(2) A large amount of support information can be gained by analyzing the site of injury and subsequent death. This "site scene" investigation requires a tremendous attention to detail and a trained observer. If forensic personnel cannot be contacted, or will be unduly delayed in arriving at the scene, then photographs of the victim and the immediate surroundings should be made. The scope and extent of the photographs should be composed to reflect as much detail as possible to assist forensic personnel in reviewing the scene retrospectively. In the event that photography is not feasible, detailed sketches of the scene should be made to assist the forensic investigation.

(3) Techniques such as cardiac or bladder puncture, needle biopsy of organs, spinal tap, or exploratory laparotomy will not be performed by untrained personnel unless specifically requested and directed by forensic investigators.

Table B-1. Specimen Collection for Suspect Biological Warfare Agents

EARLY POSTEXPOSURECLINICALCONVALESCENT/TERMINAL/POSTMORTEM
ANTHRAX
0 TO 24 HOURS.24 TO 72 HOURS.3 TO 10 DAYS.
NASAL AND THROAT SWABS, AND INDUCED RESPIRATORY SECRETIONS FOR CULTURE, FA, AND PCR.SERUM (TT OR RT) FOR TOXIN ASSAYS.
BLOOD (E, C, H) FOR PCR.
BLOOD (BC OR C) FOR CULTURES.		SERUM (TT OR RT) FOR TOXIN ASSAYS.
BLOOD (BC OR C) FOR CULTURE.
PATHOLOGY SPECIMENS.
PLAGUE
0 TO 24 HOURS.24 TO 72 HOURS.>6 DAYS.
NASAL SWABS, SPUTUM, AND INDUCED RESPIRATORY SECRETIONS FOR CULTURE, FA, AND PCR.BLOOD (BC AND C) FOR CULTURE AND BLOODY SPUTUM (C) FOR FA. SERUM (TT OR RT) FOR F-1 ANTIGEN ASSAYS.
BLOOD (E, C, OR H) FOR PCR.		SERUM (TT OR RT) FOR IgM, LATER FOR IgG.
PATHOLOGY SPECIMENS.
TULAREMIA
0 TO 24 HOURS.24 TO 72 HOURS.>6 DAYS.
NASAL SWABS, SPUTUM, AND INDUCED RESPIRATORY SECRETIONS FOR CULTURE, FA, AND PCR.BLOOD (BC OR C) FOR CULTURE.
BLOOD (E, C, OR H) FOR PCR.
SPUTUM FOR FA AND PCR.		SERUM (TT OR RT) FOR IgM AND LATER IgG, AGGLUTINATION TITERS.
PATHOLOGY SPECIMENS.
MELIOIDOSIS/GLANDERS
0 TO 24 HOURS.24 TO 72 HOURS.>6 DAYS.
NASAL SWABS, SPUTUM, AND INDUCED RESPIRATORY SECRETIONS FOR CULTURE AND PCR.BLOOD (BC OR C) FOR CULTURE.
BLOOD (E, C, OR H) FOR PCR.
SPUTUM AND DRAINAGE FROM SKIN LESIONS FOR PCR AND CULTURE.		BLOOD (BC OR C) AND TISSUE FOR CULTURE.
SERUM (TT OR RT) FOR IMMUNOASSAYS.
PATHOLOGY SPECIMENS.
BRUCELLOSIS
0 TO 24 HOURS.24 TO 72 HOURS.>6 DAYS.
NASAL SWABS, SPUTUM, AND INDUCED RESPIRATORY SECRETIONS FOR CULTURE AND PCR.BLOOD (BC OR C) FOR CULTURE.
BLOOD (E, C, AND H) FOR PCR.		BLOOD (BC OR C) AND TISSUE FOR CULTURE.
SERUM (TT OR RT) FOR IMMUNOASSAYS.
PATHOLOGY SPECIMENS.
Q FEVER
0 TO 24 HOURS.2 TO 5 DAYS.>6 DAYS.
NASAL SWABS, SPUTUM, AND INDUCED RESPIRATORY SECRETIONS FOR CULTURE AND PCR.BLOOD (BC OR C) FOR CULTURE IN EGGS OR MOUSE INOCULATION.
BLOOD (E, C, AND H) FOR PCR.		BLOOD (BC OR C) FOR CULTURE IN EGGS OR MOUSE INOCULATION.
