Abstract
Background: Ebola virus, an enveloped virus, is the cause of the largest and most complex Ebola virus disease (EVD) outbreak in West Africa. Blood or body fluids of an infected person may represent a biohazard to laboratory workers. Laboratory tests of virus containing specimens should be conducted in referral centres at biosafety level 4, but based on the severity of clinical symptoms, basic laboratories might be required to execute urgent tests for patients suspected of EVD. The aim of this work was to compare the analytical performances of laboratory tests when Triton X-100, a chemical agent able to inactivate other enveloped viruses, was added to specimens.
Methods: Results of clinical chemistry, coagulation and haematology parameters on samples before and after the addition of 0.1% (final concentration) of Triton X-100 and 1 h of incubation at room temperature were compared.
Results: Overall, results showed very good agreement by all statistical analyses. Triton X-100 at 0.1% did not significantly affect the results for the majority of the analytes tested.
Conclusions: Triton X-100 at 0.1% can be used to reduce the biohazard in performing laboratory tests on samples from patients with EVD without affecting clinical decisions.
Acknowledgments
The authors thank the entire Biochemistry and Pharmacology Laboratory staff. In particular, they are grateful to Basile MR, Gagliardi C, Giuffrè S, Luisi G and Martino G for their technical help. Authors wish to thank Baker A for language assistance.
Author contributions:All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Financial support: This study was supported by grants from Ministero della Salute of Italy (Istituto Nazionale per le Malattie Infettive I.R.C.C.S. “Lazzaro Spallanzani”, Ricerca Corrente).
Employment or leadership:None declared.
Honorarium: None declared.
Competing interests:The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Paessler S, Walker DH. Pathogenesis of the viral hemorrhagic fevers. Annu Rev Pathol 2013;24:411–40.10.1146/annurev-pathol-020712-164041Search in Google Scholar
2. Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/vhf/ebola/. Accessed December, 2014.Search in Google Scholar
3. Feldmann H, Geisbert TW. Ebola haemorrhagic fever. Lancet 2011;5:849–62.10.1016/S0140-6736(10)60667-8Search in Google Scholar
4. Gulland A. Fifteen countries are at risk of Ebola outbreak, says WHO. Br Med J 2014;17:g6305.10.1136/bmj.g6305Search in Google Scholar PubMed
5. Fusco FM, Schilling S, De Iaco G, Brodt HR, Brouqui P, Maltezou HC, et al. Infection control management of patients with suspected highly infectious diseases in emergency departments: data from a survey in 41 facilities in 14 European countries. BMC Infect Dis 2012;28:12–27.10.1186/1471-2334-12-27Search in Google Scholar PubMed PubMed Central
6. Puro V, Fusco FM, Lanini S, Nisii C, Ippolito G. Risk management of febrile respiratory illness in emergency departments. New Microbiol 2008;31:165–73.Search in Google Scholar
7. Centers for Disease Control and Prevention. Interim guidance for specimen collection, transport, testing, and submission for persons under investigation for Ebola virus disease in the United States. Available from: http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collection-submission-patients-suspected-infection-ebola.html. Accessed December, 2014.Search in Google Scholar
8. Lippi G, Mattiuzzi C, Plebani M. Laboratory preparedness to face infectious 182 outbreaks. Ebola and beyond. Clin Chem Lab Med 2014;52:1681–4.Search in Google Scholar
9. Katz LM, Tobian AA. Ebola virus disease, transmission risk to laboratory personnel, and pretransfusion testing. Transfusion 2014;54:3247–51.10.1111/trf.12913Search in Google Scholar PubMed
10. Centers for Disease Control and Prevention. Interim guidance for managing patients with suspected viral hemorrhagic fever in US. hospitals. Available from: http://www.cdc.gov/HAI/pdfs/bbp/VHFinterimGuidance05_19_05.pdf. Accessed December, 2014.Search in Google Scholar
11. Ontario Agency for Health Protection and Promotion. Available from: http://www.publichealthontario.ca/en/eRepository/Ebola_Virus_Disease_ (EVD) _Sample_Collection_Submission_Guide.pdf. Accessed December, 2014.Search in Google Scholar
12. Ukkonen P, Korpela J, Suni J, Hedman K. Inactivation of human immunodeficiency virus in serum specimens as a safety measure for diagnostic immunoassays. Eur J Clin Microbiol Infect Dis 1988;7:518–23.10.1007/BF01962603Search in Google Scholar PubMed
13. Mitchell SW, McCormick JB. Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses. J Clin Microbiol 1984;20:486–9.10.1128/jcm.20.3.486-489.1984Search in Google Scholar PubMed PubMed Central
14. Maltezou HC, Fusco FM, Schilling S, De Iaco G, Gottschalk R, Brodt HR, et al. Infection control practices in facilities for highly infectious diseases across Europe. J Hosp Infect 2012;81:184–91.10.1016/j.jhin.2012.04.019Search in Google Scholar PubMed PubMed Central
15. Word Health Organization. Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola. Available from: http://www.who.int/csr/resources/publications/ebola/filovirus_infection_control/en/. Accessed December, 2014.Search in Google Scholar
16. NYS/NYC laboratory guidelines for handling specimens from patients with suspected or confirmed Ebola virus disease. Available from: https://www.health.ny.gov/diseases/communicable/ebola/docs/lab_guidelines.pdf. Accessed December, 2014.Search in Google Scholar
17. Bhagat CI, Lewer M, Prins A, Beilby JP. Effects of heating plasma at 56 degrees C for 30 min and at 60 degrees C for 60 min on routine biochemistry analytes. Ann Clin Biochem 2000;37:802–4.10.1258/0004563001899997Search in Google Scholar PubMed
18. Lau R, Wang A, Chong-Kit A, Ralevski F, Boggild AK. Evaluation of Ebola virus inactivation procedures for Plasmodium falciparum malaria diagnostics. J Clin Microbiol 2015;53:1387–90.10.1128/JCM.00165-15Search in Google Scholar PubMed PubMed Central
19. Hersberger M, Nusbaumer C, Scholer A, Knöpfli V, von Eckardstein A. Influence of practicable virus inactivation procedures on tests for frequently measured analytes in plasma. Clin Chem 2004;50:944–6.10.1373/clinchem.2004.031666Search in Google Scholar PubMed
20. Hellstern P, Solheim BG. The use of solvent/detergent treatment in pathogen reduction of plasma. Transfus Med Hemother 2011;38:65–70.10.1159/000323552Search in Google Scholar PubMed PubMed Central
Supplemental Material:
The online version of this article (DOI: 10.1515/cclm-2015-0119) offers supplementary material, available to authorized users.
©2015 by De Gruyter