Ebola Virus PCR to Washington State Lab (Sendout)

Orders and collections must be coordinated by the Infection Prevention Special Pathogens Team (SPaT) at the associated hospital site.

Contact Infection Prevention at your facility to discuss Ebola testing for your patient.

Resources

• Contact the Infection Prevention team at your facility.

WA DOH approval is required. Infection Prevention (IP)/SPaT will coordinate with DOH. DOH approval is assumed for all orders originating from IP/SPaT.

Instructions for IP/SPaT

Prior to Collection

1. Obtain the required pre-approval from the appropriate public health authorities.
2. Notify the LMR on call.
3. Place a LABUND (Laboratory Undefined) order in Epic.
   • Lab Test Requested = Ebola virus sendout to DOH
   • Additional Test Info = OLTG 595
   • In "Comments for Lab" field, include the name and phone number of the approving LHJ epidemiologist.
   • Comments for Lab = Approved by IP and DOH. Contact Dr. Regina Kwon if you have questions.
4. Place an order in the WA DOH ETOR portal.
5. Print two copies of the Epic LABUND requisition and two copies of the WA DOH ETOR requisition.

Sample Collection:

1. Page the LMR on call upon the patient's arrival.
2. Collect 2 x 5 mL LAVENDER TOP (EDTA) tubes from the patient.
   • Note that this test requires dedicated tubes; samples cannot be shared.
   • Unacceptable Containers: GREEN TOP (Heparinized) tubes or samples collected in glass tubes.
   • Additional Resource: WA DOH Specimen Collection and Submission Instructions: Ebola Virus
3. Follow SPaT requirements for specimen handling. Contact IP/SPaT for requirements.

Post-Collection:

1. Place double-bagged samples in a designated cooler.
2. Page the LMR on call to notify them that the samples are in transit.
3. Deliver samples, a copy of the Epic LABUND requisition, and a copy of the DOH ETOR requisition directly to the Microbiology lab. Samples should be walked to the lab instead of sent via the pneumatic tube system.
   • Do not deliver samples to Specimen Processing Lab.
4. Deliver the second copy of the Epic LABUND requisition and ETOR requisition to the main Specimen Processing window.

Stability: Refrigerated (preferred): 48 hours.

PSPS

• The LMR on call will notify management and leads of an incoming order.
• Call FedEx to notify them that a Category A pickup will be needed. This should be done as soon as the approximate time of the patient's arrival is known.
• Samples will be delivered directly to Microbiology lab. Ebola samples should not be accepted by general processing staff.
• After delivering samples to Micro, IP staff will deliver a copy of the LABUND Epic requisition and the ETOR requisition to PSPS.
• Upon receipt of the LABUND Epic requisition
  • Coordinate with Micro for two-person identity verification the labels on the specimens versus the two sets of requisitions.
  • Accession an order in Sunquest as follows:
    • Login: SPMSND-;REFRIG WB, POSSIBLE EBOLA
      • MSNDTO: WPHL
      • MSPTYP: WB
      • MTSTRQ: ;Ebola Virus by PCR
• Once the package is completed by Micro, call FedEx for pickup.
  • Call 1-800-463-3339. You will need to provide this information:
    • Sample type being transported
    • Classification (in this case, Category A)
    • Name of the person packing the sample [Micro to provide]
    • Emergency contact information [Micro to provide]
    • Destination address (see Micro section below).
    • The HMC SPS FedEx account number.
• Defer to the person who packaged the sample on how and where to store the package while waiting for pickup.

Microbiology Lab

• As soon as the identity of the packager and the emergency contact information is known, provide this information to SPS. They will need it to call FedEx.
• Coordinate with PSPS for two-person identity verification of the labels on the specimens and the two sets of requisitions. Store and transport unspun whole blood samples at refrigerated temperature.
• Samples must be packaged and transported as Category A (UN 2814 Infectious Substance, Affecting Humans) according to USDOT and IATA regulations by trained staff only. Send samples refrigerated with a copy of the WPHL electronic requisition to the WA State Lab.
• Delivery address for the packaging
  • Washington State Public Health Laboratories
  • Attn: Bioterrorism Lab
  • 1610 NE 150th St, Shoreline, WA 98155
• Notify SPS that the package is ready for pickup.
• Advise SPS on how and where package should be stored while waiting for FedEx pickup.

LMR On Call

• Serves as the bridge between IP/SPaT and the Lab.
• Keeps Lab (Micro and SPS) and Operational leadership informed of all notifications of planned testing, patient arrivals, and incoming samples.
• Reinforces established requirements for accepting, logging, processing, and packaging samples.
• Ensures samples are packaged and sent within the stability timeframe.
• Communicates back to IP/SPaT as needed.