PATHOLOGY SPECIMENS.
BOTULISM
0 TO 24 HOURS.24 TO 72 HOURS.>6 DAYS.
NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR PCR (CONTAMINATING BACTERIAL DNA) AND TOXIN ASSAYS.
SERUM (TT OR RT) FOR TOXIN ASSAYS.		NASAL SWABS AND RESPIRATORY SECRETIONS FOR PCR (CONTAMINATING BACTERIAL DNA) AND TOXIN ASSAYS.USUALLY NO IgM OR IgG.
PATHOLOGY SPECIMENS (LIVER AND SPLEEN FOR TOXIN DETECTION).
RICIN INTOXICATION
0 TO 24 HOURS.36 TO 48 HOURS.>6 DAYS.
NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR PCR (CONTAMINATING CASTOR BEAN DNA) AND TOXIN ASSAYS.
SERUM (TT OR RT) FOR TOXIN ASSAYS.		SERUM (TT OR RT) FOR TOXIN ASSAY. TISSUE FOR IMMUNOHISTOLOGICAL STAINING. PATHOLOGY SPECIMENS.SERUM (TT OR RT) FOR IgM AND IgG IN SURVIVORS.
STAPH ENTEROTOXICOSIS
0 TO 3 HOURS.2 TO 6 HOURS.>6 DAYS.
NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR PCR (CONTAMINATING BACTERIAL DNA) AND TOXIN ASSAYS.
SERUM (TT OR RT) FOR TOXIN ASSAYS.		URINE FOR IMMUNOASSAYS. NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR PCR (CONTAMINATING BACTERIAL DNA) AND TOXIN ASSAYS.
SERUM (TT OR RT) FOR TOXIN ASSAYS.		SERUM FOR IgM AND IgG.
T-2 TOXICOSIS
0 TO 24 HOURS POSTEXPOSURE1 TO 5 DAYS.>6 DAYS POSTEXPOSURE.
NASAL AND THROAT SWABS AND INDUCED RESPIRATORY SECRETIONS FOR IMMUNOASSAYS, HPLC/MASS SPECTROMETRY.SERUM (TT OR RT) AND TISSUE FOR TOXIN DETECTION.URINE FOR DETECTION OF TOXIN METABOLITES.
EQUINE ENCEPHALOMYELITIS
(VEE, EEE, AND WEE VIRUSES)24 TO 72 HOURS.>6 DAYS.
0 TO 24 HOURS.
NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR RT-PCR AND VIRAL CULTURE.		SERUM (TT OR RT) AND THROAT FOR CULTURE.
SERUM (E, C, H, TT, OR RT) FOR RT-PCR. THROAT SWABS UP TO 5 DAYS FOR CULTURE THEN CSF.
SERUM (TT OR RT) FOR ANTIGEN ELISA.		SERUM (TT OR RT) FOR IgM.
PATHOLOGY SPECIMENS PLUS BRAIN.
POX)
(SMALLPOX AND MONKEYPOX)2 TO 5 DAYS.>6 DAYS.
0 TO 24 HOURS.
NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR PCR AND VIRAL CULTURE.		 SERUM (TT OR RT) FOR VIRAL CULTURE. SERUM (TT OR RT) FOR VIRAL CULTURE.
DRAINAGE FROM SKIN LESIONS/ SCRAPINGS FOR MICROSCOPY, EM, VIRAL CULTURE, AND PCR.
PATHOLOGY SPECIMENS.
EBOLA
0 TO 24 HOURS.2 TO 5 DAYS.>6 DAYS.
NASAL SWABS AND INDUCED RESPIRATORY SECRETIONS FOR RT-PCR AND VIRAL CULTURE.SERUM (TT OR RT) FOR VIRAL CULTURE.SERUM (TT OR RT) FOR VIRAL CULTURE.
PATHOLOGY SPECIMENS PLUS ADRENAL GLAND.
LEGEND:
BCBlood culture
CCitrated blood
CSFcerebrospinal fluid
DNAdeoxyribonucleic acid
EEDTA
EEEeastern equine encephalitis
ELISAenzyme-linked immunosorbent assay
EMelectron microscopy
F-1fraction-1
FAfluorescent antibody
HHeparin
HPLChigh-pressure liquid chromatography
IgGimmunoglobulin class G
IgMimmunoglobulin class M
PCRpolymerase chain reaction
RTRed Top, if TT is not available
RT-PCRreverse transcriptase/ polymerase chain reaction
TTTiger top
VEEVenezuelan equine encephalitis
WEEwestern equine encephalitis