Diana asks about how to handle suspect anthrax cases. 

These must be reported to the State Health Department, who will contact CDC.
They will apply a "case definition" to see if it fits. Any biopsy should be
handled normally with sterile technique and universal precautions. Fix in
formalin. 

The State Health Department and your clinicians will decide what to do with
it. If it is highly suspicious (as determined by the State) they may want to
send the biopsy to CDC right away.  If there is not a very high suspicion,
they will probably have you process the biopsy as a diagnostic case. If,
after testing it is still suspicious the State Health Department will send
it on to CDC for more testing. 

There is a very specific channel of communication for these cases because
they are treated as criminal cases. Therefore chain-of-custody documentation
for the specimens must be met. Work with the State Health Department and
they will give the guidence you need.

Hopefully no one else will need this information!


Tim Morken EMT(MSA), HTL(ASCP)
Centers for Disease Control and Prevention
Infectious Disease Pathology
MS-G32 
1600 Clifton Road
Atlanta, GA 30333

PH 404-639-3964
FAX 404-639-3043
email tim9@cdc.gov 



-----Original Message-----
From: Goodwin, Diana [mailto:DGoodwin@CHSNJ.org]
Sent: Friday, October 26, 2001 9:05 AM
To: 'Histonet'
Subject: processing of suspected anthrax skin biopsies


Greetings, Histonet.

Well, the inevitable has happened.  Here we are in historic Trenton, NJ,
where Washington crossed the Delaware in the famous surprise attack on the
Hessian army.  Now we have a new claim to fame:  Anthrax.

My histology dept. has received a skin bx. from a patient w/ suspected
cutaneous anthrax.  Can anyone give me a reference as to the safe processing
of such specimens, and, specifically, one that addresses if formalin kills
b. anthracis?

Much obliged, 

Diana Goodwin,  HT
Trenton,  NJ