Laboratory diagnosis of ebola virus disease eng world health. Ebola virus, marburg virus, viral hemorrhagic fever, filovirus, biocontainment, quarantine, isolation, biosafety, laboratory exposure, synopsis recent interest and increased investment in biodefense research have resulted in construction of new research laboratories with biosafety level 4 bsl4 capability 1. Laboratory biosafety manual this manual provides practical guidance on biosafety techniques for use in laboratories at all levels. The 2014 2016 ebola virus disease ebola epidemic in west africa highlighted the need to maintain organized laboratory systems or networks that can be effectively reorganized to implement new diagnostic strategies and laboratory services in response to largescale events. Who laboratory manual for the examination of human semen and spermcervical mucus interaction. Existing biosafety guidelines and biosecurity policies do not. Risk group 2 agents that are associated with human disease which is rarely serious and for which preventive or. The sierra leonechina friendship biological safety laboratory. Laboratory guidance on ebola medscape aug 29, 2014. Report on the potential exposure to ebola virus cdc.
One of the pillars in the emergency response to the 20142016 ebola virus. Developed as a quick response asset to unusual outbreaks of infectious diseases worldwide, several of these laboratories have been used as part of the world health organization response to the ebola virus outbreaks by teams of the european mobile lab project. The maximum containment laboratory biosafety level 4 6. Whoeurope organized brm training in tajikistan 20 and turkmenistan 2014. Who laboratory biosafety manual updates absa conference. The west africa outbreak of ebola virus disease evd 2014 2016 was unprecedented in terms of its impact not only in guinea, sierra leone and liberia but also internationally. On 20 july 2014, a traveler arrived from liberia at lagos. Jan 01, 2015 in addition, clinical laboratories that do have the facilities to perform biosafety level 3 bsl3 practices to include processing within a biosafety cabinet, centrifugation using safety cups or sealed rotors, and enhanced ppe to include respiratory protection are generally available only to the clinical microbiology laboratory and specific. Who europe supports biosafety and biosecurity in the region by providing training. Laboratory handling of the ebola hemorrhagic fever virus.
Rapid deployment of a mobile biosafety level3 laboratory. This satellite lab is dedicated for evd patient care in close proximity to patient room. A needlestick injury occurred during an animal experiment in the biosafety level 4 laboratory in hamburg, germany, in march 2009. Biosafety level2 laboratory diagnosis of zaire ebola virus disease imported. In august 2014, the national institute for communicable diseases nicd in south africa established a modular highbiosafety field ebola diagnostic laboratory sa fedl near freetown.
The cbsg was developed to update and harmonize three existing canadian biosafety standards and guidelines for the design, construction, and operation of facilities in which. This template is designed to assist laboratories in the development of their risk assessment for ebola virus disease evd. Management of accidental exposure to ebola virus in the. No or low individual and community risk a microorganism that is unlikely to cause human or animal disease. Nysnyc guidance for laboratory testing and management of personsunderinvestigation, for ebola virus disease evd in nondesignated hospitals purpose. For this new edition, the manual has been extensively revised and expanded. Rapid deployment of a mobile biosafety level3 laboratory in sierra leone during the 2014 ebola virus epidemic article pdf available in plos neglected tropical. Neither an approved treatment nor a postexposure prophylaxis pep exists for ebola hemorrhagic fever. The sierra leonechina friendship biological safety laboratory slechn biosafety lab, a fixed biosafety level 3 laboratory in the capital city of sierra leone, was established by the chinese government and has been active in ebov detection since 11 march 2015. Jun 27, 2016 its important to understand what the various biosafety levels mean and represent.
Template for public health laboratory risk assessment for. Study assesses safety considerations in the lab testing of ebola virus specimens countries all over the world now recognize the ebola virus disease as a threat. Cdc in atlanta, georgia two labs are located there center for biodefense and emerging infectious diseases university of texas medical branch in galveston. On december 23, 2014, scientist 2 entered the bsl4 laboratory and. Ebola virus from one of cdcs high containment biosafety level 4 bsl4. National guidelines on laboratory biosafety should be followed under all circumstances. When you have completed this lesson, you will be able to identify characteristics of the four biological safety levels. Although the risk of an ebola outbreak in the united states is very low, the centers for disease control and prevention cdc, the iowa department of public health, and their partners are taking precautions to. Guidance for collection, transport and submission of. Whole blood in edta a minimum volume of 4ml, collected in plastic tubes from live patients. At the end of the outbreak, laboratories associated with the two european. Biosafety guidelines for laboratories handling specimens from patients under investigation for ebola virus disease this document is intended to support local risk assessments, specifically for a diagnostic laboratory setting. For early detection of ebola virus in suspect or probable cases, detection of viral rna or viral antigen are the recommended tests. Ebola virus disease evd, or simply ebola, is a viral haemorrhagic fever of humans and other primates caused by ebolaviruses.
