A-183 Development of a High Risk Pathogen Laboratory

Abstract Background In 2015, Denver Health was selected as a Regional Emerging Special Pathogens Treatment Center (RESPTC) by the Centers for Disease Control and Prevention (CDC). The Denver Health RESPTC serves Region 8 consisting of – WY, MT, UT, ND, SD and CO and is made up of 2 biocontainment units (BCU) and a designated High Risk Pathogen (HRP) Laboratory. The HRP Laboratory is only in use during a BCU activation. Developing the HRP Laboratory involved creating a comprehensive test menu so physicians could treat patients with a viral hemorrhagic fever (VHF) or other high risk pathogens. It also consisted of establishing don/doff processes to keep HRP Lab staff safe from potential contamination, procedural development for the disposal of highly infectious biohazardous waste and training for Category A shipping of specimens. Methods Various healthcare leadership were involved in creating a testing menu that would allow providers to monitor and best treat BCU patients. This included test selection, type and cost of instrumentation, reagents and supplies. The HRP Lab team also collaborated with nursing educators to modify their don/doff procedures to best fit the needs of the lab. The process of removing biohazardous waste was developed to ensure waste would be properly disposed of and destroyed per regulatory guidelines. A specialized Category A shipping training program was identified so the team could be compliant in sending specimens out for confirmation testing Results The following test menu was created - CBC, PT, PTT, D-Dimer, CMP, UA, HIV, Preg, blood culture including organism identification, respiratory organism identification, gastrointestinal organism identification and special pathogen identification (including but not limited to Ebola, Marburg, Lassa Fever and malaria). Don/doff procedures were developed so laboratory staff would be protected from possible cross contamination. Laboratory staff are required to undergo quarterly training/practice of donning/doffing to maintain skills. Biohazardous waste from the HRP Lab must properly be discarded to reduce the risk of spreading infection. Waste is doused with 10% bleach, double bagged and kept in the HRP Lab until it can be safely removed. When the HRP Lab is activated, specimens are sent out for confirmation testing. These specimens are packaged and shipped by an HRP Lab team member who has undergone an 8-hour online training course about shipping Cat A infectious substances. Conclusion The Denver Health HRP Laboratory is ready to support Region 8 in the event of a BCU activation. Staff will don/doff PPE and enter the HRP Lab for no more than 4 hours at a time to prevent fatigue, overheating, or other strain. The HRP Lab offers a comprehensive test menu for providers to care for these patients. Staff will monitor the biohazardous waste volumes, package and dispose of it as needed. With the approval of the Colorado Department of Public Health and Environment (CDPHE) and/or CDC, the HRP Lab staff will package and send specimens for confirmation testing. The Denver Health HRP Lab is funded by HHS ASPR under the Region 8 RESPCT Cooperative Agreement.