Interim Guidelines for Packaging and Transport of Animal Rabies Specimens to the Public Health and Environmental Laboratories (PHEL) - May 3, 2017

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Wayne Sundmacher
Interim Guidelines for Packaging and Transport of Animal Rabies Specimens to the Public Health and Environmental Laboratories (PHEL) - May 3, 2017
Descriptive Subject for this Discussion: 

Interim Guidelines for Packaging and Transport
of Animal Rabies Specimens to the
Public Health and Environmental Laboratories (PHEL)
May 3, 2017

 
UPDATES ARE HIGHLIGHTED IN YELLOW
 
Persons who are bitten by an animal or have come into contact with a suspect rabid animal should notify the local health department (LHD) having jurisdiction where the animal is located. Animals infected with the rabies virus will display signs and symptoms including aggression or other changes in behavior, and signs of neurologic impairment such as vocalizing, circling, paralysis, etc. Rabies testing of animal specimens is available through the New Jersey 
Department of Health (NJDOH); however, SPECIMENS SHOULD NOT BE SENT TO PHEL WITHOUT FIRST CONSULTING WITH THE LHD WHERE THE INCIDENT OCCURRED. A searchable map of LHDs is posted online at www.localhealth.nj.gov, along with directories including daytime and after-hours numbers.
 
Preparation of Specimens for Submission
 
SPECIMENS SUBMITTED TO PHEL CANNOT BE RETURNED TO VETERINARIANS OR ANIMAL OWNERS UNDER ANY CIRCUMSTANCES.
 
1.   Except for bats, all animals (regardless of size), ONLY THE HEAD OR BRAIN OF THE ANIMAL will 
be accepted for testing.
 
 
2.  DO NOT USE insecticides (e.g., flea or tick spray containing permethrin) on specimens.
 
3.  Bats may be submitted alive; however, they should be packaged in an ESCAPE- PROOF container (e.g. coffee can with tight fitting lid) and clearly labeled “CAUTION - LIVE BAT.”  UNDER NO CIRCUMSTANCES SHOULD A BAT, DEAD OR ALIVE, BE WRAPPED IN ANYTHING THAT COULD HINTER ACCESS TO IT (A CLOTH TOWEL, PACKING MATERIAL, ETC).
 
4.  THE SPECIMEN SHOULD NOT BE FROZEN, as freezing delays the test process. Frozen specimens can still be tested, but freezing increases the probability that the sample will be unsatisfactory for testing.
 
5.   If the specimen is not being transported immediately, refrigerate it and then package as directed below before transport.
 
6.   The specimen should be placed in a watertight container, such as a heavy plastic bag that is tightly secured, or a non-breakable container (i.e., not glass) with a tight-fitting lid, to PREVENT FLUID LEAKAGE. This container should be placed in a larger waterproof non-breakable container, and the space between the two containers packed with coolant packs, NOT DRY ICE OR ICE IN BAGS. The specimen must be in a separate container from the coolant packs. If the specimen will be in transit for more than 12 hours, be sure to use an insulated container. As a reminder, couriers are instructed not to pick up specimens that are improperly packaged. TO AVOID DELAYS, ENSURE THAT SPECIMENS ARE PACKAGED PROPERLY.
 
7.   In the event that individuals are exposed to fluid, such as leakage from an animal head, or a splash or cut during specimen preparation and packaging, they should IMMEDIATELY WASH THE EXPOSED AREA THOROUGHLY WITH SOAP AND WATER. The name and telephone number of the exposed individual(s) should be added to the VIR-16 form, along with the type of exposure that occurred.
 
8.   The Rabies Examination Request Form, the VIR-16 form, (http://www.state.nj.us/health/forms/vir-16.dot) should be completed and placed IN AN ENVELOPE accompanying the specimen. The envelope should be either securely attached to or placed inside of the transport container. If the envelope is placed inside the transport container, the VIR-16 form should be in a plastic bag that is SEPARATE FROM ANY COOLANT PACKS, to prevent it from becoming wet and illegible.
 
