| Pre-Approval |
None |
| Supplemental Information Requested |
Requested: Travel history, symptoms, exposures (including animals, ticks, fleas, other insects, etc), disease onset date, clinical summary, antibiotic therapy (drug name, dates of therapy)
|
| Submittal Form |
Specimens must be accompanied with a hard copy
of the completed VRDL General Purpose Specimen
Submittal Form or a form generated
in the VRDL Lab
Web Portal.
|
| Methodology |
Real-time PCR (LDT) (Diagnostic) |
| Reflex Testing |
Rickettsia rickettsii subsp. californica,
Rickettsia felis, Sequencing
|
Acceptable Specimen Type(s) and Collection Method
|
Detection of of rickettsial nucleic acid is most successful
when samples are collected within 14 days of symptom onset and prior to
administration of antibiotics. Collect EDTA-whole blood, plasma, serum, or
lesion swab as soon as a rickettsial disease is suspected and within 72 hours
of initiation of a tetracycline-class antibiotic. EDTA- or ACD-treated whole blood and plasma are preferred over serum.
If an eschar is present, vigorously swab
with a sterile synthetic swab and place in a dry sterile container. Do not
clean the lesion prior to swabbing. Specimens:
Whole blood treated with anti-coagulant, e.g., EDTA- or ACD-treated whole blood preferred. Heparin (green top tube) is not recommended
Plasma: EDTA (lavender/purple top) tube preferred: heparin (green top tube) is not recommended
Serum: Serum tube (red top) or serum separator tube (red/gray or gold top)
Eschar swab: Dry lesion swab in sterile container
Scabs (tissue punch biopsy acceptable but typically not needed)
|
| Minimum Volume Requested |
- Whole blood: 5 mL
Plasma: 1 mL
Serum: 1 mL Eschar swab: 1 dry swab
|
| Transport Medium (if using) |
Not Applicable
|
| Specimen Labeling |
Each specimen tube must be labeled with at least two unique patient identifiers, e.g., patient full name and date of birth. |
| Storage & Preservation of Specimen / Shipping Conditions |
Store specimens refrigerated (2-8°C)
if sample will arrive at CDPH within 7 days of collection. Refrigerated specimens should be sent with frozen cold packs. If specimens cannot be sent within 7
days of collection, freeze at -20°C or lower. Ship specimens within 6 months of
collection.
Shipping specimens frozen is strongly recommended. Frozen specimens should be sent with dry ice. Whole blood, plasma, and serum specimens must be received at 12°C or lower, and lesion swabs must be received at 26°C or lower for diagnostic testing.
|
|
Shipping Instructions
|
Work with your local public health department to ensure samples are packaged according to instructions for Biological Substance – Category B (UN 3373) shipment.
Ship specimens and a hard copy of the completed submittal forms to:
CDPH VRDL
ATTN:
Specimen Receiving
850 Marina Bay Parkway
Richmond, CA 94804
Phone: 510-307-8585
|
| Turnaround Time |
10 Business Days |
| Limitations |
Negative results do not preclude the possibility of infection. |
| Additional Information |
- If specimens are collected outside the recommended time frame, patients must be symptomatic or have a swabbable eschar lesion.
- R. rickettsii subsp. californica was previously known as R. 364D or R. philipii
|
| VRDL Points of Contact |
Medical and Epidemiology Liaisons: (510) 307-8585 or
VRDL.Submittal@cdph.ca.gov
|