Laboratory

These documents a series of documents which are needed to carry out laboratory testing and reporting for cholera.  They include procedures for culturing V. cholerae from fecal samples as well as proper use of Rapid Diagnostic Tests (RDTs) to quickly identify cholera patients.  There are also illustrate appropriate forms for reporting and referral of samples of suspected cases and guidance of tests for antimicrobial susceptibility testing (AST). There are also instructions for specimen packaging and transportation ensure the safe handling of samples domestically and internationally. The technical note on environmental surveillance provides strategies for monitoring water sources for fecal contamination and free residual chlorine (FRC) levels.

1. Rapid Diagnostic Test (RDT) for Cholera Detection: Step-by-step guide for conducting Rapid Diagnostic Tests (RDTs) for cholera on fecal samples. This document outlines recommended procedures to accurately detect cholera in clinical and field settings, facilitating prompt diagnosis and timely intervention in outbreak scenarios.
2. GTFCC Laboratory Referral and Results Reporting Forms: The Laboratory Referral Form is completed by healthcare workers to accompany stool samples from suspected cholera cases for lab testing. The Laboratory Reporting Form, filled out by lab personnel, communicates test results to health authorities or the requesting clinician. Additionally, the Isolate Submission Form must accompany isolate shipments for further testing—such as antimicrobial susceptibility or sequencing—at referral labs. These forms are available in both English and French, ensuring consistency in cholera case management and reporting across healthcare settings.
3. Specimen Collection, Preparation, and Packaging for Transport: This set of documents provides essential guidelines for safely handling Vibrio cholerae O1/O139 specimens. The Specimen Packaging and Domestic Transportation document outlines procedures for packaging and transporting samples within a country for laboratory confirmation. Meanwhile, the Strain Conditioning for International Transportation document details protocols for preparing Vibrio cholerae O1/O139 strains for shipment abroad.
4. Isolation and Presumptive Identification of Vibrio Cholerae O1/O139 from Fecal Specimens: This resource offers guidance on isolating and presumptively identifying Vibrio cholerae O1/O139 from fecal specimens. It includes detailed instructions on laboratory procedures for detection, alongside a fact sheet covering essential points related to these processes.
5. Antimicrobial susceptibility testing for treatment and control of cholera: These documents offer guidance on antimicrobial susceptibility testing (AST) for Vibrio cholerae O1/O139 to aid in cholera treatment and control. The Antimicrobial Susceptibility Testing guide provides instructions on determining in vitro susceptibility to selected antibiotics, while the Laboratory Methods for AST document highlights considerations for phenotypic testing, including diffusion methods using antibiotic discs (Kirby-Bauer) and test strips.
6. Environmental Surveillance for Cholera Control: The document offers guidance on environmental surveillance practices to prevent, control, and monitor cholera outbreaks. It emphasizes the importance of testing drinking water sources for fecal contamination and monitoring free residual chlorine (FRC) levels in high-risk settings. The note also discusses the role of environmental surveillance in assessing cholera transmission risk, the limitations of testing specifically for Vibrio cholerae, and the preferred use of fecal indicator bacteria for a more practical public health response.