Clostridium botulinum
Clinical Specimen Submission Guidance
Submit all specimens to 50 Orms St, Providence RI 02904. Open Monday to Friday 8:30 AM to 4:30 PM
Special Pathogens & Biothreats Laboratory 401-222-5586
Clostridium botulinum
Botulism
Specimens are sent by the RI State Health Laboratories (RISHL) for testing to either the CDC or another State's Health Department Laboratory that has this testing capacity. Testing may include Mass Spectrometry, PCR, culture and mouse bioassay to detect and confirm presence of C. botulinum toxin
LABORATORIES MUST NOTIFY RIDOH Center for Acute Infectious Disease Epidemiology at (401) 222-2577 and the RISHL Special Pathogens & Biothreats Laboratory at (401) 222-5586 IMMEDIATELY when test is ordered or specimen/isolate is suspicious for a potential agent of Bioterrorism.
PREAUTHORIZATION is necessary prior to sending specimens or isolates.
Refer to the current version of the ASM Sentinel Guidance for appropriate specimen selection and testing. This protocol is available in your microbiology laboratory and can also be accessed via the internet at: https://www.asm.org/Articles/Policy/Laboratory-Response-Network-LRN-Sentinel-Level-C
Isolate: If a clinical lab has isolated and presumptively identified C. botulinum in culture, they must consult immediately with the RISHL Special Pathogens & Biothreats Laboratory (401) 222-5586.
Clinical Specimens: If, based on clinical history, there is a high index of suspicion for botulism, consult with the RISHL Special Pathogens & Biothreats Laboratory (401) 222-5586 for appropriate specimen selection and submit original specimen as soon as possible after collection. Securely seal with parafilm or other appropriate barrier film.
CLIA regulations require specimens be labeled with at least two patient identifiers. Examples of identifiers are first and last name, date of birth, chart/medical record number. The specimen container must be labeled to match the test requisition or the electronic order.
Rhode Island State Health Laboratories (RISHL) test requisition form https://health.ri.gov/forms/LabRequisitionForm.pdf
CDC 50.34 form is required
Isolates: CDC Sendout
Write C. botulinum testing under Comments/Other Test Requests
Specimens: CDC Sendout
Write botulinum toxin testing under Comments/Other Test Requests
Consultation with RISHL Special Pathogens Laboratory (4010 222-5586 is required prior to sending specimens or isolates.
Specimens must be packaged & transported in accordance with current federal shipping regulations.
Refrigerated Clinical Specimens: Transport and deliver to the laboratory within 24 hours of collection at 2-8°C in a cooler able to maintain specimen temperature. A plug-in electric cooler is recommended, however, a cooler packed with excess frozen gel packs is acceptable as long as the transport temperature is maintained at 2-8°C.
Shipments that meet the definition for 'Category A' infectious substances as defined by federal regulation require additional packaging/labeling.
Negative for Clostridium botulinum
Providers must report patient information on Botulism immediately using the RIDOH reportable disease form.
Dependent upon the reference laboratory performing the test(s) and which test(s) are performed.
Containers specifically labeled for transport of specimens and isolates to the RISHL Special Pathogens & Biothreats Laboratory are available in all Microbiology Laboratories and Laboratory Sendout Departments.