Anthrax
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Agent: Bacillus anthracis
There are three clinical forms of B. anthracis which are determined by route of entry:
Key Characteristics:
Acceptable Specimens:
Isolate Cutaneous anthrax: sterile swab from vesicular or eschar stage Gastrointestinal anthrax: Blood culture, stool (≥5 g) or rectal swab Inhalational anthrax: Blood culture, lower respiratory specimen (>1ml) Environmental samples submitted by law enforcement personnel
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Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Brucellosis
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Agent: Brucella abortus, Brucella melitensis, Brucella suis, and Brucella canis
Aerosols of Brucella spp. are considered to be highly infectious. B. melitensis produces the most severe and acute form of disease. B. abortus produces a more chronic form of disease. B. suis may also cause severe acute disease, but is associated with osteomyelitis. B. canis rarely causes disease in humans.
Key Characteristics:
Small gram-negative coccobacilli Slow-grower, colonies appear after 48-72 hrs of incubation Non-motile Oxidase positive Urease positive X and V factors not required
Acceptable Specimens:
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Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Botulism
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Agent: Clostridium botulinum
There are three forms of botulism:
Key Points:
Acceptable Specimens:
Shipping conditions:
Stools and serum
Wound
Ship tissue in anaerobic atmosphere Swab in anaerobic transport for swabs Ship without refrigeration
Food
Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Tularemia
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Agent: Francisella tularemia
Key Characteristics:
Tiny gram-negative coccobacilli Slow-grower, colonies appear after 48-72 hrs of incubation Usually requires cysteine supplementation Non-motile Oxidase negative Urease negative Beta-lactamase positive X and V factors not required
Acceptable Specimens:
Isolate Blood culture Biopsied tissue or scraping of an ulcer (preferable) Swab of an ulcer (acceptable alternative) Tissue aspirate Environmental samples submitted by law enforcement personnel
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Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Plague
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Agent: Yersinia pestis
Three forms of plague:
Bubonic: infected lymph nodes Septicemic: blood-borne organisms Pneumonic: transmissible person-to-person; deadliest
Key Characteristics:
Acceptable Specimens:
Isolate Bubonic: Aspirate of involved tissue (bubonic) or biopsied specimen: Tissue or aspirates that can be obtained for culture include liver, spleen, bone marrow, lymph node, and/or lung Septicemic: blood Pneumonic: Bronchial wash or transtracheal aspirate (>1 ml) Environmental samples submitted by law enforcement personnel
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Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Melioidosis / Glanders
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Agent: Burholderia pseudomallei and Burkholderia mallei
Key Characteristics:
Acceptable Specimens:
Isolate Blood Urine Abscesses, tissue aspirates, fluids Environmental samples submitted by law enforcement personnel
Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Ricin Toxin
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Agent: Ricin toxin
Ricin toxin is derived from castor beans, Ricinus communis. Medical tests to confirm that a person has been exposed to ricin are not widely available. No antidote exists for ricin.
Acceptable Specimens:
Clinical:
Texas Department of State Health Services, Austin, does not currently accept clinical samples for ricin toxin testing. Serum (acute and convalescent – 2 weeks apart) testing is performed at the CDC Not indicated unless a known exposure has occurred
Environmental: food, beverage, soil, water, powder, swabs, wipes, paper, plant material
Specimen collection:
Collect specimens in plastic containers and be triple contained in accordance with federal shipping Store specimens at room temperature or refrigerate NEVER freeze or heat samples suspected of containing ricin toxin, as this will denature the toxin
Specimen Submission:
Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Staphylococcal Enterotoxin B (SEB)
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Agent: Staphylococcal enterotoxin B (SEB)
Acceptable Specimens:
Clinical: Texas Department of State Health Services, Austin, does not currently accept clinical sample for SEB testing. Environmental: paper, powder, swabs, wipes, water, soil, food, beverage
Specimen Submission:
Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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Q Fever
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Agent: Coxiella burnetii
C. burnetii is an obligate intracellular organism and cannot be cultured on routine bacteriologic media. Due to the extreme infectivity of C. burnetii, Level A (Sentinel) laboratories should not attempt to culture this organism.
Acceptable Specimens:
Specimen Submission:
All specimens must be triple contained in accordance with federal shipping regulations. All clinical specimens must be accompanied by a specimen submission form (G-2B). Prior to submission, please call (512) 458-7185 or (888) 963-7111, ext. 7815 toll free.
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