Live from ASM: Lab Methods for H1N1 Handling
This afternoon brought a late-breaking session at ASM to discuss lab response to H1N1 swine flu. As ADVANCE has previously reported, the consensus seems to be that thanks to the terrific response of healthcare workers--certainly including laboratorians--what might have been a major public health crisis was handled efficiently, avoiding what could have been a far worse situation.
Christine Ginocchio, PhD, MT(ASCP), director of Microniology/Virology and Molecular Diagnostics at Long Island Jewish Health System Laboratories explained how her lab went from zero to 60 to handle the influx of testing and be prepared for continued increase in testing. "It's amazing what an outbreak can do," she said.
Dr. Ginocchio detailed some of the problems her lab faced. They went from a normal testing volume of about 160 tests a day to 790. The lab needed supplies and accessioners for specimen receipt, a system for triaging all of these specimens, not to mention LIS support for all of these extra test results.
The lab put an emergency plan in place and developed a specific testing algorithm, starting with a rapid test or viral culture, then PCR for further typing of Type A specimens. Those that came back as "probable swine flu" went on for further CDC testing. On top of the logistics of testing, the lab actually did some emergency construction to expand the physical space! "Essentially," Dr. Ginocchio said, "we were building a lab in four days."
All of the necessary teams came together in a remarkable way, though, from the lab staff and all of the couriers, to the information technology team and construction workers, and with an impressive amount of collaboration, they were able to effectively manage the emergency.
Calling in for an audioconference, Dr. Joe Miller from the CDC discussed the sequence of events since the identification of the first H1N1 case. As of this morning, he reported, the U.S. has 5,469 confirmed cases, including 229 hospitalizations and six deaths (with a possible seventh not yet confirmed).