Clinical Specimen Submission Guidance: Department of Health

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Disease	Chancroid
Reporting Requirement	Providers must report patient information on Chancroid within 4 days using the RIDOH reportable disease form.


Disease	Coccidioidomycosis fungal infection (Valley fever)
Reporting Requirement	Providers must report patient information on Coccidioidomycosis fungal infection within 4 days using the RIDOH reportable disease form.


Lab	Special Pathogens & Biothreats Laboratory 401-222-5586
Pathogen	Neisseria gonorrhoeae
Disease	Gonococcal Infection (Gonorrhea)
Test Description	N. gonorrhoeae
Special Instructions	N. gonorrhoeae is a fastidious organism and is very sensitive to temperature fluctuations. Refrigerated media must be brought to room temperature before inoculation. Incubator must remain between 35-37°C. Culture plates should remain in the incubator until they are transported to the State Health Laboratories.
Specimen	PRIMARY CULTURES ARE ONLY ACCEPTED FROM STATE DESIGNATED CLINICS. Primary specimen taken from rectal or throat (non-urogenital site) and inoculated onto Martin Lewis or Thayer Martin Plate. Sub plate immediately after specimen collection and incubate within 15 minutes of media inoculation at 35-37° C in CO2 atmosphere. Isolates for confirmation can be sent on Martin Lewis or Thayer Martin.
Form Required	Rhode Island State Health Laboratories test requisition form
Test Request	Gonorrhea Culture
Transport	Transport at ambient temperature within 48 hours in bag containing CO2 tablet. Isolates from Hospitals: All submissions must be properly packaged in accordance with current federal shipping regulations. Containers specifically labeled for transport of specimens and isolates to the HEALTH Molecular amd Enteric Laboratory are available in all microbiology labs and laboratory send out departments.
Reporting Requirement	Providers must report patient information on Gonococcal Infection within 4 days using the RIDOH reportable disease form.
Turnaround Time	3 business days


Disease	Granuloma inguinale
Reporting Requirement	Providers must report patient information on Granuloma inguinale within 4 days using the RIDOH reportable disease form.


Disease	Hemolytic Uremic Syndrome (HUS)
Reporting Requirement	Providers must report patient information on Hemolytic Uremic Syndrome within 4 days using the RIDOH reportable disease form.


Lab	STI & Arbovirus Laboratory 401-222-5591
Pathogen	Hepatitis A Virus
Disease	Hepatitis A (Hep A)
Test Description	Two-step immunoassay for the qualitative detection of IgM anti-HAV in human serum and plasma using CMIA technology
Specimen	Minimum 5ml serum or plasma
Form Required	Rhode Island State Health Laboratories test requisition form
Test Request	Hepatitis A IgM
Transport	Transport as soon a possible. Specimen can be stored at 2° - 8°C for up to one week. All submissions must be properly packaged in accordance with current federal shipping regulations. Containers specifically labeled for transport of specimens to the HEALTH Serology Laboratory are available in all serology labs and laboratory send out departments.
Integrity	Non-hemolyzed
Normal Value	Negative
Reporting Requirement	Providers must report patient information on Hepatitis A immediately using the RIDOH reportable disease form.
Turnaround Time	Routine is up to 2 weeks. STAT testing may be requested by contacting the laboratory directly at (401) 222-5591


Lab	STI & Arbovirus Laboratory 401-222-5591
Pathogen	Hepatitis B Virus
Disease	Hepatitis B (Hep B)
Test Description	Two-step immunoassay for the qualitative detection of Hepatitis B antigen and antibodies
Specimen	Minimum 5ml serum or plasma
Form Required	Rhode Island State Health Laboratories test requisition form
Test Request	Hepatitis B Core IgM, Hepatitis B Total Core, Hepatitis B Surface Antibody, Hepatitis B Surface Antigen
Transport	As soon as possible. Specimen can be stored at 2° to 8° C for up to one week. All submissions must be properly packaged in accordance with current federal shipping regulations. Containers specifically labeled for transport of specimens to the HEALTH Serology Laboratory are available in all serology labs and laboratory send out departments.
Integrity	Non-hemolyzed
Normal Value	Negative
Reporting Requirement	Providers must report patient information on Hepatitis B within 4 days using the RIDOH reportable disease form.
Turnaround Time	Routine is up to 2 weeks. STAT testing may be requested by contacting the laboratory directly at (401) 222-5591


Disease	Hepatitis D (Hep D)
Reporting Requirement	Providers must report patient information on Hepatitis D within 4 days using the RIDOH reportable disease form.