Although the risk of an ebola outbreak in the united states is very low, the centers for disease control and prevention cdc, the iowa department of public health, and their partners are taking precautions to prevent this from happening. Who laboratory biosafety manual, 3rd edition risk group 1 agents that are not associated with disease in healthy adult humans. It covers risk assessment and safe use of recombinant dna technology, and provides guidelines for the commissioning and certification of laboratories. The recent 2014 ebola outbreak emphasizes the need for a wider knowledge of the mechanisms of transmission, risk of exposure and preventive measures for these viruses. Ebola, previously known as ebola hemorrhagic fever. Testing algorithm for florida laboratories using biofire. Inside a highsecurity ebola isolation chamber youtube. Guideline for laboratory staff on specimen collection. Who guidance for collaboration and partnership highlighted. Good laboratory practices guarantee biosafety in the sierra leone.
This was the sole diagnostic capacity available to respond to the overwhelming demand for ebola diagnosis for several weeks in the western area of. The sierra leonechina friendship biological safety laboratory slechn biosafety lab, a fixed biosafety level 3 laboratory in the capital city of. Biosafety level2 laboratory diagnosis of zaire ebola virus disease imported from liberia to. The manual encouraged countries to accept and implement basic concepts in biological safety and to. A laboratory space near or adjacent to the suspected or confirmed evd patient room equipped with point of care poc testing systems. Refer to the who laboratory biosafety manual 3rd editionii for appropriate biosafety practices. The generator, water supplying unit and incineration units are located outside the building. For this new edition, therefore, the manual has been. Although clinical and public health laboratories are hard at work preparing for the pr. The second edition of the cbs updates the biosafety standard originally published as part i of the canadian biosafety standards and guidelines cbsg, 1 st edition, 20. Proper use of a certified class i or class ii biosafety cabinet and. The current ebola virus disease evd outbreak is the largest since its discovery in 1976. Outbreak supplies containment and biosafety ebola diagnostics preoutbreak preparedness 3000bp. Cdc finds lapses in latest lab mishap with ebola virus.
Formerly known as ebola hemorrhagic fever, the viral outbreak in west africa has caused the world health organization who to declare a public health emergency of international concern. Biosafety during the 2014 west african ebola outbreak, sierra leone john klena microbiologist, viral special pathogens branch, cdcatlanta biosafety global stakeholders meeting 2015 september 2324, 2015 emory conference center, atlanta, ga, usa. Manual on collection, storage, and transport of specimens for tb testing producing reliable test results does not rely solely on the right performance of the stepbystep procedures of the test itself. Who laboratory biosafety manual training of trainers course in biorisk management brm infectious substances shipment training isst. Level 1 bsl1 indicates the most innocuous and benign of organisms. Cdc finds lapses in latest lab mishap with ebola virus cdc reports on the findings of its investigation into a december 2014 laboratory mistake that potentially exposed a worker to live ebola. For these reasons, experiments with ebola virus have to be performed in biosafety level bsl4 laboratories. Laboratory guidance for the diagnosis of ebola virus disease. The manual now covers risk assessment and safe use of recombinant dna technology, and provides guidelines for the comissioning and cetification of laboratories.
A laboratory acquired infection is known or suspected, or b. Safety considerations in the laboratory testing of specimens. Through dls work with other cdc programs, federal and state agencies, professional societies, and international organizations, the division supports the development and adoption of standards, guidelines, recommendations, and tools for improved quality and safety in clinical and public health laboratories. Clinical laboratory testing of clinical specimens when ebola virus disease is a concern. Signs and symptoms typically start between two days and three weeks after contracting the virus with a fever, sore throat, muscular pain, and headaches. Four laboratories followed the who algorithm and five followed national guidelines. We established a modular, rapidly deployable laboratory system that provides diagnostic support in resourcelimited, remote areas. Sep 03, 2014 a view of the ebola outbreak effective response to emerging infectious disease outbreaks. Oral swabs stored in a universal transport medium, collected from deceased.
