Field Evaluation of Capillary Blood Samples as a Collection Specimen for the Rapid Diagnosis of Ebola Virus Infection During an Outbreak Emergency

Strecker, Thomas; Pályi, Bernadett; Ellerbrok, Heinz; Jonckheere, Sylvie; Clerck, Hilde De; Boré, Joseph Akoi; Gabriel, Marcin; Stoecker, Kilian; Eickmann, Markus; Herp, Michel Van; Formenty, Pierre; Di, Antonino; Becker, Stephan

doi:10.1093/cid/civ397

Cited by 26 publications

(30 citation statements)

References 23 publications

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“…This phenomenon was not observed for blood samples stored at 5°C, where EBOV RNA could be detected in the samples 28 days after blood collection using either extraction method without difficulty or loss of material. The current WHO guidelines recommend a storage temperature between 0 and 5°C to preserve EBOV RNA in EDTA-blood samples (3), and rapid degradation of EBOV RNA has been observed when samples are stored at room temperature compared to 4°C (17). However, our results demonstrate that MPLB buffer preserves the EBOV RNA even when the samples are stored at 25 to 37°C.…”

Section: Figmentioning

confidence: 50%

“…The steps in the QIAamp viral RNA extraction method from Qiagen that was used during the recent outbreak (15) are (i) sample collection; (ii) triple packing systems (5) for the shipment and transport of samples to high-containment laboratories (16); (iii) pipetting of aliquots; (iv) addition of AVL buffer; (v) incubation; (vi) addition of ethanol; and (vii) disinfection using 0.5% hypochlorite for 5 min before release from the glove box (17). These handling steps can be eliminated if efficient bedside inactivation of EBOV is obtained.…”

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confidence: 99%

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Rapid Bedside Inactivation of Ebola Virus for Safe Nucleic Acid Tests

et al. 2016

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Rapid bedside inactivation of Ebola virus would be a solution for the safety of medical and technical staff, risk containment, sample transport, and high-throughput or rapid diagnostic testing during an outbreak. We show that the commercially available Magna Pure lysis/binding buffer used for nucleic acid extraction inactivates Ebola virus. A rapid bedside inactivation method for nucleic acid tests is obtained by simply adding Magna Pure lysis/binding buffer directly into vacuum blood collection EDTA tubes using a thin needle and syringe prior to sampling. The ready-to-use inactivation vacuum tubes are stable for more than 4 months, and Ebola virus RNA is preserved in the Magna Pure lysis/binding buffer for at least 5 weeks independent of the storage temperature. We also show that Ebola virus RNA can be manually extracted from Magna Pure lysis/binding buffer-inactivated samples using the QIAamp viral RNA minikit. We present an easy and convenient method for bedside inactivation using available blood collection vacuum tubes and reagents. We propose to use this simple method for fast, safe, and easy bedside inactivation of Ebola virus for safe transport and routine nucleic acid detection. The most recent Ebola virus disease (EVD) outbreak began in West Africa in December 2013. As of March 2016, the number of confirmed, probable, and suspected EVD cases reported worldwide was 28,646. Guinea, Liberia, and Sierra Leone were the most affected countries with 3,804, 10,666 and 14,122 cases, respectively (1).Ebola virus (EBOV) is classified as a risk group 4 pathogen that requires handling under biosafety level 4 (BSL-4) conditions. To meet this requirement, several mobile BSL-4 facilities were used during the recent West Africa outbreak (1, 2). However, extensive safety precautions and training of medical and technical staff are needed to ensure personal safety (2-6). As of August 2015, 880 health care workers had been diagnosed with EVD, and 512 had died from the disease (7). Rapid bedside inactivation of EBOV would be a solution for the safety of medical and technical staff, risk containment, and easier transport of samples without requiring expensive category A shipping. Additionally, this process removes the need for sample handling under high-containment environments and facilitates high-throughput and rapid testing under nonbiosafety laboratory conditions and, thus, a rapid diagnosis of the disease.There is a need for a simple, efficient, and safe bedside inactivation method for EBOV. Presently, laboratory EBOV inactivation is accomplished by gamma irradiation (8), UV radiation (9), nanoemulsion (10), and photoinducible alkylating agents (11), but these methods are not applicable in outbreak situations or as bedside inactivation methods. Other EBOV inactivation methods, such as acetic acid (12), heat (12), AVL buffer (13), TRIzol (13) or the combination of heat and Triton X-100 (14), are more applicable in outbreak situations and are currently used in field laboratories. Unfortunately, all of these methods require...

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Section: Figmentioning

confidence: 50%

mentioning

confidence: 99%

Rapid Bedside Inactivation of Ebola Virus for Safe Nucleic Acid Tests

et al. 2016

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“…In infants and children where there is difficulty in obtaining blood samples, capillary samples could be used initially as an alternative, although it should be remembered that they would not be perfectly sensitive. 34 Future diagnostic regimens should incorporate rapid Ebola tests, 35 specific testing for common childhood illnesses, 36 including rapid malaria and HIV tests, and rapid multiplex polymerase chain reaction-based bacterial and viral stool studies. All of these would of course require more sophisticated and complete laboratory facilities and isolation procedures.…”

Section: Future Opportunities For Improving Pediatric Ebola Carementioning

confidence: 99%

Moving Towards a More Aggressive and Comprehensive Model of Care for Children with Ebola

Trehan

Kelly

Marsh

et al. 2016

The Journal of Pediatrics

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“…Strecker et al 40 compared capillary blood samples versus venous blood samples for polymerase chain reaction testing for EVD in Guinea. They found a sensitivity of 87% and specificity of 100% for capillary blood samples.…”

Section: Disaster and Humanitarian Responsementioning

confidence: 99%

Global Emergency Medicine: A Review of the Literature From 2015

Becker

Hansoti

Bartels

et al. 2016

Academic Emergency Medicine

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Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners.Methods: This year 12,435 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 723 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of overall quality and importance. Two independent reviewers scored all articles.Results: A total of 723 articles met our predetermined inclusion criteria and underwent full review. Sixty percent were categorized as emergency care in resource-limited settings (ECRLS), 17% as EM development (EMD), and 23% as disaster and humanitarian response (DHR). Twenty-four articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability between reviewers gave an intraclass correlation coefficient of 0.71 (95% confidence interval = 0.66 to 0.75). Studies and reviews with a focus on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review.

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Field Evaluation of Capillary Blood Samples as a Collection Specimen for the Rapid Diagnosis of Ebola Virus Infection During an Outbreak Emergency

Abstract: This study demonstrated the applicability of capillary blood samples as clinical specimens for field diagnosis of Ebola virus infection in an outbreak emergency.

Cited by 26 publications

References 23 publications

Rapid Bedside Inactivation of Ebola Virus for Safe Nucleic Acid Tests

Rapid Bedside Inactivation of Ebola Virus for Safe Nucleic Acid Tests

Moving Towards a More Aggressive and Comprehensive Model of Care for Children with Ebola

Global Emergency Medicine: A Review of the Literature From 2015

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