Laboratory Specimen Collection – Procedures

• Lymph node aspirates
• Due to the large amount of surrounding edema, care must be taken to be sure the bubo itself is aspirated.
• If little or no fluid can be aspirated, 1 cc of non-bacteriostatic saline solution can be injected into the bubo and then aspirated back into the syringe.
• Serology
• Acute and convalescent serum samples of 0.5 ml should be collected at least 14 days apart.
• Note that serology is only of use for retrospective confirmation of diagnosis; acute serology alone is of no benefit, since early in the disease patients are often seronegative.
• Pharyngeal Swab
• If there is evidence of plague pneumonia, pharyngeal swab should be made, using culturettes.