The State Bureau of Labs is ground zero for virus testing in the state of Michigan. Samples from doctor's offices, labs and clinics around the state are sent to the lab for the identification of viruses, including H1N1 or Swine Flu.
First the samples arrive at the Data Assessment Handling Unit. They come in by mail and UPS. Some places also have a courier system that brings specimens to the lab. Lab Director, Frances Pouch Downes says, "The folks here take the specimens and they open the boxes, take the specimens out and the test request forms."
Then the samples head up to the molecular biology lab where the sample is added to a mixture to prepare it for amplification and ultimately identification. A group of machines and computers help to determine what kind of virus it is. Once the samples are loaded in, the computer spits out a graph indicating what's happening with the sample. The biologists can tell if it's a flu virus by the nature of the graph's curve. Molecular Biologist Laura Mosher says, "We look for four targets to see if it's Novel H1N1 and if the target's positive...we get curves coming up.
The Virology Manager says the machine will tell them if it's H1N1 or Influenza A or B. He says, "Once we determine if it's H1N1, we don't send it to culture at that point." Molecular Biologist Laura Mosher estimates that they run about 42 to 105 samples a day.
If it's not Swine Flu, or Seasonal Flu A or B, the samples will go to the Viral Isolation Lab where they're examined to see if they are a respiratory virus. Laboratory Systems Section Manager Patty Clark says, "Those tubes of cell culture are observed for 7 days for evidence of viral infection."
The goal is to find out what's in the vials to better understand how to treat you if you become sick, even if it wasn't your sample that came to the lab. Clark says, "It benefits citizens of the state because we need to know to be able to tell physicians what viruses are circulating. Some viruses are susceptible to anti-viral medications, others are not, they can't wait for a culture to come back or test results to come back in order to treat that patient, so if they have an idea that the vast majority of viruses circulating out there are the novel H1N1 ant that is susceptible to one of the antivirals, they will start treating the patient right away rather than waiting."
The employees also look for mutations in the viruses. As far as the swine flu, so far so good. The lab director, Frances Pouch Downes says there is no indication the virus is becoming stronger. She says they pay particular attention to samples from people who have died or who have stronger symptoms. She says, "We want to look at people who've had unusual symptoms, particularly severe, because if we start to see that, it might indicate something is changing about the virus and so that's why we're going to monitor those very closely."
This is a busier time for the lab due to the presence of H1N1. Downes says, "We've been very fortunate. We had federal resources that helped us buy the right equipment, get people trained, we were able to stockpile some of the testing reagents, the supplies that we needed and so we've been ready for this. I think the planning and preparation's paid off."
As far as vaccines for H1N1 in Michigan, James McCurtis of the Michigan Department of Community Health says the state has received about 635,000 doses in the state of Michigan as of late Thursday. He says, "Hopefully by late November, early December, we'll have a vaccine for everyone."