Instructions for submitting ticks for testing



Similar documents
Please note: Contact Coppe Laboratories at if archival plasma samples need to be tested.

Lyme Disease Advisory Committee Teleconference Minutes November 16, 2011

4,1 My Experience with Lyme Disease

2016 Advanced Landscape Plant IPM PHC Short Course January 4-7, 2016 GENERAL INFORMATION FOR REGISTRATION

MEDICAL DIAGNOSTIC LABORATORIES, L.L.C Kuser Road * Hamilton, NJ Toll Free (877) * Fax (609)

Guidelines for Collection and Transport of Specimen for Laboratory Diagnosis of Pathogenic Leptospira spp.

Lyme (IgG and IgM) Antibody Confirmation

We hope you will consider this opportunity to jump start your BSN! THE CALIFORNIA STATE UNIVERSITY

CAPHLD Laboratory Listing

Connecticut Veterinary Medical Diagnostic Laboratory

Annual Biomedical Waste Code Training

4A. Types of Laboratory Tests Available and Specimens Required. Three main types of laboratory tests are used for diagnosing CHIK: virus

Government Finance Officers Association Training Seminars Registration Form January 2016 April 2016

WHICH SAMPLES SHOULD BE SUBMITTED WHEN LYMPHOID NEOPLASIA IS SUSPECTED?

Date. Name Street City, State Zip. Dear Member:

State Disability Insurance Provisions

Temecula Valley Hospital Requesting Copies of Your Medical Records

COMTO Scholarship Application Requirements

What You Need to Know About Collecting QuantiFERON (QFT) TB Gold In-Tube Samples

General Information and Guidelines. Submission of blood tubes

DIRECTED UMBILICAL CORD BLOOD AND TISSUE COLLECTION IN THEATRE (CELLCARE)

Online Communicable Disease Reporting Handbook For Schools, Child-care Centers & Camps

CAADS California Association for Adult Day Services

Inland Valley Medical Center Rancho Springs Medical Center Requesting Copies of Your Medical Record

Classic Car Guy.Com. TEL/FAX: Address: 1241 Johnson Ave., #214, San Luis Obispo, Ca 93401

County of Santa Clara

LYME DISEASE. Lijing Yao, MD

Licensee File CD Request

ALS and Lyme Disease Questions from Patient and Families Responses from Medical Experts

San Francisco: COMPLETE LIST OF FREE/LOW COST CLINICS BY COUNTY. San Francisco Community Clinic Consortium (415)

Rules and Procedures. Rule 312 August 23, Rule CRIME LABORATORY - EVIDENCE AND CRIME SCENES

Requirements for Admission (Certificate Program)

BLOOD PARASITES: CLINICAL SIGNS, DECTECTION AND TREATMENT

Do you need Emergency Custody and/or Visitation orders? FAMILY COURT

Limited Permit X-ray Technician Bone Densitometry School ID#6020 CLASS NOTIFICATION

California State Department of Fair Employment and Housing 611 West Sixth Street, 15th Floor Los Angeles, CA

Requirements for Admission (DBA)

What You Should Know About Lyme Disease and Other Tick-Borne Diseases. Sudbury Board of Health

Testing for Tick Borne Diseases: How and When?

Drop off Locations for Used/Unused/Expired Medications:

CAADS California Association for Adult Day Services

Biohazardous, Medical & Biological Waste Guidance Chart

Easter Seals Bay Area. Request for Proposals Occupational Therapy, Speech and Language Pathology and Applied Behavior Analysis Services RFP #2.

