Pandemic Influenza Plan - Questar III

Section 2: Surveillance and Laboratory Testing
• Safety precautions to be taken while handling specimens in the laboratory
o Guidance for handling respiratory secretions from patients who are suspected of
being infected with influenza virus but who do not have a history of travel to an
area where a novel influenza virus, such as the Asian HPAI H5N1 avian
influenza virus, is circulating and not suspected to be infected with a novel
influenza virus:
The following should be performed in BSL-2 facilities with standard BSL-2
practices.
• Pathological examination and processing of formalin-fixed or otherwise
inactivated tissues.
• Molecular analysis of extracted nucleic acid preparations.
• Electron microscopic studies with glutaraldehyde-fixed grids.
• Routine staining and microscopic analysis of fixed smears.
• Final packaging of specimens for transport to diagnostic laboratories for
additional testing. Specimens should already be in a sealed, decontaminated
primary container.
The following activities involving untreated specimens should be performed in a
BSL-2 facility AND in a Class II biological safety cabinet.
• Aliquoting and /or diluting specimens.
• For the appropriate strains, inoculation of cell cultures with the original
diagnostic specimen or the culture amplified isolate.
• Nucleic acid extraction procedures involving untreated specimens.
• Based on CDC guidance, rapid EIA commercial influenza antigen detection
assays.
Laboratory workers should wear protective equipment, including disposable
gloves and solid front gowns with cuffed sleeves. Work surfaces should be
decontaminated upon completion of work with appropriate disinfectants and all
disposable waste autoclaved.
Any procedure or process that cannot be conducted within a biological safety
cabinet requires the use of the appropriate combinations of personal protective
equipment (e.g., respirators and face shields) and physical containment devices
(centrifuge safety cups or sealed rotors). Centrifugation should always be carried
out using aerosol-sealed centrifuge cups and rotors that are loaded and unloaded
in a biological safety cabinet.
o Guidance for handling respiratory secretions from patients who have history of
travel to an area where a novel influenza virus, such as the highly pathogenic
Asian HPAI H5N1 avian influenza virus, is circulating OR are suspected to
be infected with a novel influenza virus:
February 7, 2006 2-19