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Volume 26, Number 12—December 2020

Control and Prevention of Anthrax, Texas, USA, 2019

Tom Sidwa, Johanna S. Salzer, Rita Traxler, Erin Swaney, Marcus L. Sims, Pam Bradshaw, Briana J. O’Sullivan, Kathy Parker, Kenneth A. Waldrup, William A. Bower, and Kate HendricksComments to Author 
Author affiliations: Texas Department of State Health Services, Austin, Texas, USA (T. Sidwa, E. Swaney, B.J. O’Sullivan, K. Parker); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.S. Salzer, R. Traxler, W.A. Bower, K. Hendricks); Shannon Health System, Ozona, Texas, USA (M.L. Sims); Shannon Medical Center, San Angelo, Texas, USA (P. Bradshaw); Texas Department of State Health Services, El Paso, Texas, USA (K.A. Waldrup)

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Table 2

Diagnostic specimens for cutaneous anthrax (33)*

Specimen Test Temperature Laboratory Response Network level
1 swab† Gram stain‡ and culture Room temperature Sentinel laboratory§
1 swab† PCR Room temperature Reference laboratory¶
Single plasma or serum Lethal factor Frozen (−70°) CDC#
Paired serum** Antiprotective antigen Frozen (−700) CDC
Full thickness punch biopsy of lesion Immunohistochemistry Room temperature CDC

*CDC, Centers for Disease Control and Prevention.
†Dry dacron swabs for swabbing moist lesions (e.g., bullae) or saline-moistened dacron swabs for swabbing beneath dry lesions (i.e., eschars) to be collected before onset of antimicrobial therapy.
‡Direct smear from lesion.
§Sentinel laboratories comprise the first level of the Laboratory Response Network; they include private and commercial laboratories that provide routine diagnostic services, rule-out, and referral steps in the identification process.
¶Reference laboratories, often called Laboratory Response Network member laboratories, are responsible for investigating, confirming, or referring specimens. These laboratories perform testing for multiple agents in high-risk environmental or clinical samples.
#CDC laboratories belong to the top tier of the Laboratory Response Network (national laboratories).
**Acute and convalescent collected 2 weeks apart.

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Page created: November 12, 2020
Page updated: November 19, 2020
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