Botulinum Toxin (Sendout)

Ordering Requirements:

• Pre-approval by WA DOH or LHJ is required. Providers must contact the Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) at 206-296-4774. Alternatively, page the Laboratory Medicine Resident (LMR) or Microbiology Fellow on-call for assistance.
• Providers must submit a completed Washington State Public Health Lab Bioterrorism Requisition.

Alternate Contact Numbers:

• Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE): (206) 418-5500
• WPHL Bioterrorism Lab: (206) 418-5562
• WA State Interactive Map of LHJ Sites

After consultation with the Washington State DOH Epidemiologist, submit one or more of the sample types listed below. Ensure that samples are clearly marked with the specimen source.

Adult:

• Stool: Collect 10-50g (ping-pong ball sized) stool in sterile, leak-proof container.
• Blood: Collect 30 mL blood in RED TOP or GOLD SST.
• Tissue, Exudate, or Wound: Collect swab in sterile container with anaerobic transport medium.
• Enema, Vomitus, or Gastric Contents: Collect with 10-20 mL non-bacteriostatic water into a sterile unbreakable container.
• Food Sample: coordinate with CDE for collection and transport.

Infant:

• Stool: Collect 10-50g (ping-pong ball sized) stool in sterile, leak-proof container.
• Enema: Collect with 10-20 mL non-bacteriostatic water into a sterile unbreakable container.

Washington State Public Health Lab Specimen Collection and Submission Instructions: Clostridium botulinum toxin.

• Serum, Stool, Enema, Gastrointestinal: Refrigerate samples. Transport with an ice pack.
• Tissue, Exudate, Wound Swabs: Maintain and transport at room temperature.

Login: SPMSND-;REFRIG

• MSNDTO: WPHL
• MSPTYP: (As specified on request, ex: STL, SERUM, GASTRC, etc.)
• MTSTRQ: ;Clostridium botulinum Toxin

Sendouts:

• If multiple specimen types are submitted, ensure that each specimen is properly labeled with the source.
  • Specimen Collection and Submission Instructions
• Place the order in the WA DOH ETOR (Electronic Test Ordering & Results Portal).
  • Manual requisitions are no longer accepted by WAPHL.
• Order Test: Rule out Clostridium botulinum toxin under General Microbiology/Emergency Response (Bioterrorism). Enter a separate order for each sample type received.
• Print the resulting requisition and package it with the sample.
• Expedite transport of samples to the state lab via DLMP or Delivery Express courier.