Preliminary Identification of the Primary Select Agents of Bioterrorism

(based on 585 customer ratings)

Author: Judi Bennett, BS, MLS(AMT)
Reviewer: Julie Ann West, PhD, MLS(ASCP)CM, SM(ASCP)CM and Joshua J. Cannon, MS, MLS(ASCP)CMSHCM

This course provides an overview of the Laboratory Response Network (LRN), including the role and purpose of the front-line clinical laboratories. The course also discusses the indigenous areas where select bioterrorism agents are naturally occurring and can be isolated outside of a public emergency event, the clinical specimens where organisms that are used as bioterrorism agents may be encountered, procedures for the presumptive identification of the primary agents of bioterrorism, and the associated safety implications.

Continuing Education Credits

Objectives

  • Define the purpose of the Laboratory Response Network (LRN).
  • Explain the role of a sentinel laboratory within the LRN and location of the appropriate laboratory protocols.
  • Describe why certain agents are more likely to be used in a bioterrorist attack to create a public health emergency.
  • Identify the clinical specimens and indigenous areas where a laboratory may be more likely to encounter an agent of bioterrorism.
  • Recognize the presumptive identification procedures for the primary agents of bioterrorism, including safe handling, prior to referring to a higher level laboratory.

Course Outline

  • Development and Purpose of the Laboratory Response Network
      • Select Agents of Bioterrorism
      • Development of the Laboratory Response Network (LRN)
      • Purpose of the Laboratory Response Network (LRN)
      • Which of the following is not a Laboratory Response Network (LRN) function?
  • Definition and Role of a Sentinel Laboratory
      • Definition of a Sentinel Clinical Laboratory
      • Role of a Sentinel Laboratory
      • Responsibilities of a Sentinel Clinical Laboratory within the Laboratory Response Network (LRN)
      • True or False: Any laboratory that analyzes microbes or refers specimens potentially containing microbial agents or toxins is a sentinel laboratory.
      • Role of Reference and National Laboratories Within the Laboratory Response Network (LRN)
      • What is the role of a sentinel clinical laboratory within the Laboratory Response Network (LRN)?
  • Sentinel Clinical Laboratory Protocols
      • Protocols
      • Additional Resources
      • Where can sentinel clinical laboratory staff find the standardized testing protocols?
  • Public Health Threats Related to the Agents of Bioterrorism
      • Why Certain Agents are Used as Weapons of Mass Destruction (WMD)
      • True or False: Bacteria, viruses, or toxins that are chosen as weapons of mass destruction (WMD) by bioterrorists are:Easy to acquire and spread Hard ...
      • Categories of Biological Agents
      • Category A Agents
      • Category A Agents: Reasons Why They May be Used to Create Public Health Emergencies
      • Category B Agents
      • Category B Agents: Reasons Why They May be Used to Create Public Health Emergencies:
      • Category C Agents
      • Which of the agent categories is the easiest to spread, can cause significant harm, panic, and death, and carries the highest level of risk regarding ...
      • Tier 1 Biological Agents
      • Tier 1 biological agents are a subset of select agents and toxins that present the greatest risk of deliberate misuse, with significant potential for ...
  • Sentinel Laboratory Safety
      • Sentinel Laboratory Safety Protocols
      • Agent Biosafety Level (BSL) Requirements and Laboratory Exposure Risk
      • Automated Systems and Exposure Risk
      • True or False: A class II or higher biological safety cabinet (BSC) must be used when manipulating potential bioterrorism agents or if aerosols are li...
  • The Primary Agents of Bioterrorism
      • The Primary Agents of Bioterrorism
    • Bacillus anthracis
      • Bacillus anthracis: Likely Clinical Specimens and Gram Stain Morphology
      • Bacillus anthracis: Culture Characteristics, Colony Morphology, and Hallmark Features
      • Bacillus anthracis: Other Diagnostic Tests to Aid in Preliminary Identification
    • Yersinia pestis
      • Yersinia pestis: Likely Clinical Specimens and Gram Stain Morphology
      • Yersinia pestis: Culture Characteristics, Colony Morphology, and Hallmark Features
      • Yersinia pestis: Other Diagnostic Tests to Aid in Preliminary Identification
    • Francisella tularensis
      • Francisella tularensis: Likely Clinical Specimens and Gram Stain Morphology
      • Francisella tularensis: Culture Characteristics, Colony Morphology, and Hallmark Features
      • Francisella tularensis: Other Diagnostic Tests to Aid in Preliminary Identification
    • Brucella species
      • Brucella species: Likely Clinical Specimens and Gram Stain Morphology
      • Brucella species: Culture Characteristics, Colony Morphology, and Hallmark Features
      • Brucella species: Other Diagnostic Tests to Aid in Preliminary Identification
    • Burkholderia species
      • Burkholderia species: Likely Clinical Specimens and Gram Stain Morphology
      • Burkholderia species: Culture Characteristics, Colony Morphology, and Hallmark Features
      • Burkholderia species: Other Diagnostic Tests to Aid in Preliminary Identification
    • Practice Questions
      • Gram stains are performed on positive blood culture bottles. Match the organism that most closely resembles the description of the Gram stain morpholo...
      • Which of the following organisms display the characteristic "Medusa head" on sheep blood agar (SBA) after 18 hours of incubation at 35°C?
      • Which of the following is not a characteristic of Burkholderia pseudomallei?
  • Commercial Identification Systems and the Agents of Bioterrorism
      • Considerations When Using Automated Identification Systems
      • Commonly Misidentified Agents
      • True or False: Commercial identification systems can reliably identify the bioterrorism threat agents.
  • When Should a Sentinel Laboratory Refer an Isolate to a LRN Reference Laboratory?
      • Suspect Bacillus anthracis?
      • Suspect Yersinia pestis?
      • Suspect Francisella tularensis?
      • Suspect Brucella species?
      • Suspect Burkholderia species?
      • True or False: When following sentinel laboratory procedures and protocols, any isolate that cannot be ruled out as one of the select agents should be...
  • Indigenous Areas and Disease Encountered Outside of a Bioterrorism Event
      • Location Where Organisms Naturally Occur, Disease Produced, and Mode of Transmission
      • Location Where Organisms Naturally Occur, Disease Produced, and Mode of Transmission, continued:
      • Match the organism to the disease produced outside a bioterrorism event.
  • Other Biological Agents: Toxins and Viruses
      • Role of a Sentinel Laboratory Regarding Toxins and Viruses
      • Toxins
      • Viruses
      • True or False: A sentinel laboratory should not accept or process environmental or animal samples or culture clinical specimens for viruses or toxins ...
  • References
      • References

