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  • Technical Bulletin
  • Rotavirus & Norovirus Specimens

Request for submission of norovirus- and rotavirus-positive specimens to the Nevada State Public Health Laboratory

The Nevada Office of State Epidemiology (OSE) and the Nevada State Public Health Laboratory (NSPHL) request that clinical laboratories retain residual stool specimen material from patients with sporadic, laboratory-confirmed norovirus and rotavirus infections and submit these residuals in batch to NSPHL. This activity supports Nevada’s participation in CDC’s National Respiratory and Enteric Virus Surveillance System (NREVSS) Enhanced program.

BACKGROUND

NREVSS is a long-standing, laboratory-based passive surveillance system for respiratory and enteric viruses. The NREVSS Enhanced initiative adds molecular characterization of two target enteric pathogens — norovirus and rotavirus — to define circulating genotypes, detect emergent strains, and inform outbreak prevention and understanding of potential vaccine impacts. Broad clinical laboratory engagement is needed for representation of the statewide population, complementing aggregate diagnostic reporting with strain-level data from sporadic cases.

REQUEST TO NEVADA CLINICAL LABORATORIES

Clinical laboratories in Nevada are asked to:

  • Retain residual stool specimen material from patients testing positive for norovirus or rotavirus by routine diagnostic testing (e.g., multiplex GI panel, EIA, or molecular assay).
  • Limit submission to sporadic cases — specimens from patients not known to be associated with a recognized outbreak (outbreak-associated specimens follow existing NORS / CaliciNet outbreak protocols).
  • Store and batch residual specimens for scheduled courier transport to NSPHL (see below).
  • Provide minimal demographic and testing data with each specimen (see below).

Rotavirus is reportable in Nevada as an individual case/condition under NAC 441A.040, and under NAC 441A.225 must be reported to the local health authority by the first working day following identification of the case or suspected case.

Norovirus is not reportable in Nevada except in outbreak situations. However, under NAC 441A.235 medical labs shall submit clinical material, if available, to the State Public Health Laboratory for confirmation or further testing if requested by the health authority.

INSTRUCTIONS FOR SUBMISSION

NSPHL is the single point of submission; clinical laboratories should not ship directly to CDC.

Requested Data Elements

Submit with each residual specimen: collection date; specimen source/type; test method and result; and minimal demographics (age or age group, sex, county of residence). Complete NSPHL Service Request Form: Select Norovirus and/or Rotavirus and note specimen is for NREVSS submission.

Specimen Handling, Storage, and Shipment

  • Store residual specimens at the temperature at which they were originally held; avoid freeze-thaw cycles during storage and transport.
  • Package and ship specimens at their storage temperature (maintain cold chain).
  • Use leak-resistant, appropriately labeled containers suitable for Category B (UN3373) biological substance transport.
  • Hold specimens for scheduled batch pickup; avoid prolonged storage that may degrade nucleic acid integrity.
  • If your facility is not on a regularly scheduled NSPHL courier route and would like courier information, call NSPHL at 775-688-1335.
  • See below for storage and shipment guidelines.

Submission Schedule

Residual specimens are batched and submitted quarterly, aligned to the NREVSS Enhanced reporting quarters: August–October, November–January, February–April, and May–July. NSPHL reconciles received specimens against accompanying data and coordinates onward submission to CDC (rotavirus) and CaliciNet upload (norovirus).

PathogenStorage/Shipment InstructionsFinal Disposition
NorovirusStorage:
– Store/ship stool in sterile plastic dry container.
– Do NOT freeze. Refrigerate 2-8⁰C.

Shipment:
– Ship refrigerated 2-8⁰C.		Confirmed and genotyped at NSPHL using CaliciNet protocols. Sequences and demographic/testing data uploaded by NSPHL to CaliciNet. Specimens are not forwarded to CDC.
RotavirusStorage:
– Store/ship stool in a sterile plastic dry container.
– Store up to 72 hours at 2-8⁰C.
– For testing occurring > 72 hours after collection, freeze specimen at -20⁰C or lower.

Shipment:
– Ship refrigerated or frozen according to specimen temperature.		Forwarded by NSPHL to CDC for confirmation and genotyping (batched to ship quarterly).

QUESTIONS

For updated guidance, review the Division of Public and Behavioral Health Technical Bulletin web page regularly. Email dpbhepi@health.nv.gov for other questions regarding NREVSS participation.