Ebola Virus Disease and Clinical Laboratory Safety in the United States

Author: Judi Bennett, BSM, MLS
Reviewers: Julie Ann West, PhD, MLS(ASCP)CMSMCM and Laurie Bjerklie, MA, MLS(ASCP)CM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 2 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - Supervision/Administration, Quality Control/Quality Assurance, and Safety: 1.5 hour(s)

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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.

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
    • Viral Hemorrhagic Fevers
    • Classification and Common Characteristics of Viral Hemorrhagic Fevers
    • What characteristics do all viral hemorrhagic fevers (VHFs) have in common?
    • Marburg and Ebola belong to what family?
  • Ebola Virus Disease
    • Ebola Virus Disease
    • The History of Ebola Virus Disease
    • Exposure and Transmission
    • Signs and Symptoms
    • Patient Management, Recovery, and Immune Response
    • In a patient infected with Ebola virus disease (EVD), how do the signs and symptoms usually present?
    • Ebola virus disease (EVD) can be transmitted from one human to another through:
  • The Foundation for Safe Laboratory Work Practices
    • Laboratory Infection Control Considerations: Reinforcing the Basics
    • Standard Precautions
    • Additional Precautions as Necessary
    • Bloodborne Pathogens Standard
    • OSHA BBP Standard: Work Practice Controls
    • OSHA BBP Standard: Personal Protective Equipment
    • OSHA BBP Standard: Engineering Controls
    • OSHA BBP Standard: Sharps Precautions
    • OSHA BBP Standard: Proper Hand Hygiene Procedures
    • General Laboratory Cleaning
    • True or False: In the United States, clinical laboratories do not have access to the necessary precautions used to safely handle suspect Ebola virus disease (EVD) specimens.
    • OSHA's Bloodborne Pathogen (BBP) Standard includes all of the following, except:
  • Specimen Collection From Patients with Suspect or Diagnosed Ebola Virus Disease
    • Recommendations for Routine Screening
    • Collecting Specimens from Hospitalized Patients With EVD
    • Key Principles of the Enhanced CDC's Personal Protective Equipment Guidelines
    • Which combination of personal protective equipment (PPE) is part of the recommended PPE worn when entering the room of a hospitalized patient with Ebola virus disease (EVD)?
    • The process of doffing is:
  • Laboratory Guidance When Working with Patients with Suspected Ebola Virus Disease
    • Developing a Laboratory Plan for Patients Suspected of Having EVD
    • Processing and Testing Laboratory Specimens Suspected of EVD
    • True or False: Clinical laboratory personnel who perform processing and testing of suspect EVD specimens should work in a certified class II biosafety cabinet (BSC), if available, or use a plexiglass splash guard, in addition to wearing the required PPE.
    • As part of the laboratory plan for patients suspected of having EVD, a risk assessment should include a determination of all of the following, except:
  • Ebola Virus Disease 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 versus Laboratory Performed Testing for Ebola Virus Disease
    • Federal select agent classification for EVD specimens applies to:
    • What is the main value of using point-of-care (POC) testing versus traditional laboratory performed testing for EVD patients?
  • Ebola Virus Disease 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 is incorrect when packaging and shipping specimens to the CDC for Ebola virus disease (EVD) testing?
    • Complete this sentence: While transporting EVD specimens within a healthcare facility,
  • Ebola Virus Disease Laboratory Waste and Spill Management
    • Spill Clean-Up Involving EVD
    • Disposal, Handling, and Transport of Waste
    • True or False: 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-up to provide a broader antiviral spectrum.
    • The Department of Transportation classifies EVD as a:
  • 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: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Judi Bennett, BSM, MLS, has over 30 years of experience as a medical laboratory scientist. 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.
The author has no conflict of interest to disclose.
Reviewer Information:
Dr. Julie Ann West is certified by the American Society for Clinical Pathology (ASCP) as a Medical Laboratory Scientist (MLS) and as a Specialist in Microbiology (SM). In addition, Dr. West has earned a Ph.D. in Public Health - Infectious Disease Epidemiology - and is Certified in Public Health (CPH) by the National Board of Public Health Examiners. Dr. West is experienced as a Technical Specialist, Safety Officer, Educator, and Lead in the Veterans Administration Healthcare System, and has prior experience as an Administrative Laboratory Director.
Laurie Bjerklie, MA, MLS(ASCP)CM, is a Lead Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.
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.