Laboratory Test Support for Ebola Patients within a High-Containment Facility
As of August 22, there have been more than 2,600 suspected or confirmed cases of Ebola hemorrhagic fever. Of these cases, two adult United States nationals were admitted to Emory University Hospital in Atlanta, Georgia, during the first week of August 2014 for treatment. To discuss their treatment, doctors of Emory Hospital authored the article, "Laboratory Test Support for Ebola Patients within a High-Containment Facility," in the American Society for Clinical Pathology's Lab Medicine journal.
According to the article, the patients were admitted to a specialized isolation unit that had been established at Emory University Hospital 12 years previously, in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), as a resource for safely quarantining, evaluating, and caring for small numbers of patients with unidentified or highly contagious infectious diseases.
To ensure containment of the patients and to prevent any risk of spreading Ebola, Emory Hospital established a self-contained point-of-care (POC) laboratory that could support all testing within the facility itself, and it acquired a team of volunteer clinical pathologists and laboratory technical staff with expertise in POC testing to perform all assays on site.
After carefully assessing the Ebola disease, the doctors selected the following instruments to provide core metabolic, coagulation, microbiologic, and other assays:
- Chemistry analyzer (Abaxis Piccolo Xpress [ABAXIS, Inc, Union City, CA]) to perform chemistry profiles; magnesium, phosphate, and liver-enzyme assays; etc.)
- Arterial blood-gas analyzer (GEM Premier 4000 [Werfen, Barcelona, Spain])
- Automated urinalysis analyzer (CLINITEK Status [Siemens Corp., Munich, Germany])
- Coagulation analyzer (CoaguChek [F. Hoffman–La Roche, Ltd, Basel, Switzerland]) for determinations of prothrombin time and international normalized ratio
- Hematology analyzer (pocH 100i [Sysmex Corporation, Kobe, Japan]) for complete blood count
- Malaria POC device (Alere BinaxNOW [Alere, Inc, Waltham, MA])
- Polymerase chain reaction–based microbiological analyzer (BioFire FilmArray [BioFire Diagnostics, Inc, Salt Lake City, UT]) designed to detect a panel of viral, bacterial, fungal, or parasitic pathogens, many of which might be found in patients returning from a resource-poor region and might complicate care. Among other pathogen-specific markers, this instrument detects Ebola viral RNA, a capability believed to have value for monitoring progression of and recovery from Ebola infection in this setting.
Read the full article to learn more about Emory Hospital's laboratory test support for the Ebola virus.