Submitting Samples

 

How to prepare samples for transit to JAX for testing and sequencing.

Should I package samples differently if I have a large number?

How should I package my 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.

What are the Specimen Acceptance Requirements for JAX COVID Testing?

  • 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.

COVID-19 Specimen Acceptance Criteria 

Specimen Type 

Swab Type

Specimen Collection Recommendations  

Shipping Temperature 

Sample Storage  
for Transport  

Amount & Quality Requirements  

Nasopharyngeal 
(NP) Swab
 *Preferred
Specimen Type*
 

Swabs with a synthetic tip (such as polyester or Dacron®) with aluminum or plastic shafts. Swabs with calcium alginate or cotton tips with wooden shafts are not recommended. 

Swab specimens should be collected by a healthcare professional. Place swabs immediately in sterile tubes containing at least 1 mL of sterile virus transport medium. 

Up to 72 hours after collection:  
2°C - 25°C in saline 

Up to 120 hours after collection: 
2°C - 35°C in viral transport medium (VTM) 

>120 hours from collection: -70°C or below and ship on dry ice 

Up to 1 month after collection: 
2°C - 37°C in Zeesan/MP+ Viral RNA Preservation buffer 

Sample must be collected into sterile, labeled tubes, and placed in a secondary biohazard container with sufficient absorbent material to contain any leakage. Sample must also be transported in a rigid, tertiary container. 

Minimum of 400 µL of  sample in sterile virus transport medium 
(≥ 1 mL recommended) 

Oropharyngeal
(OP) Swab 

Nasal mid-turbinate
(NMT) Swab 

Flocked tapered swab with a synthetic tip (such as polyester or Dacron®) with aluminum or plastic shafts. Swabs with calcium alginate or cotton tips with wooden shafts are not recommended. 

Swab specimens should be collected or supervised by a healthcare professional. Both nares should be swabbed. Place swabs immediately in sterile tubes containing at least 1 mL of sterile virus transport medium. 

Anterior Nares
Specimen 

Round foam swab with aluminum or plastic shafts. Swabs with calcium alginate or cotton tips with wooden shafts are not recommended. 

Sputum 

N/A 

Collect 1 mL into a dry, sterile container or transfer to transport medium as 1:1 dilution, 1-2 mL 

 

If not in virus transport medium: 
Store at 2°C - 8°C on frozen gel packs for up to 24 hours 
 >24 hours, sample may not be tested and must be recollected 

If using virus transport medium (VTM): Store at 2°C - 25°C for up to 120 hours 
 >120 hours, sample may not be tested and must be recollected 

 

Minimum of 400 µL of sample (≥ 1 mL recommended). 

 

Lower respiratory tract specimen, e.g. 
lower respiratory tract aspirate or
bronchoalveolar lavage 

Trachea aspirate
or wash 

 

N/A 

Collect 1-2 mL into a dry, sterile container 

Store at 2°C - 8°C on frozen gel packs for up to 24 hours 
 >24 hours, sample may not be tested and must be recollected 

Sample must be collected into sterile, labeled tubes, and placed in a secondary biohazard container with sufficient absorbent material to contain any leakage. Sample must also be transported in a rigid, tertiary container. 

Minimum of 400 µL of sample (≥ 1 mL recommended). 

 

Saliva 

 N/A

Collect 1 mL into Zeesan/MP+ Viral RNA Preservation buffer tube. 

Up to 1 month at 2°C - 37°C.  > 1 month, samples must be stored at -70°C or lower. 

Sample must be collected into sterile, labeled tubes, and placed in a secondary biohazard container with sufficient absorbent material to contain any leakage. Sample must also be transported in a rigid, tertiary container. 

Minimum of 400 µL of sample (≥ 1 mL recommended). 

What specific brands of specimen collection supplies is JAX able to process?

    • 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. 

