Nevada State Public Health Laboratory

Nevada State Public Health Laboratory

The Nevada State Public Health Laboratory (NSPHL) provides a wide range of diagnostic and analytical services for the assessment and surveillance of infectious/communicable diseases, foodborne outbreak analyses, biological and chemical terrorism analyses and the analytical evaluation of dairy products and water to evaluate safety for consumption and compliance throughout Nevada.

Special Notice

Authorization Process for Submitting Specimens for Ebola Virus Disease (EVD) Testing

Diagnostic testing for EVD is only performed at CDC or a laboratory approved by CDC. CDC has approved EVD testing at a limited number of regional laboratories. Public Health Labs in Nevada are not approved laboratories and samples will be sent to CDC or another approved laboratory as determined by CDC for testing. Before EVD testing can be performed, the appropriate health district of authority Office of Epidemiology (OOE) must be contacted to determine whether the person meets the CDC testing criteria. CDC will NOT perform testing without prior epidemiological consultation.

Please contact your appropriate Health Authority

• Nevada Division of Public and Behavioral Health (DPBH)
  Office of Public Health Informatics and Epidemiology
  (775) 400-0333 (24/7)
• Southern Nevada Health District OOE
  (702) 759-1300 option 2 (24/7)
• Washoe County Health District OOE
  (775) 328-2447 (24/7)
• Carson City Health and Human Services OOE
  (775) 887-2190 (24/7 follow the prompts)

Note

1. A healthcare provider who has access to the following patient information should be the person contacting OOE to obtain pre-authorization: name, date of birth, gender, travel history (including dates, locations, and mode(s) of travel), known Ebola exposure status, signs and symptoms of infection, laboratory test orders and/or results, and current patient status.
2. If authorized for testing, the health jurisdiction of authority will notify the appropriate laboratory (NSPHL or SNPHL), who will in turn contact the hospital clinical laboratory to determine/assist with transportation of specimens.

Specimen Collection

Specimens ideally should be taken from a symptomatic patient 3-10 days after symptoms appear. A minimum volume of 4 ml of whole blood in plastic collection tubes can be submitted for EVD testing. Whole blood preserved with EDTA is preferred but whole blood preserved with sodium polyanethol sulfonate (SPS), citrate or with clot activator is acceptable. Two tubes are recommended. Do not separate and remove serum or plasma from the primary collection container. Wipe tubes and stoppers with freshly prepared 10% bleach solution prior to placing in sealed biohazard bag. Wipe biohazard bag with 10% bleach solution and place in a durable, leak-proof secondary container for transport within a facility. Do not send to the lab by pneumatic tube system. Specimens should be immediately stored at 2-8 degrees C until shipping arrangements have been made. Label the tubes following submitting lab practices.

Packaging and Shipping of Suspect Samples

Patient specimens that are approved to be tested for Ebola virus are classified by the proper shipping name "infectious substance, affecting humans" and assigned to UN2814. They must be properly packed in UN specification packaging according to IATA packaging instruction 620 (without opening the durable leak-proof container or biohazard bag the specimen has been delivered to the laboratory in) before being offered for transport. A shipper's declaration form completed using either FedEx compliance checking software or software approved by FedEx must accompany those packages. Use "Suspected Category A infectious substance" as the technical name on the shipper's declaration form but do not put the technical name on the outer packaging. Only those employees who have been trained and certified to be a Category A shipper are allowed to package, mark, label or complete the documentation for packages being offered for Ebola testing.

FedEx will only accept patient specimens from a person under suspicion of being infected with Ebola virus, which is referred to as a "Person Under Investigation" or PUI by CDC. FedEx will not accept or transport patient specimens from those infected with Ebola virus [once tested positive by PCR for Ebola Virus Disease (EVD)]. FedEx will not accept or transport "cultures" known or suspected to contain Ebola virus from a PUI or from patients confirmed to have EVD.