NATIONAL PUBLIC HEALTH LABORATORY

Outbreak sample management

Communication

A well-established communication through a Rapid Response Ream (RRT) of the MOH at the time of the outbreak, investigations may be handled in different laboratories, thus effective intersectoral communications are employed and:
The laboratory is informed when there is a suspected outbreak, and the nature of that outbreak (haemorrhagic, diarrhoeal, etc).
The NPHL communicates results of investigations promptly and accurately to the outbreak investigation team (and to others, depending on communications protocol established). Furthermore, the laboratory has an established mechanism for communicating the results of routine surveillance of infections to the appropriate authorities.

Sample collection and transportation

Samples are collected and transported with a competent laboratory personnel using a triple packaging system and accompanying data from the outbreak to the laboratory
The NPHL provides a suitably-trained laboratory personnel at the outbreak site to organize specimen collection, packing and transport.

The NPHL needs to know:

The nature of the outbreak (therefore type of specimens to be collected)

Approximate number of specimens

Approximate timing of specimen collection and despatch to laboratory

The NPHL should provide:

Materials for the safe collection and transport of specimens (including laboratory request forms)

Guidance* on what to collect, how to collect and how much

Safe handling of specimens and how to package and transport, and where to transport to (i.e. to the NPHL or directly to international reference centre).
(*N.B. Although specimen collection and transport guidelines should be permanently available to the outbreak investigation team, these can be reinforced verbally in communication with the investigation team).

Sample testing and result interpretation

NPHL has staff trained in laboratory investigations of the common causes of outbreaks and able to produce reliable results. NPHL laboratory manager ensures effective operation of investigations, sufficient ongoing input of specimens to ensure capacity to perform reliable identification of priority pathogens on a day-to-day basis; reliable identification implies necessity for regular quality assurance. For compliance with IHR (2005), ‘countries should have the capacity to provide support to public health laboratory analysis of samples (domestically or through collaborating centres)’ For possible causes of outbreaks for which NPHL capacity is lacking, protocols has been established for shipping of specimens outside the country to collaborating centres or other international reference centres.