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Instructions for Submitting Diagnostic Specimens for Testing by the Rickettsial Reference Diagnostic Laboratory

Our laboratory serves as a national reference diagnostic laboratory for diseases due to rickettsial agents and associated pathogens. Our testing is provided free-of- charge to approved agencies. These diseases can be rapidly progressive, so prompt treatment of the patient should not be delayed while waiting upon our test results. If you require standard testing services, a number of commercial laboratories offer many of the rickettsial tests.

View Tests Offered by the Reference Diagnostic Laboratory, Viral and Rickettsial Zoonoses Branch [PDF - 2 pages] for a listing of rickettsial tests available in our laboratory.

View Appropriate Clinical Laboratory Specimens for Rickettsial Diseases [PDF - 2 Pages] for information about appropriate clinical lab specimens for Rickettsial diseases.

CDC Submission Form

  1. Complete a CDC specimen submission form (CDC 50.34)*, by downloading or call CDC for a copy at 404-639-3931. Separate forms should be submitted for each test request (i.e., serology, PCR, immunohistochemistry) for an individual patient.
    NOTE: Testing will not be initiated without the inclusion of essential information:
    • Patient name, gender, and birth date
    • unique specimen identification number
    • type of specimen (e.g. serum, whole blood, tissue, cf, etc.)
    • suspected etiology
    • date of onset of symptoms
    • brief clinical description
    • date of specimen collection
    • antibiotic treatment/therapy received including dates
    • Brief travel and animal contact history
    • Brief medical history
    • Submitting physician/organization, complete return address, and contact numbers
    • Samples for immunohistochemistry should include a copy of any other pathology report available.
  2. Patients should have a clinical or epidemiologic history reasonably suggestive of rickettsial disease. Random rickettsial testing of clinically difficult cases rarely identifies rickettsial pathogens as possible etiologic agents.
  3. All samples must be sent through your state public health laboratory or with their approval. Specimens sent directly to CDC without prior approval will not be accepted. The state laboratory will receive a copy of the report, so states are imperative about this requirement.
  4. Serum samples or fresh tissue may be submitted refrigerated on cold packs or frozen on dry ice. Serum samples and EDTA blood samples may be sent in sterile, plastic tubes (we prefer Sarstedt 2ml screw-cap tubes). Glass evacuated tubes can break in the shipment and should be avoided. Fresh tissues for PCR can be sent on sterile gauze pads moistened with sterile saline in a collection cup. Paraffin blocks or slides for immunohistochemistry should be sent at room temperature or refrigerated, but never frozen.

Testing Results

Test results are normally available within 7 days after specimen receipt. Reporting times for test results may be longer during summer months when rickettsial zoonoses activity increases. Receipt of a hard copy of the results will take 2 weeks after testing completion due to return through the state health departments.


For information regarding shipping packages and applicable regulations, please refer to the NCEZID Division of Scientific Resources' Specimen Management site for specific information.

All samples should be sent directly to the Data and Specimen Handling (D.A.S.H.) section that will process and deliver the samples to the Rickettsial Reference Diagnostic Laboratory for testing. Please do notaddress the package to a person's name as it will not properly route through the appropriate channels to us.

Shipping Address

Send all specimens to:
ATTENTION: D.A.S.H. (Attn: Rickettsial Laboratory, Unit 78)
Centers for Disease Control and Prevention
Mail Stop G-12
1600 Clifton Road, N.E.
Atlanta, GA 30333

Further Assistance

Additional assistance may be obtained from the DVBD Rickettsial Reference Diagnostic Laboratory at 404-639-1090 or the Data and Specimen Handling unit at 404-639-3931.

*NOTE: A new Specimen Submission form will be required to accompany samples being submitted to any of the CDC infectious Disease Laboratories for testing as of January 1, 2013. The Specimen Submission form link will connect you to the appropriate form, and a new form will be available in the near future from the same link.
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