CSULB Housing and Residential Life Response to Bed Bugs

6 Body Fluid Stains and Standards

DISABILITY INSURANCE PROVISIONS

ANSWERING A PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH COMPLAINT

DISABILITY INSURANCE PROVISIONS

MEDICAL WASTE DEFINITION OF TERMS HEALTH & SAFETY CODE, PART 14; COUNTY ORDINANCE #7646

Dental Assistant Application Checklist

Community Health Administration

The Association of Bay Area Health Officials: Advancing Public Health through Regional Networks

SCHOOL PERFORMANCE FACT SHEET

PARTNERSHIP HEALTHPLAN OF CALIFORNIA CLAIMS MEDI-CAL PROVIDER MANUAL CLAIMS DEPARTMENT

EPIDEMIOLOGY OF TICK-BORNE ENCEPHALITIS AND LYME DISEASES IN ESTONIA

SF Welcome Back Center Health Sector Employment Outcomes (As of 03/05)

Delaware County Community College Allied Health, Emergency Services, & Nursing Nursing Program Medical Requirements

MIGUEL GONZALEZ, MD, FCCP, FACP 303 S. Moorpark Rd. Thousand Oaks, Ca Phone Fax PATIENT INFORMATION

Guide to the Southern Pacific Company Drawings and Maps. No online items

ATTORNEY'S BRIEFCASE presents

Biohazardous Waste and Sharps Disposal

12345 El Monte Road Los Altos Hills, California

COUNSELOR LICENSURE INSTRUCTIONS Authority: P.A. 368 of 1978, as amended This form is for information only.

The Jefferson County Board of Supervisors does ordain as follows:

September 22, The Honorable Diane Feinstein 331 Hart Senate Office Building Washington, DC 20510

2015 UCI Summer Session: Application and Enrollment Form for Visiting International Students

Bed Bug Information Kit for Schools January 2014

LYME DISEASE. 2.5M specimen tests per year. 97% accuracy with Rockland tools

Bird and bat droppings

Understanding Unduplicated Count and Data Integration

BORNE BY BUGS, DISEASES OF CONCERN. Heartland Virus

LA: THE DREAM STARTS HERE BUILDING LOS ANGELES INTO A GLOBAL CAPITAL OF CLEAN TECHNOLOGY

DEPARTMENT OF ENVIRONMENTAL HEALTH Office of Solid/Medical Waste Management 1131 Harbor Bay Parkway, Rm. 200 Alameda, CA Tel.

Notice of Chapter 7 Bankruptcy Case, Meeting of Creditors, & Deadlines

$15,000 Dinner Sponsor

Department of Nursing. SUPPLEMENTAL APPLICATION for PRE-LICENSURE BACCALAUREATE PROGRAM

WELCOME TO COASTLINE COMMUNITY COLLEGE!

FORM FOR REGISTRANT NAME CHANGE (RNC)

INTERPRETATION INFORMATION SHEET

Saint Thomas Christian College & Seminary Jacksonville, FL

Transcription:

ALAMDA COUNTY Department of nvironmental Health VCTOR CONTROL SRVICS DISTRICT 1131 Harbor Bay Parkway, Suite 166, Alameda, CA 94502 (510) 567-6800 FAX (510) 337-9137 Instructions for submitting ticks for testing Lyme disease is present in Alameda County. There is a 1-2% infection rate in adult Western Black-legged ticks which are generally active November to June. Infected adult ticks need to be attached for 16-24 hours for disease transmission to occur. Nymphal ticks are very small, are active generally from April to July and have infection rates from 2 19% depending on locality. Our District will identify the tick species (Ixodes pacificus is the only Lyme disease vector in this area), and give advice on which local lab is appropriate depending on the condition of the tick. You may send the tick(s) directly to labs listed below. Specimen in poor shape and dried should be tested by PCR. IGeneX, Inc., 797 San Antonio Rd., Palo Alto, CA. 94303. Phone: 800-832-3200. Their fee for the PCR test is $65.00. (Results in approx. 3 weeks) Make check out to IGeneX, Inc. They also accept credit cards. (Tick test request forms may be downloaded from www.igenex.com) Specimens that are alive or recently dead, may be tested by IFA. The labs below will test tick by IFA tests: County of Sonoma, Dept. of Health Services, Public Health Lab, 3313 Chanate Rd., Santa Rosa, CA 94504, (707) 565-4711. The IFA test is $29.00. (Results in approx. 1-2 weeks) http://sonoma-county.org/health/ph/laboratory/services31.htm Marin County Public Health Lab, 920 Grand Ave., San Rafael, CA 94901, (415) 499-6849. The IFA test is $20.00. (1-2 weeks) http://www.co.marin.ca.us/depts/hh/main/hs/clinicalsvcs/clinicalservices.cfm Santa Clara County Public Health Lab, 2220 Moorpark Ave., 2nd Fl. San Jose, CA 95128, 408.885.4272. The IFA test is $15.00. http://www.labaspire.org/county_lab.asp?id=30 If possible, ticks should be kept alive by storing in vial or Zip-lock baggie with moist tissue/cotton wool. Avoid placing tick in alcohol or formalin. For long term storage, keep in refrigerator. Ticks brought to or mailed to our office may be put into a Ziplock baggie with water moistened cotton wool or tissue. nclose a check made out to desired lab. If the tick(s) are sent directly to the lab, place tick into a crush proof container with moistened cotton wool. Include name, address, phone number of person bitten and note location tick was most likely picked up and a check for the proper amount (see lab forms enclosed). For more information, contact David James, Alameda Co. Vector Control at 510.567.6816