COVID-19 Recommended Swabs

Specimen Type 

Manufacturer 

Item Number 

Nasopharyngeal 

Puritan 

25-3316-H, 25-3316-U, 25-3317-H, 25-3317-U, 25-3318-H, 25-3318-U, 25-3319-H, 25-3319-U, 25-3320-H, 25-3320-U, 25-3320-H EMB 80, 25-3320-U EMB 80, 25-3320-H EMB 100, 25-3320-U EMB 100, 25-1406 1PF 50ff, 25-800 1PD 50**, and 25-800 1PD ALUM 50** 

Copan 

503CS01, 518CS01, 501CS01, and 502CS01 

BD 

220252 and 220251 

DHI/Quidel 

503CS01.DHI 

Fisher Healthcare 

23600952, 23600956 and 23600950 

Oropharyngeal 

Puritan 

25-1506 1PF SOLID f, 25-1506 1PF 100f, 25-3206-H, 25-3206-U, 25-3706-H, 25-806 1PD** and 25-806 1PD BT** 

Copan 

502CS01, 519CS01, 164KS01** and 175KS01** 

BD 

220250 

Fisher Healthcare 

23600950, 23600957 and 1490650** 

Mid-Turbinate 

Copan 

56380CS01, 56750CS01, 56780CS01 

Anterior Nares 

Puritan 

25-3206-H, 25-3206-U, 25-3706-H, 25-1506 1PF 100f , 25-1506 1PF solid f, 25-1506 1PF BT f, 25-1506 1PF TT MC f, 25-1506 2PF BT f, 25-1406 1PF BT*** f 

Copan 

502CS01, 519CS01 

BD 

220144 f, 220145 f, 220250 

DHI/Quidel 

20103f 

Fisher Healthcare 

23600950, 23600957 

* 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. 

COVID-19 Recommended Transport Media 

Manufacturer 

Item Number 

Puritan 

UT-367, UT-317, UT-302*, UT-366** and UT-300*** 

Copan 

305C, 307C, 360C and 519CS01* 

Hardy/Healthlink 

330CHL 

BD 

220526, 220527, 220528*, 220529, 220531 

DHI-Quidel 

330C*** 

Fisher Healthcare 

23001718, 23600952, 23600956, 23600950 and 23600957* 

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

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

COVID-19 Alternative Transport Media  

Liquid Amies media:  
May be used for viral transport when universal transport media is not available. All of the products listed below include a nasopharyngeal (NP) flocked swab unless noted otherwise. 

Manufacturer 

Item Number 

Storage Temperature 

Storage Time Limit 

Puritan 

LA-117, LA-116-H and LA-100*** 

4℃ 

Up to 72 hours after collection 

Copan 

481C, 482C 480C* and 480CFA* 

Hardy/Healthlink 

481C, 482C 480C* and 480CFA* 

BD 

220246, 220532 and 220245* 

Fisher Healthcare 

23600901, 23600902, 23600900* and 23600905* 

ThermoFisher 

R723481, R723482 and R723480* 

VWR 

89136-656, 89136-658, 89136-654* and 76181-494* 

Phosphate buffered saline (PBS)  
(including molecular grade PBS when available, and other similar formulations including Delbecco's PBS):  
May be used to collect and transport samples for molecular RT-PCR SARS-CoV-2 assays. Specimens can be stored up to 72 hours at 4℃. 

Normal 0.85% saline:  
May be used to collect and transport samples for molecular RT-PCR SARS-CoV-2 assays.  All the products listed below are examples of 1-3 mL of normal saline distributed in a vial without a swab. 

Manufacturer 

Item Number 

Storage Temperature 

Storage Time Limit 

ThermoFisher 

R064430, R064432, R064434, R064436 and R064438 

2°C - 25°C 

Up to 72 hours after collection 

Hardy-Healthlink 

D185, K248, R45 and R55 

Edge Biologicals 

T-0625 and T-0110f 

Zeesan Viral RNA Preservation Buffer:  
May be used for viral transport when universal transport media is not available. This may also be used for saliva collections as well. 

Manufacturer 

Item Number 

Storage Temperature 

Storage Time Limit 

Zeesan  

401120  

2°C - 37°C 

Up to 1 month after collection 

How should I label my specimen?

  • 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.

How should I store my samples until the courier picks them up?

  • 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.
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