collect in a sterile screw-capped tube
Molecular Testing:
Pref.: prior to antimicrobial therapy • NPS: Swab (2) the collected sample; Place the 2 swabs
(NPS/NPA) in Regan-Lowe TM, if unavailable, use UTM or
Atypical Pneumonia Transport Medium (APTM)
• NPA: Collect in a sterile screw-capped tube

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Food- and Water-borne Illness
1. Acute Bloody Diarrhea (ABD)
2. Acute Viral Hepatitis A
3. Cholera
4. Typhoid/ Paratyphoid Fever

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Acute Bloody Diarrhea
Rectal swab (alternative to stool) • Unpreserved: Transport as soon as

possible
• Preserved: ≤ 7 days in Cary Blair TM, RT
As soon as the suspicion arises, 1-2 Rectal swab

Pref.: prior to antimicrobial therapy • Unpreserved: Sterile tube
• Preserved: Place in a Cary-Blair TM

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Acute Viral Hepatitis A
• Transport on cold pack as soon as
Serum possible
• Storage: Freezer temperature (-20°C)
prior to transport
Upon first contact with the patient ▪ 1 ml Serum

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Cholera
• Unpreserved: Transport as soon as

Rectal swab (alternative to stool) possible
• Preserved: ≤ 7 days in Cary Blair
TM, RT
Collection:
Time of Collection:
1-2 Rectal swab
Acute stage of illness prior to
antimicrobial therapy • Unpreserved: Sterile tube
• Preserved: Place in a Cary-Blair
Transport Medium (TM)

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Typhoid
Unpreserved: Transport as soon as
possible
Rectal swab (alternative to stool)
Preserved: ≤ 7 days in Cary Blair TM,
RT
Acute stage of illness prior to 1-2 Rectal swab

antimicrobial therapy
•Unpreserved: Sterile tube
•Preserved: Place in a Cary-Blair TM

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Vector-borne and
Zoonotic Diseases
1. Anthrax
2. Chikungunya
3. Dengue
4. Malaria
5. Rabies
6. Leptospirosis
**Zika
©RITM

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Anthrax
• Freeze the serum immediately after it
has been transferred into the plastic
Serum freezing vial (s)
• Store the specimen at -20° C or colder
until it is shipped to referring laboratory

Acute Phase: ≤7 days from onset
2 Serum
Convalescent Phase:
- 1 ml from each phase
- 14-35 days after symptom onset
- recommended that theconvalescent
phase specimen be taken 2 weeks after
the acute specimen
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Chikungunya
• Immediately refrigerate at 2-8 degree
Serum Celsius while awaiting transport
within 72 hours
After 7 days from onset of fever ▪ 1 - 2 ml Serum

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Dengue
• Immediately refrigerate at 2-8 ˚C
Serum while awaiting transport
• Transport in ice to be received at
RITM within 72 hours
Within 5 days from onset of fever ▪ 1 ml - 2 ml Serum

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Malaria
Whole blood • Room Temperature (25 - 37°C)
Upon first contact with the patient 5-10 drops (Thin and Thick Smear)
• Finger prick preferred
• Avoid exposure of smear to heat
• Protect smear from dust and insects

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Rabies
1. Serum
2. CSF •Transport on ice pack as soon as possible
3. Saliva •Storage: Freezer temperature (-20°C)
4. Brain Tissue prior to transport

▪ 1-2 ml serum (screw-capped tube)
Upon first contact with the patient ▪ 1-2 ml CSF (screw-capped tube)
▪ Saliva:
or - 5 ml per collection
- 0.5 ml saliva collected serially by aspiration,
Upon appearance of rabies specific every 4-6 hours.
signs and symptoms - 3-5 sample collections pooled & aliquoted for
antemortem/tests & specimen banking.
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Leptospirosis
•Transport on ice pack as soon as
1. Serum
possible
2. CSF
•Storage: Freezer temperature (-20°C)
3. Urine
prior to transport
Serum: Acute phase (5-10 days after onset of
symptoms)
Convalescent Phase (5-20 days ▪ ≥ 1 ml Serum;
after onset of symptoms ▪ ≥ 0.5 - 1 ml CSF;
CSF: within 10 days after onset of symptoms ▪ 10-20 ml Urine
Urine: 2nd week up to 30 days after onset of
symptoms

