If your doctor thinks you have type 1 diabetes, your blood may also tested for autoantibodies (substances that indicate your body is attacking itself) that are often present in type 1 diabetes but not in type 2 diabetes. You may have your urine tested for ketones (produced when your body burns fat for energy), which also indicate type 1 diabetes instead of type 2 diabetes.
Getting tested is the only way to know your HIV status. If you are HIV-positive, you can start getting treated, which can improve your health, prolong your life, and greatly lower your chance of spreading HIV to others.
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A1. No, an employer may not include non-CDL drivers in the DOT random testing pool. Please see 49 CFR 40.347 (B) (2) The DOT and FMCSA drug and alcohol testing regulations apply to any person who operates a CMV, as defined in 382.107, in intrastate or interstate commerce and is subject to the CDL requirements of 9 CFR Part 383. An employer may perform testing beyond that required by the DOT rules, but the employer may not represent such testing as a DOT test and must place non-DOT covered employee drug and alcohol testing in a pool that is completely separate from the DOT covered testing pool. See 382.305 Question 15.Q2. Random Testing Selection Period: A motor carrier conducts or administers a DOT random test on a driver that was selected in the fourth quarter of the year, but the test was not verified by the medical review officer (MRO) until the next year. What year does this DOT random test count towards?A2. The test will count towards the MIS results for the year during which the specimen was collected, and not when the test was verified.Q3. Random Testing Selection Period: A driver that was selected in the first quarter but was tested on April 4. Is the motor carrier in violation for not testing the driver in the selection period they were selected, since the first quarter selection runs from January 1 to March 31? Also, does this random test count towards the first quarter or second quarter?
A3. Yes, the motor carrier is in violation because the driver was not tested in the selection period he/she was selected, as is required by 49 CFR 382.305(i)(3). However, the test will count towards the motor carrier meeting their minimum random testing requirements of 25% for DOT random controlled substance testing and 10% for DOT random alcohol testing. Please see 49 CFR 382.305(b)(1)(2).Q4. Requirements While Not Performing Safety-Sensitive Functions: A CDL driver is selected for a random drug test and the employer directs the driver to be tested when he was (off duty) not performing a safety-sensitive function. The collection site instructs the driver to submit to a random drug test and a random alcohol test. The driver tests positive for the random alcohol test. Is the driver required to undergo the return-to-duty process before performing safety sensitive duties again as a result of the positive alcohol test?
A11. Yes. If a random selection is done based on locations or terminals, a two-stage selection process must be utilized. The first selection would be made by the locations and the second selection would be of those employees at the location(s) selected. The selections must ensure that each employee in the pool has an equal chance of being selected and tested, no matter where the employee is located. [382.305, Question 7]
Chagas is a serious disease caused by the parasite Trypanosoma cruzi. The agent is endemic in Latin America, but approximately 20 reports of transmission by blood transfusion have been published worldwide. The Red Cross blood donations are screened using the Ortho T. cruzi Enzyme-Linked Immunosorbent Assay (ELISA) for the qualitative detection of antibodies to T. cruzi in human serum or plasma samples. An FDA licensed enzyme strip immunoassay (ESA) is used for confirmatory testing. The FDA has approved a T. cruzi reentry algorithm requiring a follow-up sample testing nonreactive by the two FDA licensed screening tests and the ESA. Although T. cruzi can be transmitted by blood transfusion, to date, the Red Cross has not identified any recipients infected by blood components from screen-negative donors or screened-negative donors who subsequently tested positive (seroconverted). All reports of transfusion transmission have been from unscreened platelets, except from one red cell case, or from whole blood from unscreened donors in Latin America. Because T. cruzi is not endemic in the United States, the Red Cross (and all US blood centers) donors are tested only once. The frequency of detecting a positive donor is about 1 per 15,000 first-time donations screened.
HBV DNA and HBsAg are the first viral markers to circulate in an individual infected with HBV. Anti-HBc appears in the blood of individuals infected with HBV one to four weeks after the appearance of HBsAg, and at the onset of symptoms for those adults who develop symptoms (5% or less). The tests used for blood donor screening are the GS HBsAg EIA 3.0, a qualitative ELISA for the detection of Hepatitis B Surface Antigen (HBsAg), and the Ortho HBc ELISA for the qualitative detection of antibody to HBV core antigen (anti-HBc) in human serum and plasma samples. An FDA licensed triplex nucleic acid test (NAT) using transcription-mediated amplification was introduced by the Red Cross in 2009. The assay detects HBV DNA, HIV-1 RNA, and HCV RNA. Testing is performed in mini-pools (MP) of 16 samples; components of reactive MP are tested individually to identify the reactive donations, followed by virus-specific testing to determine the virus responsible for the sample's reactivity. Specific antigen neutralization is used for HBsAg reactive confirmation; HBsAg-reactive samples that are HBV DNA reactive do not require further testing by neutralization. If neutralization testing is positive and MP-NAT is nonreactive, or the donation sample is anti-HBc reactive and HBsAg and MP-NAT are nonreactive, further testing is performed by HBV individual donation NAT. False-positive donors for any HBV marker may be reentered. The per-unit risk of HBV infection through blood transfusion is less than 1 per million units screened. NAT has reduced the window-period from HBV infection to detection by about 12 days. This leaves an approximate period of 2 to 3 weeks when an infected donor may not be detected by blood donation screening. The frequency of detecting an active HBV infection in a blood donor is about 1 per 12,000 donations screened.