Disease	Hepatitis E (Hep E)
Reporting Requirement	Providers must report patient information on Hepatitis E within 4 days using the RIDOH reportable disease form.


Pathogen	Histoplasma capsulatum
Disease	Histoplasmosis infection (Histoplasmosis)


Disease	Leptospirosis
Reporting Requirement	Providers must report patient information on Leptospirosis within 4 days using the RIDOH reportable disease form.


Pathogen	Borrelia burgdorferi
Disease	Lyme Disease
Reporting Requirement	Providers must report patient information on Lyme Disease within 4 days using the RIDOH reportable disease form.


Disease	Lymphogranuloma venereum infection (LGV)
Reporting Requirement	Providers must report patient information on Lymphogranuloma venereum infection within 4 days using the RIDOH reportable disease form.


Disease	Meningitis (Meningitis, viral)
Reporting Requirement	Providers must report patient information on Meningitis (Viral) within 4 days using the RIDOH reportable disease form.


Lab	Special Pathogens & Biothreats Laboratory 401-222-5586
Pathogen	Streptococcus pneumoniae
Disease	Streptococcus pneumonia disease
Test Description	MIC (performed by CDC)
Specimen	Only isolates from invasive disease/normally sterile site that are penicillin resistant by oxacillin disk screen and have not had a MIC performed. Submit a freshly growing pure isolate (< 48 hours old) on a chocolate agar slant secured with a screw cap. Isolates on plated media are acceptable if plates are sealed with parafilm or other appropriate barrier film.
Form Required	Rhode Island State Health Laboratories test requisition form CDC DASH Form
Test Request	Special Pathogens Bacterial Isolate Write "S. pneumoniae" in comment field of requisition form
Transport	All submissions must be properly packaged in accordance with current federal shipping regulations. Containers specifically labeled for transport of specimens and isolates to the HEALTH Bioterrorism Response & Special Pathogens Laboratory are available in all microbiology labs and laboratory send out departments.
Turnaround Time	Unknown (testing performed at CDC)


Pathogen	simplex viruses HDV-1, HSV-2
Disease	Herpes


Pathogen	Pediculosa capitis and corporis
Disease	Pediculosis (Lice, Head and Body Lice)


Pathogen	Phthirus pubis
Disease	Pthiriasis (Crabs; Pubic Lice Infestation)


Pathogen	Scabies hominis
Disease	Scabies Infestation (Scabies)


Disease	Clostridium Perfringens (Epsilon Toxin)
Reporting Requirement	Providers must report patient information on Clostridium Perfringens immediately using the RIDOH reportable disease form.


Disease	Meningitis
Reporting Requirement	Providers must report patient information on Meningitis immediately using the RIDOH reportable disease form.


Lab	Special Pathogens & Biothreats Laboratory 401-222-5586
Disease	Ornithosis
Test Description	Preauthorization from the HEALTH Division of Infectious Disease and Epidemiology is required (401) 222-2577. If testing is approved, specimens are sent from the HEALTH Special Pathogens Laboratory to the CDC for testing.
Specimen	Consult with the HEALTH Special Pathogens Lab at (401) 222-5586 for guidance on specimen selection, collection and submission.
Form Required	Rhode Island State Health Laboratories test requisition form
Test Request	CDC Sendout
Transport	All submissions must be properly packaged in accordance with current federal shipping regulations. Containers specifically labeled for transport of specimens and isolates to the HEALTH Bioterrorism Response & Special Pathogens Laboratory are available in all microbiology labs and laboratory send out departments.
Reporting Requirement	Providers must report patient information on Ornithosis within 4 days using the RIDOH reportable disease form.
Turnaround Time	Unknown (testing performed by CDC)


Disease	Paralytic Shellfish Poisoning (Paralytic Shellfish Poisoning, Ciguatera)
Reporting Requirement	Providers must report patient information on Paralytic Shellfish Poisoning immediately using the RIDOH reportable disease form.


Disease	Pelvic Inflammatory Disease (PID)
Reporting Requirement	Providers must report patient information on Pelvic Inflammatory Disease within 4 days using the RIDOH reportable disease form.


Disease	Pneumococcal Disease (Pneumonia)
Reporting Requirement	Providers must report patient information on Pneumococcal Disease within 4 days using the RIDOH reportable disease form.


Disease	Poliomyelitis (Polio)
Reporting Requirement	Providers must report patient information on Poliomyelitis immediately using the RIDOH reportable disease form.


