Laboratory Test Support for #Ebola Patients Within a High-Containment Facility

Two adult United States (US) nationals contracted the Ebola virus while on a humanitarian mission in Africa amidst a large Ebola outbreak there. They were admitted to our medical center (Emory University Hospital in Atlanta, GA) during the first week of August 2014 for treatment. Both survived their illness and were released after approximately 3 weeks of inpatient care. We received approximately 3 days’ advance notice that the first patient would be transported from Africa to our medical center; the second patient arrived 3 days after the first. The diagnosis in each case had been confirmed virologically by detecting Ebola-specific nucleic acid in blood specimens sent to a World Health Organization laboratory in Europe; however, few details of either patient’s condition had been available to us before their arrival. Herein, we summarize the approach we used to plan for and provide laboratory diagnostic testing during their treatment.
Hill CE, et al. Laboratory test support for ebola patients within a high-containment facility. Lab Med. 2014 Summer;45(3):e109-11.
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Transmission of #Ebola Viruses

Available evidence demonstrates that direct patient contact and contact with infectious body fluids are the primary modes for Ebola virus transmission, but this is based on a limited number of studies. Key areas requiring further study include (i) the role of aerosol transmission (either via large droplets or small particles in the vicinity of source patients), (ii) the role of environmental contamination and fomite transmission, (iii) the degree to which minimally or mildly ill persons transmit infection, (iv) how long clinically relevant infectiousness persists, (v) the role that “superspreading events” may play in driving transmission dynamics, (vi) whether strain differences or repeated serial passage in outbreak settings can impact virus transmission, and (vii) what role sylvatic or domestic animals could play in outbreak propagation, particularly during major epidemics such as the 2013–2015 West Africa situation. In this review, we address what we know and what we do not know about Ebola virus transmission. We also hypothesize that Ebola viruses have the potential to be respiratory pathogens with primary respiratory spread.
Osterholm MT, et al. Transmission of ebola viruses: what we know and what we do not know. MBio. 2015 Feb 19;6(2).
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#Ebola outbreak in Western Africa 2014: what is going on with Ebola virus?

The 2014 outbreak of Ebola virus disease (EVD) in West Africa, caused by Ebola virus (Zaire Ebola virus species), is the largest outbreak of EVD in history. It cause hemorrhagic fever in human and nonhuman primates with high mortality rate up to 90% and can be transmitted by direct contact with blood, body fluids, skin of EVD patients or persons who have died of EVD. As of December 17, 2014, 450 healthcare personnel are known to have been infected with Ebola, of whom 244 died. For development of Ebola vaccine and treatment are highly difficult due to its dangerous and accessibility that requires biosafety level 4 (BSL-4) to conduct experiment. Also there is no specific vaccine and treatment for Ebola virus; however, many candidate vaccines and antiviral-drugs such as ZMapp and TKM-Ebola are being developed for Ebola virus disease. In this review, we focus on the epidemiology of 2014 outbreak of Ebola virus and candidate agent for preventing and curing from Ebola virus.
Na W, et al. Ebola outbreak in Western Africa 2014: what isgoing on with Ebola virus? Clin Exp Vaccine Res. 2015 Jan;4(1):17-22. Review.
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Evaluation of Virus Inactivation by Formaldehyde to Enhance Biosafety

Formaldehyde (FA) fixation of infectious samples is a well-established protocol in diagnostic electron microscopy of viruses. However, published experimental data that demonstrate virus inactivation by these fixation procedures are lacking. Usually, fixation is performed immediately before the sample preparation for microscopy. The fixation procedure should transform viruses in a non-infectious but nonetheless structurally intact form in order to allow a proper diagnosis based on morphology. FA provides an essential advantage in comparison to other disinfectants, because it preserves the ultrastructure of biological material without interfering significantly with the preparation (i.e., the negative staining) and the detection of viruses. To examine the efficiency of FA inactivation, we used Vaccinia virus, Human adenovirus and Murine norovirus as models and treated them with FA under various conditions. Critical parameters for the inactivation efficiency were the temperature, the duration of the FA treatment, and the resistance of the virus in question. Our results show that FA inactivation at low temperature (4 °C) bears a high risk of incomplete inactivation. Higher temperatures (25 °C) are more efficient, although they still require rather long incubation times to fully inactivate a complex and highly robust virus like Vaccinia. A protocol, which applied 2% buffered FA for 60 min and a temperature-shift from 25 to 37 °C after 30 min was efficient for the complete inactivation of all test viruses, and therefore has the potential to improve both and speed of diagnostic electron microscopy.
Möller L, Schünadel L, Nitsche A, Schwebke I, Hanisch M, Laue M. Evaluation of Virus Inactivation by Formaldehyde to Enhance Biosafety of Diagnostic Electron Microscopy. Viruses. 2015 Feb 10;7(2):666-679.
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Guidance on regulations for the Transport of Infectious Substances 2015-2016

Applicable as from 1 January 2015


Publication details 

Number of pages38 
Publication date2015
WHO reference numberWHO/HSE/GCR/2015.2



This publication provides information for identifying, classifying, marking, labelling, packaging, documenting and refrigerating infectious substances for transportation and ensuring their safe delivery. 

The document provides practical guidance to facilitate compliance with applicable international regulations for the transport of infectious substances by all modes of transport, both nationally and internationally, and include the changes that apply from 1 January 2015. The current revision replaces the document issued by the World Health Organization (WHO) in 2012 (document WHO/CDS/EPR/2012.12). This publication, however, does not replace national and international transport regulation.


Survey of Safety Practices Among Hospital Laboratories in Ethiopia

BACKGROUND: Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia.
METHOD: Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software.
RESULT: All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards.
CONCLUSION: Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.
Sewunet T et al. Survey of Safety Practices Among Hospital Laboratories in Oromia Regional State, Ethiopia. Ethiop J Health Sci. Oct 2014; 24(4): 307–310.

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