Laboratory and other healthcare personnel handling and testing routine clinical specimens when concern about ebola virus disease evd has been raised by a physician. South african ebola diagnostic response in sierra leone. Mobile diagnostics in outbreak response, not only for ebola. Decreases transport distance of infectious evd blood and body fluid. Guidelines for laboratory facility certification part ii. Managing potential laboratory exposure to ebola virus by. Harmonization of biosafety and biosecurity standards for high. Laboratory response to ebola west africa and united states. Biosafety level 4 bsl4 is the highest level of biosafety precautions, and is appropriate for work with agents that could easily be aerosoltransmitted within the laboratory and cause severe to fatal disease in humans for which there are no available vaccines or treatments. Recognizing the biosafety levels for cne this quick learn lesson will take approximately 15 minutes to complete. Laboratory biosafety for handling emerging viruses. The 2014 west african ebola outbreak has spawned a chain of preparedness planning in the united states u. In particular for biosafety level 4 bsl4 investigation, guidelines for. Furthermore, the installations should have a sink with water supply, a refrigerator and a water bath or heating block for the inactivation of the sample by heat.
Who laboratory biosafety manual having served for global biosafety community hereinafter, who manual for more than 20 30 years, since it was first published in 1983, the laboratory biosafety manual has provided practical guidance on biosafety techniques for use in laboratories at all levels. Receive training in standard microbiological techniques. The 2014 ebola outbreak is the largest ebola outbreak in history and the first in west africa. Virus disease received by cdc united states, july 9november 15, 2014. Canadian biosafety standard cbs second edition canada. Author summary in response to ebola virus disease outbreak in west africa, the national institute for communicable diseases in south africa established a modular high biosafety field ebola diagnostic laboratory fedl near freetown, sierra leone. We describe the organisation of the three laboratories, the biosafety aspects, the. Guidelines for laboratory facility commissioning 8. The outbreak of ebola virus disease evd in west africa between 2014 and. Laboratories need leaders who can effectively utilize the laboratories resources, maximize the laboratoriescapacity to detect disease, and advocate for laboratories in a fluctuating health care. To provide guidance on how hospitals and offcampus emergency departments in new york state can safely perform the laboratory testing necessary for the management of personsunder. Who laboratory biosafety manual lbm revision update. The laboratory community has been actively engaged in responding to testing and biosafety concerns.
The 2014 ebola epidemic is the largest in history, affecting multiple countries. The air flow in bsl2 laboratory is also monitored in the central control room. The united states is helping to fight the spread of the disease in west africa and also providing care for those infected, including patients brought to the united states for treatment. It all starts in the acceptance of correct, adequate and quality specimens brought to the laboratory. The outbreak of ebola virus disease evd in west africa between 2014 and 2015 was the largest edv epidemic since the identification of ebola virus ebov in 1976, and the countries most strongly affected were sierra leone, guinea, and liberia. Laboratory guidelines research institute for tropical. Through the cooperative agreement, domestic laboratory biosafety for ebola and other highly infectious diseases, aphl is working closely with cdc to strengthen biosafety and biosecurity in the nations laboratories by providing. Graduatelevel genomics education programs diagnostic. Laboratory biosafety manual world health organization. Who laboratory manual for the examination and processing. Until last week, the assays that have received emergency use. An extended biosafety advisory group bag meeting was held in geneva from 2426 november 2014 for agenda, see annex 1. Safety measures in the lab testing of ebola virus specimens. It is recommended that countries without appropriate biosafety capacity to perform a laboratory diagnosis.
A spill of any quantity involving an agent infectious to humans, plants, or animals occurs in a public area. Laboratory biosecurity concepts are introduced, and the latest regulations for the transport of infectious substances are reflected. Its important to understand what the various biosafety levels mean and represent. Good microbiological technique and appropriate use of biosafety equipment by well trained staff remain the fundamental elements of laboratory biosafety.
