sábado, 3 de mayo de 2014

CDC-MERS-Interim MERS Lab Biosafety Guidelines

CDC-MERS-Interim MERS Lab Biosafety Guidelines

Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

To date, little is known about pathogenic potential and transmission dynamics of Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Until more information becomes available, precautions should be taken in collecting and handling specimens that may contain MERS-CoV.
Timely communication between clinical and laboratory staff is essential to minimize the risk incurred in handling specimens from patients with possible MERS-CoV infection. Such specimens should be labeled accordingly, and the laboratory should be alerted to ensure proper specimen handling. General and specific biosafety guidelines for handling MERS-CoV specimens are provided below.
For additional detailed instructions please refer to the following:

General Guidelines (for working with potentially infectious materials)

Laboratory workers should wear personal protective equipment (PPE) which includes disposable gloves, laboratory coat/gown, mask, and eye protection when handling potentially infectious specimens.
Acceptable methods of respiratory protection include: a properly fit-tested, NIOSH-approved filter respirator (N-95 or higher level) or a powered air-purifying respirator (PAPR) equipped with high-efficiency particulate air (HEPA) filters. Accurate fit-testing is a key component of effective respirator use. This includes training, fit-testing, and fit-checking to ensure appropriate respiratory selection and use. To be effective, respirators must provide a proper sealing surface on the wearer’s face. Personnel who cannot wear fitted respirators because of facial hair or other fit limitations should wear loose-fitting hooded or helmeted PAPRs. See detailed information on a respiratory protection programExternal Web Site Icon
Any procedure with the potential to generate fine-particulate aerosols (e.g., vortexing or sonication of specimens in an open tube) should be performed in a Class II Biological Safety Cabinet (BSC). Appropriate physical containment devices (e.g., centrifuge safety buckets; sealed rotors) should be used for centrifugation. Ideally, rotors and buckets should be loaded and unloaded in a BSC.
Perform any procedures outside a BSC in a manner that minimizes the risk of exposure to an inadvertent sample release.
After specimens are processed, decontaminate work surfaces and equipment with appropriate disinfectants. Use any EPA-registered hospital disinfectant. Follow manufacturer's recommendations for use-dilution (i.e., concentration), contact time, and care in handling.
All disposable waste should be autoclaved.

Specific Guidelines

The following activities may be performed in BSL-2 facilities using standard BSL-2 work practices:

  • Pathologic 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 examination of bacterial and mycotic cultures
  • 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.
  • Inactivated specimens (e.g., specimens in nucleic acid extraction buffer)

The following activities involving manipulation of potentially infected specimens should be performed as above and in a Class II BSC:

  • Aliquoting and/or diluting specimens
  • Inoculating bacterial or mycological culture media
  • Performing diagnostic tests that do not involve propagation of viral agents in vitro or in vivo
  • Nucleic acid extraction procedures involving potentially infected specimens
  • Preparation and chemical- or heat-fixing of smears for microscopic analysis

The following activities must be performed in a BSL-3 facility using BSL-3 work practices:

  • MERS-CoV propagation in cell culture
  • Initial characterization of viral agents recovered in cultures of MERS-CoV specimens

The following activities must be performed in Animal BSL-3 facilities using Animal BSL-3 work practices:

  • Inoculation of animals for potential recovery of virus from MERS-CoV samples
  • Protocols involving animal inoculation for characterization of putative MERS-CoV agents

Packing, Shipping and Transport

Packaging, shipping, and transport of specimens from suspect cases of MERS-CoV infection must follow the current edition of the International Air Transport Association (IATA) Dangerous Goods RegulationsExternal Web Site Icon

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