Managing Potential Laboratory Exposure to Ebola Virus by Using a Patient Biocontainment Care Unit1

Kortepeter, Mark G.; Martin, James W.; Rusnak, Janice M.; Cieslak, Theodore J.; Warfield, Kelly L.; Anderson, Edwin L.; Ranadive, Manmohan V.

doi:10.3201/eid1406.071489

Cited by 60 publications

(43 citation statements)

References 23 publications

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“…Previously reported laboratory support located within an isolation area was found to reduce specimen processing times, provide personnel improved safety assurance for handling of specimens, and decrease exposure risks (9,13,16). In this study, we noted that many ETCs have adopted at least some portion of a contained laboratory care model in which the location of the laboratory is located in close proximity to the patient care area to allow rapid laboratory processing and enhanced laboratory safety and patient supportive care.…”

Section: Discussionmentioning

confidence: 92%

U.S. Ebola Treatment Center Clinical Laboratory Support

et al. 2016

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Section: Discussionmentioning

confidence: 92%

U.S. Ebola Treatment Center Clinical Laboratory Support

et al. 2016

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“…Although a small handful of infections with viral hemorrhagic fever viruses have occurred in research settings (5)(6)(7), it is reassuring that imported clinical cases in the US have not led to known laboratory-acquired infections (8 -11 ). Nevertheless, patients with EVD treated in the US and Europe have frequently been managed in high containment facilities-often using point-of-care testing and/or satellite laboratories (10,(12)(13)(14).…”

confidence: 99%

Bloodborne Viral Pathogen Contamination in the Era of Laboratory Automation

Bryan¹,

Cook²,

Atienza³

et al. 2016

Clinical Chemistry

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BACKGROUND The CDC states that laboratory testing for persons under investigation for Ebola virus disease can be safely performed using automated laboratory instruments by adhering to bloodborne pathogen practices. We therefore sought to investigate the levels of viral contamination of a total laboratory automation (TLA) system to guide risk mitigation strategies for handling infectious agents. METHODS Environmental swabs followed by PCR for hepatitis B (HBV) and hepatitis C (HCV) viruses were taken from a chemistry TLA system during routine clinical use and after running a small number of high-titer HCV samples. Control experiments were performed to ensure the recovery of DNA and RNA viruses by swabs from a representative nonporous surface. RESULTS Of 79 baseline swabs for nucleic acids performed on the TLA system, 10 were positive for HBV and 8 for HCV. Viral nucleic acid was consistently detected from swabs taken from the distal inside surface of the decapper discharge chute, with areas adjacent to the decapper instrument and the centrifuge rotor also positive for HBV or HCV nucleic acid. Contamination was occasionally detected on exposed surfaces in areas without protective barriers between samples and personnel. After running known HCV-positive samples, at least one additional site of contamination was detected on an exposed area of the line. CONCLUSIONS A low level of viral contamination of automated clinical laboratory equipment occurs in clinical use. Given the risks associated with highly infectious agents, there is a need for risk-mitigation procedures when handling all samples.

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“…Case fatality rates of up to 90% have been reported for outbreaks (6,13). Isolated cases of MHF and EHF have occurred as a result of laboratory work involving nonhuman primate species imported from regions of endemicity, through accidental needle stick injuries of laboratory workers (12), and through travel by individuals unknowingly exposed in regions of endemicity (20). Currently, there are no therapies or preventative vaccines licensed for use to treat filovirus infections.…”

mentioning

confidence: 99%