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Influenza A subtyping (H3 / pdmH1 / H5)

Influenza A (H3, pdmH1, H5)

Last reviewed 2026-08-13

Public health significance

Subtyping is how a seasonal wave becomes a novel-influenza investigation. Unsubtypable A is itself a signal.

Specimen types

Respiratory (from Flu A-positive material)

Method

Target-specific NAA

CLIA / validation

High complexity. H5 assays often remain LDT or LRN-restricted. Document the confirmation algorithm.

Interpretation

Detected / Not detected per subtype. An A-positive that is H3/H1/H5 negative is an unsubtypable event, not a negative test.

Reflex / referral

H5 detected: immediate notification and CDC/LRN confirmation per current protocol.

Quality control

Subtype-specific positives. Watch primer/probe drift each influenza season.

Reportability

H5 and unsubtypable influenza A are immediately reportable in most states.

HL7 / ELR

Separate OBX rows: 49524-2 (H3), 55465-9 (pdmH1), 68986-9 (H5).

Sources

CDC influenza laboratory guidance; LOINC influenza A subtype family.