○ Serology is only performed in cases of suspected exposure, not recommended if post-exposure prophylaxis has been administered
○ Contact UHN/SH medical microbiologist on-call if anthrax is suspected
○ Whole blood: EDTA-blood tube (lavender top) ○ CSF/tissue: sterile container (with small amount of saline if tissue) ○ Serum: serum separator tube
Whole blood/serum: ○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood.
CSF: ○ Decontaminate skin, collect at least 5 mL of CSF by lumbar puncture for each test into a sterile container. Microbiology laboratory receives first tube when only one tube of fluid is available; if more than one tube, microbiology laboratory should receive the second or third tubes (less bloody)
Tissue: ○ Collect 5-10 mm3 tissue aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline.
Refer to section Sample Processing / Delivery
Confirmation of isolate, PCR and Serology PHOL
○ Culture ○ PCR ○ Enzyme-linked Immunosorbent Assay (ELISA) – IgG ○ Culture: up to 72 hours ○ PCR: Preliminary result: 4 days, final result 14 days ○ Serology: 14 days
416-586-4800 extension 4442
YES
○ Label specimen container. Place specimens in biohazard bag and seal.
○ Specimens should be stored at refrigeration temperature (2-8˚C) after collection EXCEPT CSF which should be kept at room temperature (20-25˚C) and transported to the UHN/SH Microbiology Laboratory ASAP.
○ UHN/SH Microbiology Laboratory will culture plates on site and refer the original specimen to the National Microbiology Laboratory for PCR and serology