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

Our laboratory serves as a national reference diagnostic laboratory for rickettsial pathogens. Our testing is provided free-of-charge to approved agencies. Rickettsial diseases can be rapidly progressive, so prompt treatment of the patient should not be delayed while waiting upon our test results. Routine testing should be performed by state or commercial laboratories when possible.

View Sample Specifications and Packaging Guidelines for Rickettsial Diseasepdf icon[PDF – 1 page] for information about appropriate clinical lab specimens for Rickettsial diseases.

Specimen submission guidelines

  1. Samples should be sent through your state public health laboratory or with their approval. Final reports of test results are returned to the state public health laboratory that is responsible for providing these reports to the primary submitter.
  2. Specimens must be accompanied by the CDC Specimen Submission Form (CDC 50.34). Separate forms should be submitted for each test requested (i.e., serology, PCR, immunohistochemistry, culture) for an individual patient. Specimen submission forms must include:
    • Patient name, sex, and birthdate
    • Date of illness onset
    • Date of specimen collection
    • Specimen type (e.g., serum, whole blood, tissue, etc.)
    • Shipping medium, if applicable (e.g., saline, formalin, etc.)
    • Test requested (see test codes below)
    • Brief clinical summary (including details of antibiotic therapy and dates) and pertinent clinical findings
    • Brief travel and exposure history (including animals, arthropods, etc.)
    • Submitting physician/organization, complete return address, and contact numbers
    • Samples for immunohistochemistry should include a copy of any existing pathology
  3. Samples should be sent directly to the Specimen Triage and Tracking (STAT) lab at this address:
    Centers for Disease Control and Prevention
    ATTN: Reference Diagnostic Laboratory, Rickettsial Zoonoses Branch (unit 78)
    1600 Clifton Road, NE
    Atlanta, GA 30329-4027
  4. Packages should be mailed for receipt Tuesday-Friday, and should take into consideration U.S. Federal holidays. Exceptions can be made for urgent samples with prior approval.
  5. Test codes for rickettsial samples:
    Test codes for rickettsial samples
    Anaplasma Molecular Detection CDC-10290
    Anaplasma Serology CDC-10292
    Anaplasma Special Study CDC-10291
    Coxiella burnetii Molecular Detection CDC-10304
    Coxiella burnetii Serology CDC-10305
    Coxiella Special Study CDC-10306
    Ehrlichia Molecular Detection CDC-10499
    Ehrlichia Serology CDC-10311
    Ehrlichia Special Study CDC-10498
    Orientia Molecular Detection CDC-10359
    Orientia Serology CDC-10360
    Orientia Special Study CDC-10500
    Rickettsia Molecular Detection CDC-10402
    Rickettsia Serology Spotted Fever Group (RMSF) Serology CDC-10403
    Rickettsia Serology Typhus Group Serology CDC-10404
    Rickettsia Special Study CDC-10405

For questions, please email,