Francisella tularensis
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
Francisella tularensis
Tularemia (Rabbit fever)
PCR and culture to detect and confirm Francisella tularensis
Serology: Sera is shipped to CDC for serological testing
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 lab is unable to rule out F. tularensis after performing ASM Sentinel screening tests, isolate is to be submitted on either a slant or a culture plate sealed with parafilm (or other appropriate barrier film). If, based on clinical history, there is a high index of suspicion for tularemia, labs may be requested by the Rhode Island Department of Health to submit the original culture plate on the initial day of isolation.
Clinical Specimens: If, based on clinical history, tularemia is suspected, specimens are accepted for PCR testing. Consult with the RISHL Special Pathogens & Biothreats Laboratory (401) 222-5586 for appropriate specimen selection. Submit original specimen as soon as possible after collection.
If serological test requested, the RISHL Special Pathogens & Biothreats Laboratory will forward serum specimens to CDC for F. tularensis testing. Securely seal specimen containers 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 also required for serological testing
Biothreat Agent rule out (including Ebola)
Serology testing: CDC Sendout
Consultation with RISHL Special Pathogens & Biothreats 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 Francisella tularensis
Providers must report patient information on Tularemia immediately using the RIDOH reportable disease form.
PCR result: within 24 hours
Culture result: within 3 business days (dependent on growth rate)
CDC Serology: 2 weeks
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.