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Zika
Urine (Ideal Sample)

• Transport on ice packs (2-8 °C)
Within 7 days from onset of illness 5-10 ml Urine

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Other Diseases
1. Acute Meningitis-Encephalitis Syndrome (AMES)
2. Hand, Foot, and Mouth Disease (HFMD)
3. Influenza-Like Illness
4. Meningococcal Disease
©RITM

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Acute Meningitis-Encephalitis Syndrome (AMES)
• Immediately refrigerate at 2-8 ˚C while
1. Serum awaiting transport
2. CSF
within 72 hours
• Place container in a ziplock/leakproof
plastic bags

Serum: Acute phase (Upon first contact
with the patient) ▪ 2 Serum (≥ 1 ml);
▪ 1- 2 ml CSF
Convalescent Phase (24-48 hrs.
after collection)
CSF: Upon first contact with the patient
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Hand, Foot, and Mouth Disease (HFMD)
• Immediately refrigerate at 4-8 °C/
1. NPS/OPS
thermobox with 6 frozen ice packs while
2. Vesicular Swab awaiting transport
3. Rectal swab • Transport in ice to be received at RITM
4. CSF within 72 hours
• Place container in a ziplock/leakproof
plastic bags
NPS/OPS: within 14 days from onset of rash or
lesions ▪NPS/OPS: 2 swabs (UTM/VTM)
Vesicular Swab: With presence of unraptured
vesicle/fresh lesions
▪Vesicular Swab: 1 swab (UTM/VTM)
Rectal swab: up to 6 weeks from onset of ▪Rectal swab (placed in sterile screw
symptoms capped container
CSF: Within 7 to 10 days after from onset of ▪CSF: 1 ml
symptoms
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Influenza-Like Illness (ILI)
• Immediately refrigerate at 2-8
NPS/OPS degree Celsius while awaiting
transport
• Transport in ice to be received at
RITM within 72 hours
ILI: within 10 days from onset of 1-2 swabs

illness
TM: UTM/VTM

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Meningococcal Disease
• Transport in cold chain,<72 hours, on
1. Serum ice pack
2. CSF • Storage: Refrigerate (2-8°C) prior to
transport (If culture is requested, take
a separate sterile container that will
be transported at room temperature)
As soon as the suspicion arises; ▪0.5 – 2 ml Serum;

Preferably prior to antimicrobial ▪0.5 - 2 ml CSF
therapy

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Specimen PIDSR

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NOTIFIABLE

Republic of the Philippines

Republic of the Philippines

SPECIMEN TYPE SHIPMENT

Republic of the Philippines

Republic of the Philippines

Note: plate or tube must be wrapped with sealing film or any

Time of Collection: Collection:

Republic of the Philippines

Time of Collection: Collection:

Republic of the Philippines

Time of Collection: Collection:

Republic of the Philippines

Republic of the Philippines

Republic of the Philippines

Rectal swab (alternative to stool) • Unpreserved: Transport as soon as

Time of Collection: Collection:

As soon as the suspicion arises, 1-2 Rectal swab

Republic of the Philippines

Time of Collection: Collection:

Upon first contact with the patient ▪ 1 ml Serum

Republic of the Philippines

• Unpreserved: Transport as soon as

Republic of the Philippines

Time of Collection: Collection:

Acute stage of illness prior to 1-2 Rectal swab

Republic of the Philippines

Republic of the Philippines

Time of Collection: Collection:

Time of Collection: Collection:

After 7 days from onset of fever ▪ 1 - 2 ml Serum

Republic of the Philippines

Time of Collection: Collection:

Within 5 days from onset of fever ▪ 1 ml - 2 ml Serum

Republic of the Philippines

Whole blood • Room Temperature (25 - 37°C)

Time of Collection: Collection:

Republic of the Philippines

Time of Collection: Collection:

Republic of the Philippines

Urine (Ideal Sample)

Time of Collection: Collection:

Within 7 days from onset of illness 5-10 ml Urine

Republic of the Philippines

Republic of the Philippines

Time of Collection: Collection:

ILI: within 10 days from onset of 1-2 swabs

Republic of the Philippines

As soon as the suspicion arises; ▪0.5 – 2 ml Serum;

Republic of the Philippines

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