Additional Information

Level of instruction: Intermediate to advanced
Intended audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents..
Author information: 
Judi Bennett, BS, MLS(AMT) is a Product Sales Specialist for MediaLab. During her 25 year career as a medical technologist, she has served as a senior system analyst, laboratory manager, point-of-care coordinator, microbiology supervisor, and generalist. Judi has been a speaker at various LIS, AMT, and CLMA conferences and has been published in CLMA magazine. 
Reviewer information:
Dr. Julie Ann West is certified by the American Society for Clinical Pathology (ASCP) as a Medical Laboratory Scientist (MLS) and as a Specialist in Microbiology (SM). In addition, Dr. West has earned a PhD in Public Health, Infectious Disease Epidemiology and is certified in Public Health (CPH) by the National Board of Public Health Examiners. Dr. West is experienced as a technical specialist, safety officer, educator, and lead in the Veterans Administration Healthcare System, and has prior experience as an administrative laboratory director.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Course description: This course provides an overview of the Laboratory Response Network (LRN), including the role and purpose of the front-line clinical laboratories. The course also discusses the indigenous areas where select bioterrorism agents are naturally occurring and can be isolated outside of a public emergency event, the clinical specimens where organisms that are used as bioterrorism agents may be encountered, procedures for the presumptive identification of the primary agents of bioterrorism, and

This course is part of:
Compliance & CE
B.pseudo at 72h on choc
1B anthracis BA 2
Yersinia for question
Gram stain of Brucella melitensis coccobacilli. (12)
Y. pestis fried egg appearance on SBA at 72h image courtesy CDC