Stool Specimens – Shipment

Submit the specimen to the appropriate city, county or state health department laboratory (see http://www.aphl.org) for processing and examination. That facility will refer specimens to CDC if necessary. Click on the following link to see proper labeling and packaging of specimens: (https://www.cdc.gov/od/ohs/biosfty/bmbl4/b4acf1.htm).

Note: When you ship a specimen to CDC, make sure your package will arrive on a weekday and will not arrive at CDC on the weekend or a federal holiday.

Shipment of Unpreserved Specimens

On some occasions, unpreserved stool is requested in order to isolate a known or suspected pathogen (i.e., culture for microsporidia, PCR testing). In these cases, the specimen must be placed in a clean container as quickly as possible and kept under refrigeration until necessary arrangements are made for pick-up and delivery by an overnight courier. The sender must ensure that the specimen remains cold during transport by using available packing materials such as cold-packs. CDC follows regulations describing the requirements for proper packaging and shipment of biomedical materials (42 CFR Part 72 – Interstate Shipment of Etiologic Agents) which can be located at https://www.cdc.gov/od/ohs/biosfty/shipregs.htm.

Shipment of Preserved Specimens

The rules for the shipment of preserved specimens are the same as those for unpreserved specimens except that they do not need refrigeration.

Packaging

Stool specimens must be packaged so as to avoid leakage. The package should be able to withstand rough handling and passage through routinely used sorters, conveyer belts, etc. There are two sets of instructions for packaging, depending on the volume:

Volume not exceeding 50 ml.

1. The material to be shipped shall be placed in a securely closed, watertight tube, vial, or similar container that is referred to as the primary container.
2. The primary container is then placed in a durable, watertight container referred to as the secondary container.
3. Several primary containers can be placed in one secondary container as long as the combined volume does not exceed 50 ml.
4. Cold packs along with absorbent material must be placed around the primary containers. There must be enough material to absorb all of the contents of the primary container in case of leakage. The absorbent material should not be particulate such as sawdust or vermiculite.
5. Each set of primary and secondary containers is then placed in an outer shipping container constructed of corrugated fiberboard, cardboard, wood, or other like material.
6. The shipping container must have a “Etiologic Agents – Biomedical Material” label affixed in a prominent location.

Volume greater than 50 ml.

Packaging of these larger volumes of material must comply with all of the requirements of the above but in addition:

1. Shock absorbent material, in volume at least equal to that of the material used between the primary and secondary containers, should be placed on all sides around the secondary container before placing in the outer shipping container.
2. Single primary containers shall not contain more than 1000 ml; however, two or more primary containers, whose combined volume does not exceed 1000 ml can be placed in a single secondary container.
3. The maximum amount of specimen within one shipping container may not exceed 4000 ml.

For additional information on shipping stool specimens, call the Division of Parasitic Diseases at (404) 718-4110.