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Sampling and Transportof Specimens Potentially Related to Yellow Fever Vaccination
(Information for doctors/clinicians)
Please refer to the following for details on storage and shipment of specimens
- Table 1. Storage and shipment of sera, cerebrospinal fluid, peritoneal fluid, pleural fluid
- Table 2. Storage and shipment of vaccine vials (from same lot as administered to patient)
- Table 3. Storage and shipment of biopsy, surgical, or autopsy specimens
For further information on the enhanced surveillance and diagnostic system for adverse events potentially related to yellow fever vaccine, please see MMWR 2001;50:343-5.
| Table 1. Storage and shipment of sera, cerebrospinal fluid, peritoneal fluid, pleural fluid |
| Type | Test | Preferred
Amount | Storage | Shipping | Other |
| Serum and CSF | Serology testing | 1 ml | 4°C | Cool Pack | Multiple, serial samples may be tested. |
| Serum, CSF, peritoneal, or pleural fluid | Viral isolation and PCR | 1 ml | -70°C | Dry ice | Promptly freeze at -70°C. Repeated freeze/thaw cycles are deleterious to virus. Multiple, serial samples may be tested. |
| Table 2. Storage and shipment of vaccine vials (from same lot as administered to patient) |
| Vaccine | Preferred
Amount | Storage | Shipping | Other |
| Lyophilized form (preferred) | Vial | 4°C | Cool Pack | Lyophilized form preferred over rehydrated form. |
| Rehydrated form | 1 ml | -70°C | Dry ice | Promptly freeze at -70°C. |
| Table 3. Storage and shipment of biopsy, surgical, or autopsy specimens |
| WARNING: Although not documented in recipients of yellow fever vaccine, persons with naturally-acquired yellow fever and associated bleeding diathesis have died of bleeding complications after liver biopsy. Liver biopsy should be performed only with extreme caution in recent recipients of yellow fever vaccine who develop hepatitis or serious systemic illness. |
| Tissue | Preferred
Amount | Storage | Shipping | Other |
Solid organ (brain, liver, spleen, pancreas, heart, kidney, etc.) –
fresh frozen | 1 g | -70°C | Dry ice | Promptly freeze at -70°C. NO formalin or other preservatives. |
| Solid organ – fixed (formalin or similar preservatives) | Representative samples | Ambient | Ambient | Do NOT freeze. |
| Solid organ – in paraffin | Representative tissue blocks | Ambient | Ambient | Do NOT freeze. |
| Skin (rash) – fixed (formalin or similar preservatives) | Representative samples | Ambient | Ambient | Do NOT freeze. |
| Postmortem heart serum | 1 ml | -70°C | Dry ice | Promptly freeze at -70°C. |
General sample shipping information
After the patient has been reported and specimen submission has been discussed with RKI medical officers, samples may be shipped to the RKI under the conditions listed above.
A Report Form (WORD 160 KB) must accompany each specimen. Please fill in the form with computer as completely as possible and include the following:
- Date of yellow fever vaccination
- Date of onset of symptoms
- Date of collection of specimen
- Travel history for the 3 months before onset of symptoms
- Also indicate that the patient is being evaluated for adverse events potentially related to yellow fever vaccination
Please put samples in a substantial container. Wrap samples in absorbent material and pack it in two different plastic containers to ensure that any leakage is contained. Using precautions generally required for shipping of potentially infected materials, samples should be sent by overnight shipping to
Dr. Matthias Niedrig
Robert Koch-Institut
ZBS1
Nordufer 20
13353 Berlin
Germany
Phone number: +49-30-18-754-2370 / 2321
- To ensure that these samples arrive during the week, shipments should be scheduled to arrive according previous arrangements made with Matthias Niedrig.
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