9.   Specimens should be addressed to:
 
New Jersey Department of Health
Public Health, Environmental, and Agricultural Laboratories (PHEAL)
Rabies Laboratory
New Jersey State Police Headquarters
3 Schwarzkopf Drive
Ewing, NJ  08628
 
Transportation of Specimens to PHEL
 
PHEL is located at the secure State Police Headquarters Complex in Ewing, near Exit 1 of I-95, bordered by Upper Ferry Road and Route 175/River Road. For GPS and mapping devices, use  “1040 River Road, Ewing, NJ 08628.” All deliveries must enter using the MAIN ENTRANCE to the State Police Headquarters Complex off Route175/River Road, and all drivers entering the complex will be asked to PRESENT PHOTO IDENTIFICATION to the State Police guard booth. After showing ID, ask for directions to the PHEL building. Once at the PHEL building, specimens should be delivered to the loading dock/specimen receiving area in the rear of the building, where a PHEL security guard will facilitate specimen submission.
 
The loading dock/specimen receiving area of PHEL is open from 8:30am to 4:00pm to receive specimens. It is the duty of the LHD to ensure rabies specimens are submitted to PHEL on a timely basis. HIGH PRIORITY SPECIMENS MUST BE APPROVED BY THE NJDOH COMMUNICABLE DISEASE SERVICE (CDS) PRIOR TO DELIVERY. LHDs may contact CDS at (609) 826-5964 or 4872 during routine business hours and (609) 392-2020 after-hours (after 5pm or during weekends and holidays).
 
IMPORTANT NOTE: If possible, animals should not be euthanized until prompt delivery has been arranged, so that rabies observation can continue if transport and testing cannot be performed in a timely manner (i.e., if the animal improves in health, testing may not be necessary).
 
The following methods of transportation can be utilized to deliver specimens to PHEL:
 
1.      Drop-off: This is the fastest and most reliable method of delivery to ensure the quickest test result turnover time for high priority specimens. LHDs may assign staff to drop-off properly packaged specimens to PHEL. In addition, the owner of the affected animal, the person bitten or otherwise exposed, or their family members/friends can be asked to drop-off properly packaged specimens. While specimens can be delivered via drop-off any time of day or night, it is 
best to deliver specimens when the loading dock is open.

2.      Non-NJDOH delivery services: There are numerous private delivery services that will transport properly packaged rabies specimens. Because many private delivery services do not deliver to State agencies outside of routine working hours, specimens sent using a private delivery service must always be sent for arrival Monday through Friday, between 8:30am and 4pm. 

IMPORTANT NOTE: Express Mail and other delivery services offered through the U.S. Postal Service (USPS) should NOT be used. The USPS delivers specimens to a mailing center (i.e., not directly to PHEL), resulting in additional transit times of three days or more. Because of this delay, specimens delivered by USPS have decomposed during transit and could not be tested.

3.      NJDOH Courier: There is a courier system that picks up laboratory specimens from various locations throughout the State and delivers them to PHEL. LHDs can use these couriers, however, pick-up schedules can change without notice and utilizing the state courier system will usually result in additional transit times of one to four days. As such, COURIERS SHOULD ONLY BE USED FOR SURVEILLANCE, ANIMAL EXPOSURE OR OTHER VERY LOW RISK SPECIMENS.

 

As a reminder, the LHD or other entity dropping off the specimen at a courier pick- up location is responsible for verifying that the specimen was subsequently picked up and delivered to the PHEL. If there is a question or problem with a courier, please contact Fenton Snell at PHEL during routine business hours at (609) 530-8519.
 
The New Jersey Department of Agriculture, Division of Animal Health, may be able to assist with delivery of livestock rabies specimens. The DAH can be contacted during routine business hours at (609) 406-6999.
 
Contact Information for PHEL
 
For questions related to preparing, packaging and tracking specimens, the best way to contact PHEL is to send an email inquiry to rabies.PHEL@doh.nj.gov. A team of technical staff are monitoring this group email and will provide prompt responses.
 
PHEL may also be contacted by phone at (609) 530-8416, (609) 671-6418 or (609) 671-6419. These phones will be answered or messages left on the associated voicemails will be retrieved multiple times during routine business hours. Messages should not be left regarding test results. All test reports will be delivered via fax to the LHD specified onthe submitted VIR-16 form, and the NJDOH CDS will contact LHDs by phone to convey positive and unsatisfactory results.
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