Ebola environmental health and safety iowa state university. Biosafety during the 2014 west african ebola outbreak, sierra leone john klena microbiologist, viral special pathogens branch, cdcatlanta biosafety global stakeholders meeting 2015 september 23. Pdf ensuring worker safety during an ebola virus disease. The syringe contained zaire ebolavirus zebov mixed with freunds adjuvant. To provide updated guidance for management and evaluation of routine clinical specimens for differential testing and diagnoses other than evd. Biosafety guidelines for laboratories handling specimens. To provide guidance for laboratory workers on collecting, transporting and submitting specimens for ebola virus testing.
Who laboratory manual for the examination and processing of human semen 5th ed. Jun 23, 2016 the outbreak of ebola virus disease evd in west africa between 2014 and 2015 was the largest edv epidemic since the identification of ebola virus ebov in 1976, and the countries most strongly affected were sierra leone, guinea, and liberia. Safe laboratory techniques biosafety and recombinant dna technology. The 2014 ebola zaire epidemic is the largest the world has ever seen and has crossed us borders causing widespread concern and declaration of a public health emergency. Status, quality and specific needs of ebola virus diagnostic capacity. Despite high standards of protection in these laboratories, laboratory workers are still at risk of contracting ebola hemorrhagic fever, in particular during animal experimentation. Sierra leone, ebola virus and containment of biohazards researchgate, the. Laboratory diagnosis laboratory results should be communicated to who as quickly as possible, in addition to international health regulations ihr reporting. The slechn biosafety lab fully meets the biosafety level 3 laboratory standards of the world health organization fig. On 20 july 2014, a traveler arrived from liberia at.
Biosafety level2 laboratory diagnosis of zaire ebola virus disease. Who has developed several tools and training courses in biosafety and biosecurity. Laboratory guidelines research institute for tropical medicine. This guidance document replaces the previously posted document. Currently, seven operational labs in the united states are designated bsl4 and can therefore do ebola research. The third edition of the who laboratory biosafety manual is a helpful reference and guide to nations that accept the challenge to develop and establish national codes of practice for securing microbiological assets, yet ensuring their availability for clinical, research and epidemiological purposes. Interim guidance for specimen collection, transport, testing, and submission for persons under investigation puis for ebola virus disease evd in the united states. Aslm ebola resource centre to learn more about joining the african public health laboratories network listserv, please click here for more information. Biosafety guidelines for laboratories handling specimens from. Rapid deployment of a mobile biosafety level3 laboratory in sierra. Who extended biosafety advisory group bag meetings, geneva, 2425 november 2014, and 15 december 2016 key recommendation 2014 revision to the who biosafety manual is both a necessary and a priority key recommendation 2016 general agreement for the proposed modifications to the manual, the revision of which remains a priority. Pdf biosafety level2 laboratory diagnosis of zaire ebola virus. Centers for disease control and prevention cdc and partners are taking precautions to prevent the spread of ebola.
Good laboratory practices guarantee biosafety in the sierra. Who laboratory biosafety manual training of trainers course in biorisk management brm infectious substances shipment training isst film demonstrating safe practices in different laboratory settings. It is also known as ebola virus disease evd and ebola hemorrhagic fever. These pathogen safety data sheets, regulated under workplace hazardous materials information system whmis legislation, are produced for personnel working in the life sciences as quick safety reference material relating to infectious microorganisms. Eurosurveillance mobile diagnostics in outbreak response. Pdf south african ebola diagnostic response in sierra leone.
Template for public health laboratory risk assessment for ebola virus disease evd testing. Biosafety level refers to the stringency of biocontainment precautions deemed necessary by the centers for disease control and prevention cdc for laboratory work with infectious materials. Why does ebola require such different safety precautions. Good laboratory practices guarantee biosafety in the. Implementation of a mentored professional development programme in laboratory leadership and management in the middle east and north africa. Another thing to appreciate is that using the wrong level of personal protective equipment may actually cause more risks. It is recommended that the following specimens be collected for the diagnosis of evd. Why does ebola require such different safety precautions in a. Who contributed with other participants to establish a common understanding of how existing mechanisms such as the international health regulations ihr, 2005, unscr 1540 and the bwc complement each other and why partnerships and collaboration for biosecurity and biosafety are a necessity for progress in biosafety and biosecurity.
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