HCV is the causative agent for most, if not all, blood-borne non-A, non-B hepatitis. The test used for blood donor screening is the Ortho HCV ELISA for the qualitative detection of antibody to HCV antibodies (anti-HCV) in human serum or plasma samples. A duplex nucleic acid test (NAT) was introduced for HIV-1/HCV RNA detection in 1999 and updated to include the detection of HBV DNA in 2009 (see above). Donors who test HCV-antibody reactive, but NAT nonreactive by routine testing are further tested individually for HCV RNA by NAT. If nonreactive on the specific individual HCV NAT assay, the sample is further tested by another FDA licensed HCV-antibody screening test to determine if the antibody reactivity is specific. Donors who test anti-HCV and HCV NAT reactive do not require further testing. False-positive donors by either antibody or HCV NAT may be reentered. The per-unit risk of HCV infection through blood transfusion is less than 1 per 2 million units screened. NAT closes the window period between infection and the detection of antibody for those infected with HCV by about 50 to 60 days. This leaves an approximate period of about 1 week when an infected donor may not be detected by blood donation screening. The frequency of detecting a positive donor is about 1 per 5,000 donations screened.
Blood donation screening for HIV-1, the causative agent of AIDS began with antibody testing in 1985. Many improvements in testing have occurred, including the detection of a second HIV agent (HIV-2 in 1992). The test used for blood donor screening is the GS HIV-1/HIV-2 PLUS O EIA for the simultaneous qualitative detection of anti-HIV 1 (groups M and O) and/or HIV-2 in human serum or plasma. A duplex nucleic acid test (NAT) was introduced for HIV-1/HCV RNA detection in 1999 and updated to include the detection of HBV DNA in 2009 (see above). The next version of NAT will include HIV-2 RNA detection (to be implemented in 2020). Donors who test antibody reactive are further evaluated by additional tests to confirm the presence of HIV antibody and to differentiate HIV-1 from HIV-2 antibodies. Such tests have included an HIV western blot, an HIV-2 enzyme-linked immunoassay, and an HIV-1 and HIV-2 rapid test for viral differentiation (all FDA licensed). Donors who test anti-HIV-1/HIV-2 and HIV-1 NAT reactive are not further tested. Currently only a rapid test is performed on HIV-1/HIV-2 antibody reactive donations that test NAT negative to confirm antibody reactivity and differentiate HIV-1 from HIV-2 antibodies. Donors testing falsely positive by either antibody or HIV NAT may be reentered. The per-unit risk of HIV-1 infection through blood transfusion is less than 1 per 2 million units screened. NAT closes the window period between infection and antibody detection for those infected with HIV by about 2 weeks. This leaves an approximate period of 7 to 10 days when an infected donor may not be detected by blood donation screening. The frequency of detecting HIV-1 in a blood donor is about 1 per 33,000 donations screened. However, detecting HIV-2 in a blood donor is extremely rare at 1 per 57 million donations, with only 5 such infected donors ever identified since HIV-2 screening began in 1992.
HTLV-1 and HTLV-2 are human retroviruses. While HTLV-1 has been associated with neoplastic conditions and various demyelinating disorders, HTLV-2 is not yet proven unequivocally to be of significant clinical concern. The test used for blood donor screening is the Avioq HTLV-1/2 Microelisa system for the qualitative detection of antibodies to HTLV-1 and HTLV-2 in human serum or plasma samples. Donors who test reactive for anti-HTLV-1/2 are further tested using an FDA licensed western blot to determine if antibodies are present. The western blot confirms infection and differentiates between HTLV-1 and HTLV-2 (with HTLV-2 slightly more common than HTLV-1). There are no nucleic acid tests (NAT) available for HTLV-1/2. False-positive donors by antibody may be reentered, except those that were confirmed positive by various tests used before the availability of an FDA licensed western blot. The per-unit risk of transfusion-transmitted HTLV-1/2 is less than 1 per 2 million units screened, and the frequency of detecting an infected donor is 1 per 27,000 donations screened. 2ff7e9595c
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