A risk assessment should be performed by the appropriate personnel within each laboratory to determine the potential for generating sprays, splashes, or aerosols during laboratory procedures performed within the facility. Each laboratory should work with hospital experts to develop a site-specific plan that includes processes designed to protect workers who are known or likely to be exposed to EVD.
At a minimum, the plan should provide detailed procedures that address issues that include:
- Infection control practices
- Specimen collection and handling procedures
- Appropriate PPE, including proper selection, use (putting on and removing), and provision of training
- Limiting laboratory-performed testing to only tests deemed medically necessary
- Specimen transport and shipping procedures
- Waste and spill management procedures
If testing is performed on a patient with confirmed EVD, facility-specific plans should be in place to define standardized procedures for specimen transport. The CDC will consult with the appropriate facility personnel to determine the routine laboratory diagnostic testing that should be performed. The routine testing performed will be based on the needs of the patient and the capabilities of the facility/laboratory.
Some recommended measures to minimize the risk of laboratory transmission when testing patient specimens include: limiting the number of staff engaged in testing, evaluating and segregating equipment used for testing, and performing testing in a dedicated space.
Performing routine laboratory diagnostic testing on a patient with confirmed Ebola virus disease (EVD)
The CDC recommends that Ebola testing be conducted only for persons who meet the criteria for persons under investigation (PUIs) for EVD. A PUI is a person who has both consistent signs and/or symptoms, including:
- Elevated body temperature or subjective fever or symptoms, including severe headache, fatigue, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage, AND
- an epidemiological risk factor within the 21 days preceding the onset of symptoms.
The decision to test for Ebola should be made in consultation with public health officials. Laboratories handling specimens from PUIs for EVD should utilize the following two documents for guidance:
