Ebola Virus Disease (EVD) and Clinical Laboratory Safety in the United States

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Judi Bennett, MT, BSM
Reviewers: Barbara Cebulski, MS, MLS(ASCP); Pamela Henderson, BS, MLS(ASCP)CM

Specimens from patients suspected of having Ebola virus disease (EVD) can enter the laboratory at any time, without any advance notice or knowledge. The best defense is the consistent use of safe laboratory practices. This course provides a general understanding of the classification and characteristics of viral hemorrhagic fevers (VHFs) and provides an overview of Ebola virus disease (EVD). Emphasis is placed on the laboratory guidelines, procedures, and protocols necessary to maintain a safe working environment, including recommendations and guidelines from the Centers for Disease Control and Prevention (CDC) for working with patients and patient specimens that may be infected with EVD.

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Continuing Education Credits

  • P.A.C.E.® Contact Hours: 1.5 hour(s)
  • Florida Board of Clinical Laboratory Science CE - Supervision/Administration, Quality Control/Quality Assurance, and Safety: 1.5 hour(s)

Objectives

  • Demonstrate a general understanding of the classification and characteristics of viral hemorrhagic fevers (VHFs).
  • Outline the epidemiology, transmission, and symptoms of Ebola virus disease (EVD).
  • Identify the laboratory guidelines, procedures, and protocols necessary to maintain a safe working environment.
  • Recognize the recommended laboratory protocols for safe handling of EVD specimens.

Course Outline

  • Introduction
      • Intent of this Course
  • Viral Hemorrhagic Fevers (VHFs)
      • Viral Hemorrhagic Fevers (VHFs)
      • Classification and Common Characteristics of Viral Hemorrhagic Fevers (VHFs):
      • What characteristics do ALL viral hemorrhagic fevers (VHFs) have in common?
  • Ebola Virus Disease (EVD)
      • Ebola Virus Disease (EVD)
      • The History of EVD
      • Exposure and Transmission of EVD
      • Signs and Symptoms of EVD
      • EVD Patient Management, Recovery, and Immune Response
      • In a patient infected with Ebola virus disease (EVD), how do the signs and symptoms usually present?
  • The Foundation for Safe Laboratory Work Practices
      • Laboratory Infection Control Considerations: Reinforcing the Basics
      • Standard Precautions
      • Additional Precautions as Necessary
      • OSHA's Bloodborne Pathogens (BBP) Standard
      • OSHA BBP Standard: Work Practice Controls
      • OSHA BBP Standard: Personal Protective Equipment (PPE)
      • OSHA BBP Standard: Engineering Controls
      • OSHA BBP Standard: Sharps Precautions
      • OSHA BBP Standard: Proper Hand Hygiene Procedures
      • General Laboratory Cleaning
      • In the United States (US), clinical laboratories do NOT have access to the necessary precautions used to safely handle suspect Ebola virus disease (EV...
  • Specimen Collection From Patients with Suspect or Diagnosed Ebola Virus Disease (EVD)
      • Recommendations from the CDC Regarding Routine Screening for EVD
      • Collecting Specimens from Hospitalized Patients With EVD: Personal Protective Equipment (PPE)
      • Key Principles of the Enhanced CDC's Personal Protective Equipment (PPE) Guidelines
      • Which combination of personal protective equipment (PPE) is part of the recommended PPE worn when entering the room of a hospitalized patient with Ebo...
  • Laboratory Guidance When Working with Patients with Suspected Ebola Virus Disease (EVD)
      • Developing a Laboratory Plan for Patients Suspected of Having EVD
      • Processing and Testing Laboratory Specimens Suspected of EVD
      • Clinical laboratory personnel who perform processing and testing of suspect EVD specimens should work in a certified class II biosafety cabinet (BSC),...
  • Ebola Virus Disease (EVD) Specimen Testing
      • Biosafety and Select Agent Classification for EVD Specimens
      • Diagnosis of EVD and Other Laboratory Findings
      • Additional Testing Options for Consideration
      • Submitting Specimens for Diagnostic Ebola Testing
      • Point of Care (POC) Versus Laboratory Performed Testing for Ebola Virus Disease (EVD) Patients
  • Ebola Virus Disease (EVD) Specimen Shipping and Transport
      • Packaging and Shipping Specimens for EVD Testing to the CDC
      • Internal Transport of EVD Specimens Within a Healthcare Facility
      • Which of the following are TRUE when packaging and shipping specimens going to the CDC for Ebola virus disease (EVD) testing? (Choose all that apply.)
  • Ebola Virus Disease (EVD) Laboratory Waste and Spill Management
      • Spill Clean-Up Involving EVD
      • Waste Handling: Disposal, Handling, and Transport
      • In the event of a laboratory spill involving a suspect EVD specimen, disinfectants that work against non-enveloped viruses should be used in the clean...
  • Conclusion
      • Key Strategies for Laboratory Professionals Working with Suspect EVD Specimens
  • Additional Resources
      • Additional Resources
  • References
      • References

Additional Information

Level of instruction: Basic

Intended audience: This course is intended for all laboratory personnel. This course is also appropriate for clinical laboratory science students and pathology residents.

Author information: Judi Bennett BSM, MT is a Program Director for MediaLab, Inc. During her 30 year career as a medical technologist, she has served as a Senior System Analyst, laboratory manager, Point-of-Care coordinator, microbiology supervisor, and generalist. Judi has been a speaker at various conferences and has been published in CLMA magazine.

Reviewer information: Barbara Cebulski, MS, MLS(ASCP) has over 40 years of experience in the medical laboratory profession as a technologist, section supervisor, and laboratory manager. She was an Inspection and Technical Specialist for nine years with the College of American Pathologists in the Laboratory Accreditation Program and, until her retirement in 2015, was Program Director for MediaLab, Inc. Barbara holds a Masters in Instructional Technology from Georgia State University.

Reviewer information: Pamela Henderson, BS, MLS(ASCP)CM is the Operations Manager at Gwinnett Medical Center laboratory, located in Lawrenceville, GA. She has over 36 years experience in the medical laboratory profession as a technologist, section supervisor and laboratory manager.

Course description: Specimens from patients suspected of having Ebola virus disease (EVD) can enter the laboratory at any time, without any advance notice or knowledge. The best defense is the consistent use of safe laboratory practices. This course provides a general understanding of the classification and characteristics of viral hemorrhagic fevers (VHFs) and provides an overview of Ebola virus disease (EVD). Emphasis is placed on the laboratory guidelines, procedures, and protocols necessary to maintain a safe working environment, including recommendations and guidelines from the Centers for Disease Control and Prevention (CDC) for working with patients and patient specimens that may be infected with EVD.

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Work practice controls
gloves and goggles
Handwashing with soap.
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Colorized transmission electron micrograph (TEM) of EBOV. Image courtesy of the CDC.
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