Friday, April 15, 2005, 0:20 EDT (12:20 PM EDT)
CDCHAN-00228-2005-04-15-UPD-N
Instructions for monitoring health of laboratory workers and for destroying influenza A (H2N2) samples
On April 13, 2005, CDC issued a Health
Advisory describing the inadvertent distribution of influenza
A (H2N2) samples to domestic and international laboratories and recommending
that those samples be destroyed immediately.
This update provides instructions for 1) monitoring for and reporting
influenza-like illness among laboratory workers who might have been exposed to
the A (H2N2) samples and 2) destroying influenza A (H2N2) samples by use of
autoclaves, incineration, or chemical decontamination.
Monitoring and reporting influenza-like illness among
laboratory staff
Testing of laboratory personnel who may have worked
with the influenza A (H2N2) panels is not recommended in the United States at
this time. The biosafety level 2 (BSL-2) precautions
required for this agent would be expected to protect workers from exposure and
infection, and therefore the risk of transmission is considered low. However,
CDC is recommending that laboratories with workers with relatively recent
exposure (within the last 10 days) to the H2N2 test samples monitor their
worker's health for influenza-like-illness (i.e., temperature of greater than
or equal to 100 degrees F and cough or sore throat). If a laboratory worker
with recent exposure to the H2N2 samples develops such symptoms, clinical
specimens should be obtained and tested for influenza A. Commercially available rapid test kits for
influenza and other methods for rapid detection of influenza virus, such as
indirect fluorescent antibody assay, direct fluorescent antibody assay, and
polymerase chain reaction should be used. If the
sample is positive for influenza A virus, contact your state health department
and CDC immediately at (770)-488-7100.
Instructions for destroying influenza A (H2N2) samples
Laboratories
have been advised to immediately destroy and treat as potentially infectious and
hazardous all materials retained or derived from the influenza A (H2N2)
proficiency testing panels created by Meridian Bioscience and sent out by the
College of American Pathologists (CAP), the American Association of Bioanalysts, the American College of Family Physicians, or
the American College of Physician Services.
These
materials may be destroyed by autoclave, incineration, or chemical
disinfection
To autoclave:
· Autoclave with moist heat at 121 degrees C (15-19 pounds of pressure)
for at least 20 minutes or
· Autoclave with dry
heat at 170 degrees C for 1 hour or 160 degrees C for 2 hours or 121 degrees C
for at least 16 hours.
To chemically
disinfect:
Any of the following
liquid disinfectants can also be used to destroy the virus; however, with the
exception of the alcohols, these should not be used with autoclaving due to the
chemical fumes that would result. The length of exposure time required to kill
the virus depends on the disinfectant used, but overnight exposure would be
adequate for all of them.
· 200 ppm fresh sodium hypochlorite (a freshly
made 1:10 dilution of household bleach should provide this level of free
chlorine)
· 60%-95% ethanol or isopropryl alcohol
· 5% phenol
· 3% lysol
Other agents that may be used but that have toxic or
irritant properties include
· 5-8% formalin
· 2% alkaline glutaraldehyde
Other Instructions:
If the
autoclave/incinerator is offsite, the material should be sealed in an
impervious bag while being transported. If the bag will be shipped, it must
conform with all International Air
Transport Association and Department of
Transportation requirements regarding packaging and labeling of infectious
substances (http://www.cdc.gov/ncidod/srp/specimens/DOT%20Final%20Rule%208-14-02.pdf).
CDC and HHS remain
in close communication with the World Health Organization, as well as the
College of American Pathologists and other providers of proficiency testing
panels, about the identification and destruction of the H2N2 panels of concern
and will provide additional information as it becomes available.
HAN Message Types
- Health Alert: Conveys the highest level of importance; warrants immediate action or attention. Example: HAN00001
- Health Advisory: Provides important information for a specific incident or situation; may not require immediate action. Example: HAN00316
- Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action. Example: HAN00309
- Info Service: Provides general information that is not necessarily considered to be of an emergent nature. Example: HAN00319
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