3.6 What samples should be obtained and who is responsible?

For humans:
Samples should be taken when (i) a suspect patient is submitted to a hospital and receives intensive care (ante mortem) and (ii) a patient exhibiting neurological signs suspicious of rabies died (post mortem) needs to be distinguished. Specimens obtained for ante mortem testing of patients include serial saliva samples to be taken at a three to six hour interval (intermittent virus shedding) and/or a skin biopsy taken from the nape of the neck (comprising hair follicles). The chances to detect rabies virus / lyssaviruses or genetic surrogates of those in hospitalized patients is highest in skin biopsies. Other samples to be taken are serum, cerebral spinal fluid, and other biopsied nerve tissue. Samples to be taken post mortem to confirm rabies infection in a patient are brain tissues (Ammonshorn, cerebellum, brain stem) or other biopsied nerve tissue. Skin biopsies from the nape of the neck can also be used if because religious or cultural issues the former is not feasible.

For animals:

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Field Diagnostic Kit - photo KwaZulu-Natal rabies project

To detect rabies, brain or brain stem tissue is required from either dead or suspect animals. In the latter case animals may be shot (wildlife) or humanely euthanized (domestic animals). Those samples should be taken by professionals ( e.g., veterinarians or trained rabies surveillance personnel—see section 3.4.). For further information see here.
If a professional is not available to obtain a sample from the animal for laboratory diagnosis, head removal should be accomplished to minimize the chance for potential rabies exposure. Where appropriate storage conditions are not available or frequent submission of samples to the laboratory cannot be guaranteed, the use of filter paper (FTA Gene Guard System – commercially available) technology for sampling, alternative storage and subsequent submission of samples should be considered (for more information read here).
The samples or the head of the animal should be provided to the laboratory with the appropriate labeling.

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[en]Version 1 Last updated December 2014[fr]Première version, dernière mise à jour Juin 2015