13 research outputs found
South African Ebola diagnostic response in Sierra Leone : a modular high biosafety field laboratory
BACKGROUND : In August 2014, the National Institute for Communicable Diseases (NICD) in South Africa
established a modular high-biosafety field Ebola diagnostic laboratory (SA FEDL) near
Freetown, Sierra Leone in response to the rapidly increasing number of Ebola virus disease
(EVD) cases.
METHODS AND FINDINGS : The SA FEDL operated in the Western Area of Sierra Leone, which remained a ªhotspotº of
the EVD epidemic for months. The FEDL was the only diagnostic capacity available to
respond to the overwhelming demand for rapid EVD laboratory diagnosis for several weeks
in the initial stages of the EVD crisis in the capital of Sierra Leone. Furthermore, the NICD
set out to establish local capacity amongst Sierra Leonean nationals in all aspects of the
FEDL functions from the outset. This led to the successful hand-over of the FEDL to the
Sierra Leone Ministry of Health and Sanitation in March 2015. Between 25 August 2014 and
22 June 2016, the laboratory tested 11,250 specimens mostly from the Western Urban and
Western Rural regions of Sierra Leone, of which 2,379 (21.14%) tested positive for Ebola
virus RNA.
CONCLUSIONS : he bio-safety standards and the portability of the SA FEDL, offered a cost-effective and practical alternative for the rapid deployment of a field-operated high biocontainment facility. The SA FEDL teams demonstrated that it is highly beneficial to train the national staff in the course of formidable disease outbreak and accomplished their full integration into all operational and diagnostic aspects of the laboratory. This initiative contributed to the international efforts in bringing the EVD outbreak under control in Sierra Leone, as well as capacitating local African scientists and technologists to respond to diagnostic needs that might be required in future outbreaks of highly contagious pathogens.S1 Video. ªHotº processing of Ebola clinical specimens, PPE and decontamination procedures
in South African modular, field-operated biocontainment facility in Sierra Leone.Janusz T Paweska was supported by
funding from National Research Foundation and
the Global Disease Detection Programmehttp://www.plosntds.orgam2017Microbiology and Plant Patholog
Layout of the SA FEDL in Freetown-Lakka, Sierra Leone with emergency generator and wiring to allow for rapid switch to generator mode in case of power failure.
<p>(<b>A</b>) Biocontainment negative pressure chamber (IsoArk), (<b>B</b>) Room housing biocontainment negative pressure chamber, (<b>C</b>) Donning room, (<b>D</b>) Doffing room, (<b>E</b>) Laboratory airlock area, (<b>F</b>) PCR amplification room, (<b>G</b>) PCR master mix room, (<b>H</b>) Specimens and reagents storage area, (<b>I</b>) RNA extraction room, (<b>J</b>) Facility entrance, (<b>K</b>) Toilet, (<b>L</b>) Office 1, (<b>M</b>) Office 2, (<b>N</b>) Office 3. Petrol generator (5.5 kVa) placement indicated by the red rectangle, distribution of extension cords are indicated with red lines, and emergency connection points by red stars.</p
Number of specimens from EVD suspected cases in Sierra Leone tested daily (total blood and buccal swabs) by SA FEDL during the first weeks of operation, 25 August—30 Sept 2014.
<p>Column = Number of specimens tested daily; Dotted line = Trend line of a number of specimens tested; Solid line = Maximum testing capacity of 58 specimens per day.</p
South African Ebola diagnostic response in Sierra Leone: A modular high biosafety field laboratory - Fig 3
<p>(<b>A</b>) Operators dressed in BSL3 PPE processing clinical specimens from EVD suspected cases in a glovebox located within the IsoArk biocontainment negative pressure chamber, (<b>B</b>) Blood tubes in centrifuge adapters with safety caps passed into the main chamber of the glovebox for “hot” inactivation and aliquoting for long-term storage.</p
Ebola virus polymerase gene TaqMan real-time RT-PCR results in blood specimens.
<p>Ebola virus polymerase gene TaqMan real-time RT-PCR results in blood specimens.</p
Operators dressed in BSL3 PPE (scrubs, Tyvek suits, surgical gown, double pair surgical gloves, gumboots, overshoes and PAPR with full face hood) entering the IsoArk main chamber through the airlock.
<p>Operators dressed in BSL3 PPE (scrubs, Tyvek suits, surgical gown, double pair surgical gloves, gumboots, overshoes and PAPR with full face hood) entering the IsoArk main chamber through the airlock.</p