Since the organism is difficult to isolate and constitutes a potential danger to laboratory personnel, serologic evidence of infection in a patient with a compatible clinical syndrome is commonly used for diagnosis. Culture F. tularensis grows poorly on standard media. The organism has also been isolated from automated radiometric detection systems if the media is subcultured on chocolate agar. Notify the clinical laboratory in advance of submitting specimens for culture which may contain F. tularensis, since isolation of the organism can put laboratory workers at risk for infection. Significant antibody does not appear until the end of the second week of illness, peaks at 4-5 weeks, and can persist for more than a decade.
Serology testing is available through national reference laboratories.
Cases have occurred among clinical laboratorians working with bacterial cultures. Blood cultures should be maintained in a closed system and clinical isolates from blood or any other site should be handled in Biological Safety Level 3 cabinets. Every effort should be made to avoid splashing or creating an aerosol. Biosafety Level 3 practices and facilities should be used for inoculation, incubation, centrifugation and harvesting of cell cultures and the manipulation of infected tissues. All biohazardous waste should be decontaminated by autoclaving.