Submitting Samples

• It would be very helpful for our processing if providers could follow the following guidelines for certain batch sizes of samples:
• If over 300 samples in one shipment refer to Shipping Flyer for over 300 samples (racked)
• If under 300 samples in one shipment refer to Shipping Flyer for under 300 samples

• Testing Do’s and Don’ts for a quick summary
• All packages must be sent in the appropriate packaging container and comply with relevant shipping criteria (e.g., DOT and/or IATA) or is subject to rejection. Per DOT 49 CFR Part 173, All Category B infectious substances must be packaged in a “Triple Packaging” consisting of a primary receptacle, a secondary packaging and a rigid outer packaging (a.k.a the tertiary container).
1. Primary container is the sample tube. The tube should be examined prior to use to ensure there are no cracks. Ensure the cap is on and tightened appropriately; be aware that under or over tightening a tube cap can lead to sample leaking.
2. Secondary container is a leakproof container such as a plastic, sealable bag for each individual sample tube (e.g., one bag per sample) or a locking container for specimens in a sample rack. The secondary packaging must also contain sufficient absorbent material to cushion the primary receptacle(s) and absorb the entire liquid contents of the primary receptacle(s), should the primary receptacle(s) leak. The sample and absorbent material should be the only thing placed in the secondary packaging. The secondary packaging should be placed in the cooler. Ice packs and cold block should be placed in the cooler, but outside the secondary packaging.
   1. If using a bag, the bag should be tightly sealed. Bags should never be re-used, patient paperwork should never be stapled to the bag and wet ice/cold blocks should not be added to individual bags.
   2. If using a rack and locking container, sealed specimens should be placed upright in a sample rack. The rack of samples should be placed on top of an absorbent pad inside the secondary locking container.
3. Tertiary containers are rigid containers to help prevent sample tube breaks (e.g., cooler). This container should be clearly labeled with “<Institution Name> COVID-19 Samples” and any necessary biohazard warnings. The name and telephone number of a person responsible must also be available on the tertiary container or on accompanying written document, such as the courier slip. As long as there is space, multiple samples can be added to the sample tertiary container. Samples should be packaged upright to minimize the risk of leaks. Be sure to leave room for cold packs, when applicable, and do not overfill the container. Cold packs should be added to the bottom of the tertiary container, when necessary, to ensure that all samples maintain proper temperature (refer to Do’s and Don'ts). If space allows, JAX recommends placing the samples in the cooler with the ice packs and then leaving the entire cooler in the fridge until the courier comes to pick it up. JAX kindly requests that a hard plastic container (e.g., an Igloo cooler) is used rather than containers made of Styrofoam or cardboard.
   1. If there is a breach in the first and secondary containers, Styrofoam and/or cardboard can absorb infectious material which presents a possible safety risk for all parties involved. JAX cannot properly decontaminate Styrofoam and/or cardboard as these materials will absorb the disinfectant and may weaken the rigidity of the packaging. 
   2. A tertiary container cannot be a paper or plastic bag.
   3. Do not use “wet ice”. Wet ice will likely melt, creating liquid in the bag. Safety regulations dictate that we must assume any liquid in the bag is a contaminated sample and cannot process it. To avoid this situation, we ask all institutions to use ice packs in lieu of “wet ice”. If samples are delivered on “wet ice” the courier will be asked to return the sample to the respective institution.

• Note: Acceptable specimen types, swabs and transport media are subject to update as bridging studies are made available to the FDA. Please refer to the FDA FAQs on Diagnostic Testing for SARS-CoV-2 page for the most up-to-date information.
• Multiple specimens may be taken with a single swab. If both NP and OP swabs are collected, they should be combined in a single tube to maximize test sensitivity and limit testing resources. Avoid tongue swabs, as they may have reduced sensitivity and could result in a false negative test result.

• Note: Acceptable specimen types, swabs and transport media are subject to update as bridging studies are made available to the FDA. Please refer to the FDA FAQs on Diagnostic Testing for SARS-CoV-2 page for the most up-to-date information. If you are unable to obtain any of these specific types of collection supplies, please contact CGL_COVID_CS@jax.org
• If you are submitting for the first time, you may be asked to please send a blank sample of a tube so we can confirm it is compatible with our workflow.
• Below is a list of individually wrapped swabs. All swabs are flocked unless noted. Some swabs may be acceptable for specimen collection at multiple locations and are therefore listed under each location. 

* flocked oropharyngeal swab  ** Polyester swab  *** no swab   f Foam swab 

•  Viral Transport Medium/Universal Transport Medium remains the preferred transport media. Examples of universal transport media for viruses and molecular transport media are listed below. Specimens can be stored up to 120 hours at room temperature or refrigeration. All of the products listed below include a nasopharyngeal (NP) flocked swab unless noted otherwise. 

* flocked oropharyngeal swab  ** Polyester swab  *** no swab 

• Below is a list of alternative transport media in case any of the above medias are unavailable:

• Each specimen tube must be labeled with the following information (the bolded items are the minimum requirement; the others are optional but recommended)
  • Patient First and Last Name
  • Patient Date of Birth
  • Specimen ID (barcode required)
  • Collection Date/Time
• Unlabeled or illegible tubes will be discarded. Ensure the label is properly placed on the tube, and there are no wrinkles in the label, as this could affect the receiving process. Missing information will delay processing, and without two unique identifiers, samples cannot be processed.

• You may use cold packs or dry ice. Do not use wet ice.
• Please refer to FAQ: “What are the Specimen Acceptance Requirements for JAX COVID Testing” for more specific details.
• Shipping Checklist