Appendix F

Appendix F: Specimens for Laboratory Diagnosis

Agent	Face or Nasal Swab ¹	Blood Culture	Smear	Acute & Convalescent Sera	Stool	Urine	Other
Anthrax	+	+	Pleural and CS fluids mediastinal lymph node spleen	+	-	-	Lesion aspirates
Brucellosis	+	+	-	+	-	-	Bone marrow and spinal fluid cultures; tissues, exudates
Cholera	-	-	-	+	+
Plague	+	+	Sputum	+	-	-	Lymph node, buboes, CSF, and sputum culture
Tularemia	+	-	+²	+	-	-
Q-fever	-	4	Lesions	+	-	-	Lung, spleen, lymph cultures

1Within 18-24 hours

2Fluorescent antibody test on infected lymph node smears. Gram stain has little value.

3Virus isolation from blood in appropriate containment.

4C. burnetti can persist for days in blood and resists desiccation. EDTA anticoagulated blood preferred.
Culturing should not be done except in BL3 containment.

Appendix F: Specimens for Laboratory Diagnosis
(continued)

Agent	Face or Nasal Swab¹	Blood Culture	Smear	Acute & Convalescent Sera	Stool	Urine	Other
Congo-Cri mean Hemorrhagic Fever	-	3	-	+	-	-	Liver
VEE	-	3	-	+	-		CSF
Clostridial	+		Wound tissues	+	+	-
SEB Toxin	+	-	-	+	+	+	Lung
Ricin Toxin	+	-	-	+	-	-	Spleen, lung, kidney

¹Within 18-24 hours

²Fluorescent antibody test on infected lymph node smears. Gram stain has little value.

³Virus isolation from blood in appropriate containment.

⁴C. burnetti can persist for days in blood and resists desiccation. EDTA anticoagulated blood
preferred. Culturing should not be done except in BL3 containment.

Nuclear