Question 1

How should other lab tests requested for PUIs be handled?

Accepted Answer

Discussion about what tests can safetly be done in your facilicy should be done prior to receiving a patient if possible. Discuss with physicians, nurses, lab leadership and personnel about what is safe and what will not be able to be done based on risk assessment. Some tests may not be able to done safely, so physicians, nurses and lab staff need to know that information if a patient is in-house.

Question 2

What is the best instrument for PT/INR testing for a suspected Ebola patient?

Lisa Stone · Accepted Answer

We currently use the Hemochron, however, this will be facility dependent. The CDC has a resource as to what some facilities are using for different tests. Do the risk assessment to determine what will work for your facility. Check out this blog post: https://netec.org/2022/10/11/laboratory-testing-for-ebola/

Question 3

Are there any mobile rapid testing units that could help resource limited hospitals rapid test for malaria, which might otherwise be a more common cause of fever in a traveler.

Accepted Answer

We are looking into whether there are agencies that would be able to be deployed in this situation. This avenue has not been identified at this time, but discussions are on-going.

Question 4

Is 30 minutes inactivation sufficient for malaria slides and positive blood culture slides?

Lisa Stone · Accepted Answer

Thirty minutes should be sufficient. Here is an article with more info: https://journals.asm.org/doi/full/10.1128/JCM.02960-15

Question 5

What lab tests do you expect the assessment hospitals to perform versus frontline hospitals?

Lisa Stone · Accepted Answer

Contact your public health department to discuss your role. Size of your facility and location in relation to a Treatment Center may determine the testing that is requested. See the CDC's link on testing that is anticipated for a VHF patient in each of the tiers: https://www.cdc.gov/viral-hemorrhagic-fevers/php/laboratories/specimen-collection.html.

Question 6

If doing routine testing do the machines then need to be decontaminated?

Lisa Stone · Accepted Answer

The recommendation would be to clean and disinfect the instrumentation after each patient specimen.

Question 7

Will there be different recommended order guidelines for obtaining blood cultures in suspected Ebola patients?

Lisa Stone · Accepted Answer

The CDC does give recommendations on patient care management, however the ordering guidelines at your facility will be dependent on your care team and their protocols. Discuss with your care team the expectations for patient management in your facility. If blood cultures are expected, discuss with your lab and care team the risks involved in collection and how to safely mitigate those risks.

Question 8

As an assessment center, our medical center has dedicated lab equipment for an Ebola PUI: offer Malaria test, CBC, CMP. Isn't routine testing with specimens from an Ebola patient going to contaminate routine lab equipments?

Lisa Stone · Accepted Answer

Testing on certain larger analyzers is possible, however it would be dependent on your facilities risk assessment. Looking at the workflow, any areas that may be aerosol generating, and the ability to decontaminate after a patient sample should all be taken in to consideration.

Question 9

In terms of laboratory waste associated with blood specimen collection, its it important to log specimens collected and to document any wasted blood or unused specimens that were collected?

Lisa Stone · Accepted Answer

It is not required, however it is recommended to document every tube (including waste tubes) so that everything is accounted for and does not accidentally get mixed with other laboratory specimens.

Ebola Q&A for Health Care Workers

Q&As:

Laboratory