Goals
        Define and describe animal and 
         human clinical specimens.
        Define and describe environmental 
         specimens such as food, water, 
         and fomites.
        Discuss proper methods of human 
         specimen collection and 
         transportation 
        Outbreaks Involving 
        Clinical Specimens
         Human clinical specimens from 
          case-patients
            Blood         Saliva
            Serum         Hair
            Urine         Feces
         Type of specimen depends on the 
          outbreak
         Similar specimens from animals
         Clinical Specimen Example 
         1: Monkeypox
           Midwestern United States: more than 70 
            individuals experienced febrile rash 
            thought to be caused by monkeypox virus
              Cases laboratory confirmed using blood, skin, 
               lymph node, pharyngeal specimens
              All lab-confirmed human cases associated 
               with purchase of prairie dogs as pets
              Samples from prairie dogs confirmed infection
              Prairie dogs infected at animal distribution 
               facility where housed/transported with exotic 
               rodents from Africa
          Clinical Specimen Example 
          2: Hantavirus
           1993, southwestern United States: 
             outbreak of a fatal unexplained pulmonary 
             illness associated with previously unknown 
             type of hantavirus
              Rodents found near homes of case-patients 
                trapped and tested 
              Same strain of hantavirus cultured from tissue 
                of a deer mouse captured near home of a case-
                patient who had died from the hantavirus strain
              Results of a case-control study consistent with 
                hypothesis that the fatal pulmonary disease 
                was associated with proximity to infected            
                  deer mice. 
         Outbreaks Involving 
         Environmental Specimens 
           Environmental specimens may be 
            collected to confirm a source: food, water, 
            fomites
              Food/water samples often collected in food or 
               waterborne outbreaks
              Frequently collected in conjunction with human 
               clinical samples
           When clinical and environmental 
            specimens yield same results, supports 
            hypothesis that outbreak source is same 
            as environmental specimen source