BACTERIAL CONTAMINATION REND- 
ERS SPECIMENS UNSATISFACTORY FOR 
TESTING. SERA SHOULD NOT CONTAIN 
PRESERVATIVE OR ANTICOAGULANT. 
(c) Secure the stopper in the tube with 
adhesive tape. 
(d) Place the blood specimen in a 
mailing container with the com- 
pleted clinical history form and 
mail it immediately to the State 
public health laboratory. 
(e) A clinical history form on the 
patient should be submitted to the 
State laboratory with the speci- 
men. This should include infor- 
mation on evidence or history of 
syphilis, other treponematoses or 
venereal diseases in the patient or 
family, previous therapy, a record 
of previously performed serologic 
tests for syphilis on serum or 
spinal fluid specimens, and evi- 
dence of diseases or conditions 
other than syphilis. 
(3) Preparation of the sterile serum sample 
(a) The State public health laboratory 
will aseptically separate and trans- 
fer the serum to a sterile tube 
stoppered with a paraffin-coated 
cork. 
(b) The sterile serum sample will then 
be forwarded immediately to; 
The National Communicable 
Disease Center 
Venereal Disease Research 
Laboratory 
Atlanta, Georgia 30333 
(4) Reporting of results 
Test results will be reported to the 
State public health laboratory for for- 
warding to the submitting physician. 
f5) Public Health Service facilities 
These facilities have special instructions 
and forms for submitting specimens 
directly to the Venereal Disease Re- 
search Laboratory. 
b. Darkfleld examinations for Treponema pal- 
lidum 
Darkfield examination is an examination of 
exudate from suspected syphilitic lesions 
with a compound microscope equipped with 
a darkfield condenser. The darkfield exami- 
nation should be performed on any rash or 
lesion suspected of being syphilitic, and, 
ideally, it should be performed immediately 
after the specimen is collected. If this exami- 
nation cannot be performed locally, contact 
the State department of public health labora- 
tory and/or the venereal disease control 
section for information on the availability 
of this service. 
c. Fluorescent antibody darkfield (FADF) 
examination for T. pallidum 
( 1 ) Clean the suspected syphilitic lesion 
with a gauze sponge wet with tap water 
or saline. Dry the area and abrade it 
with a dry sponge. It may be necessary 
to squeeze the base of the lesion to pro- 
mote the appearance of serum. For dry 
lesions, apply a large drop of saline and 
emulsify the surface material with a 
toothpick or bacteriological loop. 
(2) Collect the specimen in a dry capillary 
tube (optimum dimensions — 75 x 
1.5 mm.). 
(3) With a 70%-alcohlol sponge, wipe off 
the top of the capillary tube which con- 
tacted the lesion and seal both ends of 
the tube with clay, paraffin, Critocaps, 
or a small flame. 
(4) For mailing specimens to a central 
laboratory, place the capillary tube in 
a cardboard slide-mailing container, 
seal with cellophane or masking tape, 
OR, place the capillary tube in a test 
tube, stopper, place in a mailing con- 
tainer, and pack to protect against 
breakage. 
FREEZING SPECIMENS BEFORE 
MAILING TO A CENTRAL LAB- 
ORATORY IS NOT NECESSARY. 
(5) When specimens are received in the 
laboratory for examination, the capil- 
lary tube (in the mailing container), 
plus the identification slip, is placed in 
a freezer (— 20°C. to — 40°C.) until 
the specimen is completely frozen. If 
the specimen is to be examined imme- 
diately, the capillary is removed from 
the mailing container for more rapid 
freezing. After freezing, thaw the speci- 
men at room temperature and examine 
it according to the FADF procedure. 
d. Blood specimens for the nontreponemal 
14 
