{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:43:57Z","timestamp":1761896637637,"version":"3.41.2"},"reference-count":18,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>In late 2014, 56 hospitals in the United States were designated by state and federal public health authorities as specially designed high-level isolation units (HLIUs) equipped with advanced infrastructure, laboratory capabilities, and trained staff to care for patients with highly hazardous communicable diseases (HHCDs), such as Ebola virus disease. This survey describes the clinical laboratory support capabilities of U.S. HLIUs, including the specific test menus that HLIUs have identified to safely manage HHCD patients and the locations where such testing would be performed. In spring 2016, a survey was electronically distributed, as a fillable pdf file, to the 56 U.S. HLIUs. Site representatives completed the surveys, and data were coded and analyzed in an electronic spreadsheet, using descriptive statistics. Thirty-six HLIUs (64%) responded, and 33 completed the laboratory capabilities section. Thirty-one HLIUs (94%) had performed risk analyses for all laboratory procedures and equipment. Twenty-nine (88%) had decontamination procedures specified for all laboratory equipment used for patients with suspected or confirmed HHCDs. On-site laboratories in 27 HLIUs (81%) had the capacity to inventory and to securely store HHCD patient specimens. Ten HLIUs (31%) had at least one test they would conduct within the patient isolation room. The high-risk nature of HHCDs and the occupational exposures that may occur in clinical laboratories demand advanced preparation and risk assessment of work practices, laboratory equipment, and instrumentation by HLIU laboratories. Although risk analyses of clinical laboratory testing and equipment that HLIUs have conducted have likely focused on those for Ebola virus, HLIUs must be prepared to revise their current procedures for other HHCDs.<\/jats:p>","DOI":"10.1128\/jcm.01608-17","type":"journal-article","created":{"date-parts":[[2017,11,22]],"date-time":"2017-11-22T16:30:21Z","timestamp":1511368221000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":6,"title":["U.S. High-Level Isolation Unit Clinical Laboratory Capabilities Update"],"prefix":"10.1128","volume":"56","author":[{"given":"Jocelyn J.","family":"Herstein","sequence":"first","affiliation":[{"name":"Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter C.","family":"Iwen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA"},{"name":"Nebraska Public Health Laboratory, Omaha, Nebraska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn C.","family":"Jelden","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Biddinger","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Division of Emergency Preparedness, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn G.","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurora B.","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela L.","family":"Hewlett","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Lowe","sequence":"additional","affiliation":[{"name":"Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","volume-title":"Interim guidance for U.S. hospital preparedness for patients under investigation (PUIs) or with confirmed Ebola virus disease (EVD): a framework for a tiered approach","author":"Centers for Disease Control and Prevention","year":"2015","unstructured":"Centers for Disease Control and Prevention. 2015. Interim guidance for U.S. hospital preparedness for patients under investigation (PUIs) or with confirmed Ebola virus disease (EVD): a framework for a tiered approach. Centers for Disease Control and Prevention, Atlanta, GA. https:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/preparing\/hospitals.html."},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2006.4.351"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70304-9"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02905-15"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2202.151431"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.300"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2306.170062"},{"key":"e_1_3_1_9_2","volume-title":"HHS selects regional Ebola treatment center for southwestern U.S","author":"U.S. Department of Health and Human Services","year":"2016","unstructured":"U.S. Department of Health and Human Services. 2016. HHS selects regional Ebola treatment center for southwestern U.S. U.S. Department of Health and Human Services, Washington, DC. https:\/\/www.hhs.gov\/about\/news\/2016\/06\/14\/hhs-selects-regional-ebola-treatment-center-southwestern-us.html."},{"key":"e_1_3_1_10_2","volume-title":"Guidance for U.S. laboratories for managing and testing routine clinical specimens when there is a concern about Ebola virus disease","author":"Centers for Disease Control and Prevention","year":"2015","unstructured":"Centers for Disease Control and Prevention. 2015. Guidance for U.S. laboratories for managing and testing routine clinical specimens when there is a concern about Ebola virus disease. Centers for Disease Control and Prevention, Atlanta, GA. https:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/laboratories\/safe-specimen-management.html."},{"key":"e_1_3_1_11_2","volume-title":"Guidance for collection, transport and submission of specimens for Ebola virus testing","author":"Centers for Disease Control and Prevention","year":"2015","unstructured":"Centers for Disease Control and Prevention. 2015. Guidance for collection, transport and submission of specimens for Ebola virus testing. Centers for Disease Control and Prevention, Atlanta, GA. https:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/laboratories\/specimens.html."},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1309\/LMTULFM62W3RKMYI"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP26MIFUIETBPL"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1309\/LMTMW3VVN20HIFS"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409838"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0134-RA"},{"key":"e_1_3_1_17_2","unstructured":"Malone B. 2014. Confronting Ebola in the U.S.: labs race to plan with evolving guidance and missing details. Clin Lab News https:\/\/www.aacc.org\/publications\/cln\/articles\/2014\/december\/confronting-ebola."},{"key":"e_1_3_1_18_2","volume-title":"Interim\u2014planning guidance for the handling of solid waste contaminated with a category A infectious substance","author":"U.S. Department of Transportation","year":"2017","unstructured":"U.S. Department of Transportation. 2017. Interim\u2014planning guidance for the handling of solid waste contaminated with a category A infectious substance. U.S. Department of Transportation, Washington, DC. https:\/\/www.phmsa.dot.gov\/sites\/phmsa.dot.gov\/files\/docs\/Interim_Planning_Guidance_for_Handling_Category_A_Solid_Waste.pdf."},{"key":"e_1_3_1_19_2","volume-title":"Latest Ebola fear: safety of lab equipment","author":"Eisler P","year":"2014","unstructured":"Eisler P. 6 November 2014. Latest Ebola fear: safety of lab equipment. 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