Emergency Preparedness

Kern Medical Bioterrorism Response Guide Section 2-C-1 – Smallpox

SMALLPOX – SPECIMEN COLLECTION Contact the Department of Health Services, Viral and Rickettsial Disease Laboratory Branch (510 307 8575) prior to shipping any Biosafety Level IV specimens. Clinical laboratories should follow procedures for packaging, labeling and transporting requirements as defined by the Viral and Rickettsial Disease Laboratory and the CDC. Safety Recommendations ? Wear personal protective equipment including N-95 respirators. ? Use safety blood-collection equipment. ? Use plastic vials or tubes, when possible. ? Dispose of needles, scalpel blades, and other sharp objects in sharps disposal container. ? Deposit waste in biohazard red bag. ? Seal all specimens with Parafilm. ? Transport all specimens in sealed, plastic zip-lock bags. Pustule/Vesicle Specimens ? Open the top of a vesicle or pustule with a scalpel or 26-gauge needle and remove the top of the vesicle or pustule. ? Place the vesicle skin into a 1.5 - 2 mL labeled, screw-capped, plastic tubeand let the material dry. ? Scrape the base of the vesicle or pustule with the blunt edge of a scalpel or wooden applicator stick and apply the vesicular fluid to a labeled, microscope slide multiple times (touch prep) on the same slide. Allow the fluid to air-dry without smearing. Place the slide into a dry, plastic slide holder and seal. ? Alternately, swab the base of the vesicle or pustule with a polyester or cotton dry swab. Place the swab into a labeled, plastic, screw capped container. ? Obtain at least three (3) slides or swabs. ? Do not place the slides from more than one patient in the same container. Scabs Specimens ? Remove the top of the vesicle, pustule or scab with the blunt edge of a scalpel blade or 26-gauge needle. ? Deposit 2 - 4 scabs in 2 labeled dry, plastic, screw-capped containers. Biopsy Specimens ? Specimens for biopsy should be obtained with a 3.5. or 4.0 mm punch biopsy kit. ? One biopsy specimen should be placed informalin. ? The second biopsy should be placed in a dry screw capped container. ? Label containers as instructed below.

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