Disease	Encephalitis
Reporting Requirement	Providers must report patient information on Encephalitis (Arboviral or parainfectious) immediately using the RIDOH reportable disease form.


Disease	Ricin Poisoning
Reporting Requirement	Providers must report patient information on Ricin Poisoning immediately using the RIDOH reportable disease form.


Disease	Scombroid
Reporting Requirement	Providers must report patient information on Scombroid immediately using the RIDOH reportable disease form.


Disease	Smallpox
Reporting Requirement	Providers must report patient information on Smallpox immediately using the RIDOH reportable disease form.


Disease	Staphylococcal Food Poisoning (Staph Food Poisoning)
Reporting Requirement	Providers must report patient information on Staphylococcal Food Poisoning (Enterotoxin - B Poisoning) immediately using the RIDOH reportable disease form.


Pathogen	Staphylococcus aureus,Vancomycin Intermediate
Disease	Staphylococcal Infection (VISA)
Reporting Requirement	Providers must report patient information on Staphylococcal Infection (Vancomycin Intermediate) immediately using the RIDOH reportable disease form.


Disease	Streptococcal Disease (Strep-B)
Reporting Requirement	Providers must report patient information on Streptococcal Disease (Group B) within 4 days using the RIDOH reportable disease form.


Disease	Streptococcal Toxic-Shock Syndrome (STSS, TSS)
Reporting Requirement	Providers must report patient information on Streptococcal Toxic-Shock Syndrome (STSS, Toxic Shock) within 4 days using the RIDOH reportable disease form.


Disease	Tetanus Infection (Lock Jaw)
Reporting Requirement	Providers must report patient information on Tetanus Infection (tetani) within 4 days using the RIDOH reportable disease form.


Pathogen	Trichinella spiralis
Disease	Trichonosis Infection (Trichinosis)
Reporting Requirement	Providers must report patient information on Trichonosis Infection within 4 days using the RIDOH reportable disease form.


Disease	Varicella (Chickenpox)
Reporting Requirement	Providers must report patient information on Varicella within 4 days using the RIDOH reportable disease form.


Disease	Yellow Fever
Reporting Requirement	Providers must report patient information on Yellow Fever immediately using the RIDOH reportable disease form.


Lab	STI & Arbovirus Laboratory 401-222-5591
Disease	COVID-19 (Coronavirus Disease 2019)
Test Description	TEST CURRENTLY NOT PERFOMED AT THE RISHL The Abbott Laboratories SARS-CoV-2 IgG serological test is an immunoassay for the qualitative detection of IgG antibodies to SARS-CoV-2 in human serum and plasma using chemiluminescent microparticle immunoassay (CMIA) technology. The Abbott Laboratories SARS-CoV-2 IgG assay is only for use under a Food and Drug Administration Emergency Use Authorization. The performance characteristics of this assay were validated by the Rhode Island State Health Laboratories (RISHL). Results should be used in conjunction with the patient's clinical symptoms, medical history, and other clinical/laboratory findings to determine an overall clinical diagnosis. Results should not be used to infer an immunity status nor predict resistance or susceptibility to a future exposure to SARS-CoV-2. Provider Fact Sheet: https://www.fda.gov/media/137381/download Patient Fact Sheet: https:www.fda.gov/media/137382/download
Special Instructions	PREAUTHORIZATION by the Rhode Island Department of Health (RIDOH) Center for Acute Infectious Disease Epidemiology at (401)222-3577 is required prior to transport.
Specimen	Collect minimum 3 mL serum or plasma or 5 mL whole blood in EDTA or heparin tube Refrigerate at 2 ° - 8°C. Stable for one week following centrifugation. Collected specimens are delivered to the Rhode Island State Health Laboratories (RISHL) for SARS-CoV-2 testing. CLIA regulations require two patient identifiers on the specimen container and the test requisition.
Form Required	Rhode Island State Health Laboratories (RISHL) test requisition form https://health.ri.gov/forms/LabRequisitionForm.pdf
Test Request	COVID-19 Serology
Transport	Specimens must be transported in accordance with current federal shipping regulations. PREATHORIZATION is required prior to sending specimens.
Integrity	Non-hemolyzed
Normal Value	Negative
Reporting Requirement	Providers must report patient information on COVID-19 immediately using the RIDOH reportable disease form.
Turnaround Time	Testing at Rhode Island State Health Laboratories completed within 3 business days from specimen receipt