Laboratory Test Guide

Botulinum Toxin (Sendout)

General Information

Lab Name

Lab Code

509

Description

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

Synonyms

Botulism, Clostridium botulinum

Interpretation

Method

Real-Time Polymerase Chain Reaction (RT-PCR), Mouse bioassay, ELISA, standard reference procedures for biochemical identification

Guidelines

Ordering & Collection

Specimen Type

Stool, Food, Serum, Tissue, Swab, Gastric Aspirate

Collection

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.

Handling Instructions

Expedite transport of samples to the laboratory.

Quantity

requested: Blood: 10 mL serum (refer to Collection section for other specimen types)
minimum: Blood: 10 mL serum (refer to Collection section for other specimen types)

Processing

  • 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.
  • 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.

Performance

LIS Dept Code

Performing Location(s)

Sendout Washington State Public Health Laboratory
206-418-5400

1610 NE 150th St.
Shoreline, WA 98155

Frequency

Daily on regular business days. STAT testing is available 24/7 for critical situations.

Available STAT?

No

Billing & Coding

CPT codes

LOINC