Lab and Testing Procedures
To improve efficiency across IDPH labs, the Illinois Department of Public Health has implemented the IL ETOR portal (Illinois Electronic Test Ordering and Reporting portal).
ETOR is a web-based portal that will allow a submitter to enter all the necessary data to submit a COVID sample electronically on a laptop, tablet, or desktop. Once the submission is complete, the printed ETOR order form must accompany the sample to the lab. The patient data is electronically transferred to the IDPH lab where the specimen will be processed. In ETOR, the submitter can view when the sample has been received at the designated IDPH lab along with real-time testing progress. Once testing is complete, the laboratory releases results into the portal as a PDF which can be downloaded for quick access and follow up with the patient.
Enrollment and use of this system is critical to the Division of Laboratories’ ability to maintain quick turnaround times while increasing testing capacity.
To enroll your facility in the IL ETOR portal or if you have further questions, please email DPH.LABS.DMG@illinois.gov and a ETOR project manager will contact you.
ALL positive COVID-19 lab results should be entered as 'Novel Coronavirus 2019' case in I-NEDSS.
When sending specimens for testing at references laboratories, the ordering provider must complete address, phone, and demographic information on the patient. This information is required for ELR (electronic laboratory report) data to be correctly routed to the appropriate local health department.
Proper collection of specimens is the most important step in the laboratory diagnosis of infectious diseases. A specimen that is not collected correctly may lead to false negative test results. General guidance can be found here: https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html?deliveryName=USCDC_2067-DM26911
For initial diagnostic testing for SARS-CoV-2, CDC recommends collecting and testing an upper respiratory specimen. The following are acceptable specimens:
- A nasopharyngeal (NP) specimen collected by a healthcare professional; or
- An oropharyngeal (OP) specimen collected by a healthcare professional; or
- A nasal mid-turbinate swab collected by a healthcare professional or by a supervised onsite self-collection (using a flocked tapered swab); or
- An anterior nares (nasal swab) specimen collected by a healthcare professional or by onsite or home self-collection (using a flocked or spun polyester swab); or
- Nasopharyngeal wash/aspirate or nasal wash/aspirate (NW) specimen collected by a healthcare professional.
Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19): https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html
Post-Mortem Specimen Collection: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-postmortem-specimens.html
Infection Control Guidance: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
FDA Coronavirus Emergency Use Authorizations for In Vitro Diagnostics. Link: https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas The Illinois Department of Public Health does not recommend use of serology tests that are not authorized under EUA.
|RT-PCR||Antigen||Serology (Antibody Testing)|
|Method||Detects the virus’s genetic material||Detects the presence of a specific viral antigen.||Measures antibody response to viral protein target|
|Sample Type||Usually nasopharyngeal (NP) or oropharyngeal (OP) swab although other specimen types are possible||Usually NP or nasal swab (specimens from the respiratory tract)||Usually blood-based test|
|Timing||Most likely to be positive in the 1-2 days prior to symptoms onset and while symptomatic but may persist as positive up to several weeks||In symptomatic infection, positive as symptoms develop and wanes over time||Takes at least 7-14 days after symptom onset to develop antibodies and varies depending n the antibody class measured|
|COVID-19 Case Classification as per Lab Result||
Positive = Confirmed
Negative= not a case currently.
Positive = probable case.
Negative = may be a probable case if there is an epidemiologic link to a COVID-19 case or outbreak and if the case has had COVID-19 symptoms
Positive = suspect case.
May be a probable case if there is an epidemiologic link to a COVID case or outbreak or if the case has had COVID-19 symptoms Negative= may be a probable case if there is an epidemiologic link to a COVID case or outbreak or if the case has had COVID-19 symptoms
More information on point-of-care testing platforms: https://www.cdc.gov/coronavirus/2019-ncov/downloads/OASH-COVID-19-guidance-testing-platforms.pdf