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Anthrax: Collecting, Preparing, and Shipping Serum Samples to CDC for Serology Testing

  1. Collection and processing of whole blood for serum
    A 10 mL volume of blood should be collected aseptically from a peripheral vein using appropriate gauge needles and a Vacutainer™ serum separator tube (SST). Separation of serum from the blood cells must be done within 60 minutes of sample acquisition to prevent hemolysis. Serum separation must be completed before storing or shipping the serum. All serum separation must be done aseptically to avoid contamination. To separate serum from cells or the clot the Vacutainer™-drawn blood must be stored at room temperature for at least 30 minutes for complete clot formation to minimize the potential of trauma-induced hemolysis. The serum must be separated from the clotted blood by centrifugation, and then decanted using sterile technique into PLASTIC freezing vials with leak-proof screw caps (such as 2 mL Sarstedt Screw Cap Micro Tube with an O-ring in the lid or equivalent). Approximately 5 mL of serum* will be obtained from a 10 ml blood volume. The plastic vials must be labeled appropriately, with patient name and / or identification number, date the sample was obtained, and a notation indicating if the sample is an acute or convalescent-phase specimen. The serum must be frozen immediately following the separation and stored at -20°C or colder until shipped to CDC. 1.0 mL is the minimum acceptable volume needed for testing by CDC.

    *NOTE: As a precaution, CDC recommends shipping only part of this approximately 5mL serum sample, with the drawing site retaining an aliquot that should remain frozen. This provides a backup sample in case the CDC sample shipment is lost or arrives in a compromised condition unsuitable for testing.
  2. Shipping serum samples on dry ice to CDC
    1. Put the plastic vials containing paired serum samples into appropriate mailing canisters.
    2. Place canisters into sealable plastic bags (“baggies”); seal plastic baggie.
    3. Each shipping ice box must contain a large plastic liner that must be placed inside the shipping box; all contents, including dry ice, must be placed inside this large box liner.
    4. Place the sealed plastic bag with canister in dry ice box.
  3. Determining the amount of dry ice needed for your shipment
    1. Use at least 6 pounds (3-4kg) of dry ice for each day of shipping time: 12 pounds is required for overnight shipment (2 days).
    2. Divide the weight of the ice in pounds by 2 to get weight in kg. This number has to be written on the outside shipping label for this box.
  4. Labeling the dry ice box for shipping
    The official requirements state that 3 labels be placed on one side only of each box:
    1. The clinical specimens label
    2. The dry ice hazard label (label with #9 on it)
    3. The carbon dioxide, solid label, where you must list the amount (in kg.) of dry ice for each box

NOTE: Do not send any shipments of specimens or samples without coordination with and authorization from CDC. Please contact CDC at 1-800-CDC-INFO (TTY: 888-232-6348) or cdcinfo@cdc.gov for coordination of shipping specimens for any anthrax testing and for specific shipping instructions.

 
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    Atlanta, GA 30333
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