This guide helps determine which clinical samples to collect from individuals exposed to aerosolized biological threat agents. Proper collection of specimens is dependent on the time-frame following exposure. Sample collection is described for "Early post-exposure", "Clinical", and "Convalescent/ Terminal/ Postmortem" time-frames. These time-frames are not rigid and will vary according to the concentration of the agent used, the agent strain, and predisposing health factors of the patient.

• Early post-exposure: when it is known that an individual has been exposed to a bioagent aerosol; aggressively attempt to obtain samples as indicated
• Clinical: samples from those individuals presenting with clinical symptoms
• Convalescent/Terminal/Postmortem: samples taken during convalescence, the terminal stages of infection or toxicosis or postmortem during autopsy

Shipping Samples: Most specimens sent rapidly (less than 24 h) to analytical labs require only blue or wet ice or refrigeration at 2 to 8˚C. However, if the time span increases beyond 24 h, contact the USAMRIID "Hot-Line" (1-888-USA-RIID) for other shipping requirements such as shipment on dry-ice or in liquid nitrogen. Blood samples: Several choices are offered based on availability of the blood collection tubes. Do not send blood in all the tubes listed, but merely choose one. Tiger-top tubes that have been centrifuged are preferred over red-top clot tubes with serum removed from the clot, but the latter will suffice. Blood culture bottles are also preferred over citrated blood for bacterial cultures. Pathology samples: routinely include liver, lung, spleen, and regional or mesenteric lymph nodes. Additional samples requested are as follows: brain tissue for encephalomyelitis cases (mortality is rare) and the adrenal gland for Ebola (nice to have but not absolutely required).