kf IGeneX,Inc. 795 SanAntonio Road PaloAlto, CA 94303 800/832-3200 www.igenex.com TICK TST RQUST FORM Revised: JUN 2008 TO SNDATICK: ' Place ticks (up to 20) in a small tube or plastic baggy with a small piece ofmoist cotton, ' Place container in a sealed plastic bag. ' Fill out lower portion ofthis form. ' Place form, ch ckand seal d plasticbag in padded enyelope or bol ' Send to IG nex,inc. and markfront ofenvelope or box with "TT". ' lcenex does not "TYP" or determine the species ofthe ticks. lfyou want to "TYP" your tick, please contact your local Vector Control Center.. Once your tick(s) have been processed, the tick can not be returned to you.. For Multiple Ticks: up to 20 ticks will be t sted togeth r at one time unless indicated otherwise. Ifticks aretested separately, the charge is pertick. Please test my ticks separately. Yes Please test the tick by PCR for: tl Test 140 Lyme Disease (B. burgdorferi) $6s.00 Test 689 Babesiosis (B microti and/or B duncani) 565.00 Test 148 hrlichiosis (hrlichia) f-] Test 290 Bartonella henselae Test 975 Rickettsia Name and Address of Sender: $65.00 s65.00 s65.00 If you would like results faxed or called, please indicate below. Otherwise, results will be mailed by USPS. Please fax my completed results to: (_) Phone: ( ) Check enclosed payable to IGeneX, Inc. Please call me with my results atz Please charge my credit card for the above tests: Visa Mastercard Discover Card Number: xp.date S ign atu re

Lyme disease & other tick diseases requested by: physician, laboratory or Clinic County of Sonoma Department of Health Services Public Health Laboratory 3313 Chanate Road, Santa Rosa, CA 95404 Telephone (707) 565-4711 NAme ADDReSS CiTy, Zip Daytime phone: source print Complete mailing address for RepoRt PLace of tick contact arm leg others: geographic Location: bite date (Rev 4/07) examination requested lyme Disease serology lyme Disease organisms in ticks ehrlichia serology babesia microscopic babesia serology tick panel note: keep tick moist, and mail to lab in crush proof container test used Lyme disease test elisa ifa western blot Lab no. date received: Patient s name: last first age sex disease suspected result of test: Lyme disease major clinical findings ecm this area for Lab use only A. ANTiBODy NOT DeTeCTeD B. infection AT UNDeTeRmiNeD Time (BY BORRLia BURGDORFRi) C. evidence OF ReCeNT OR CURReNT infection D. ReCOmmeND Re-TeST in 3-4 WeeKS TiCK i.d.: ixods PaCiFiCUS DRMaCNTOR SP. Lyme DiSeASe ORGANiSm in TiCK: BORRLia BURGDORFRi NOT DeTeCTeD BORRLia BURGDORFRi DeTeCTeD Date RepoRteD: Lyme disease