Specimen Collection, Storage, & Shipment
|Specimen Type: Blood (serum)|
|Minimum Amount||0.5-1 ml preferred; 0.1 ml minimum|
|Storage||Can be stored at 4°C or at -20°C prior to shipping.|
|Shipping||Can be shipped overnight on a wet ice pack or frozen with dry ice.|
Rubella RNA Detection by RT-PCR or Virus Isolation
|Throat (oropharyngeal) swab, nasal swab, or NP (nasopharyngeal) swab (preferred)||Urine|
|Minimum Amount||1-3ml of viral transport medium||10-50ml|
|Storage||Freeze at -70°C or if ultra-low temperature freezers are not available, keep sample at 4°C.||If ultra-low freezers are available, freeze the re-suspended urine sediment at -70°C. If facilities for processing the urine are not available, keep the un-centrifuged urine sample at 4°C and ship on cold packs as soon as possible in a leak-proof container.|
|Shipping||Ship on cold packs if stored at 4°C, with dry ice if frozen at -70°C.||Ship on cold packs if stored at 4°C, with dry ice if frozen at -70°C|
Naso-pharyngeal swabs and urine samples should be collected as close to birth as possible and stored and shipped as described above for acute samples. To screen for shedding from confirmed CRS cases, naso-pharyngeal and/or urine samples should be collected monthly after the age of 3 months to determine if rubella RNA is still present in the specimen. Collection of samples can be stopped after two consecutive negative tests are obtained. In CRS cases where cataracts are present, surgically removed cataracts can be submitted for molecular testing. Rubella virus RNA has been detected in cataracts up to three years after birth.
Clinical Samples from Cases of Rubella Persistence
In some cases, rubella has been known to establish persistent infections in humans. An eye disease known as Fuchs’ Uveitis Syndrome (FUS) is associated with persistent rubella virus, and virus has been detected in aqueous humor decades after the original infectionexternal icon. The strong association between rubella vaccine persistence and development of granulomatous lesions in individuals with various primary immunodeficiency diseases has been recently established and infectious mutated vaccine-derived viruses have been recovered from these granulomas. Samples of aqueous humor removed from FUS cases and biopsy samples of chronic inflammatory lesions of unknown etiology, as part of clinical management of the case, can be submitted to CDC for molecular detection and virus culture. The samples should be placed in a dry sterile container or tube and immediately frozen on dry ice. The samples should be shipped overnight on dry ice or stored at -70°C until shipment.
Clinical specimens or rubella virus isolates should be sent along with CDC Form 50.34.
For additional information and to notify the CDC Measles Mumps Rubella and Herpesvirus Laboratory Branch of specimen shipments, please contact:
Shipping address for specimens:
STAT Unit #81 Attn: Dr. Icenogle
Centers for Disease Control and Prevention
1600 Clifton Road NE
Atlanta, GA 30329-4027