CSF: 2.0 ml (1.0 ml), Refrigerated or Frozen; Serum: 2.0 (1.0 ml), Refrigerated or Frozen; EDTA or ACD Whole Blood: 2.0 ml (1.0 ml), Refrigerated;
NATÔ or STD Swab: from any site, place in viral transport medium, Ambient; Fresh Tissue: 0.2 g (0.1 g), place in viral transport medium, Ambient, Refrigerated or Frozen; ThinPrep™:1.0 ml (0.5 ml); SurePath™: 0.5 ml (0.25 ml), Ambient; Urine:  5.0 ml (1.0ml), Refrigerated or Frozen.

CSF: refrigerate or freeze;  Serum: refrigerate or freeze; Whole Blood EDTA or ACD: refrigerated; Swab or Tissue in viral transport medium: ambient;
ThinPrep™ or  SurePathä Solution:  In addition to the cervix, a thorough brushing of the vaginal walls is necessary to ensure adequate sample source.  Store and ship ThinPrep™ at ambient temp up to 3 months and SurePath™  up to 28 days.  Ship refrigerated specimens on an ice pack; frozen specimens on dry ice; Urine:  Collect first catch (not midstream) urine in sterile, leakproof container.  The patient should not have urinated for 2 hours prior to collection.  Immediately store urine at 2-8°C and ship within 24 hours of collection on cold pack.

Whole blood: in heparin, insufficient volume, shipped at incorrect temperature; ThinPrep™ Solution: Less than 0.5 ml and/or more than 3 months; 
SurePath™: Less than 0.25 ml and/or more than 28 days;  Urine:  Less than 5.0 ml, and/or more than 24 hours at non refrigerated temperature (2-8°C); NAT or STD Swabs:  No swab in tube.

ThinPrep™: Stable for up to 3 months at room temp;  SurePath™: Stable for up to 28 days at room temp; Urine: Stable for up to 7 days at 2-8°C; NAT or STD Swabs: Stable for up to 7 days at 2-8°C. Other Refrigerated specimens stable for 7 days and ambient specimens stable for 4 days.  Frozen specimens stable indefinitely.

87801: Infectious agent detection by nucleic acid, multiple organisms, amplified probe(s) technique: HSV Types I & II                 

Herpes simplex virus (HSV) is one of the most prevalent viruses found in the general population today.  It is estimated that more than 107 million people worldwide are infected with herpes and only 21.4 million are diagnosed. Type 1 infections usually involve nongenital areas, whereas type 2 infections are primarly found in genital areas, although there is overlap between the two types.  The clinical courses of acute first-episode genital herpes among patients with HSV-1 and HSV-2 infections are similar and both can cause symptomatic or asymptomatic rectal and perianal infections. HSV infections may be inapparent because symptoms do not always follow a typical pattern or patients may be asymptomatic.  By utilizing polymerase chain reaction (PCR), HSV has been demonstrated in asymptomatic patients on 28% of days tested versus 8.1% by viral isolation.  As a result, the rate of detection for PCR is 3.5 times that of a traditional viral culture in asymptomatic patients.  More importantly, asymptomatic shedding was shown on 60% of days where HSV DNA was measured by PCR.  This has a significant impact on patient counseling since asymptomatic shedding of HSV DNA can occur to a much broader extent than previously thought.  Patients with ulcerative lesions have positive PCR results on 15 of 17 days (88.2%) versus positive culture results on 3 of 17 days (17.6%). 

Culture isolation or immunologic analysis of HSV from cerebrospinal fluid (CSF) is limited at best.  These techniques lack sensitivity and specificity and do not yield results quickly.  PCR offers a rapid and sensitive way to test for HSV infections in CSF and has evolved to become the standard of care in patients with suspected CNS infection.  Studies have shown the range of sensitivity of PCR detection for HSV DNA to be from 75% to 100% with specificity of 100%.  In conclusion, the detection of HSV DNA by PCR has been proven to be the most specific, rapid, and sensitive means to diagnose anogenital and CNS infections. 64(4):757-60.