Preliminary Identification of the Primary Select Agents of Bioterrorism

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Author: Judi Bennett, MT, BSM
Reviewer: Laura Stowers, MBA, MT(ASCP)

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.
  • Understand 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 function of the Laboratory Response Network (LRN)?
  • 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)
      • Any laboratory that analyzes microbes or refers specimens that have the potential to contain 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)
      • Bacteria, viruses, or toxins that are chosen as weapons of mass destruction (WMD) by bioterrorists are:Easy to acquire and spread Hard to detect and d...
      • 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, has the ability to cause major harm, panic, and death, and carries the highest level of risk w...
  • Sentinel Laboratory Safety
      • Sentinel Laboratory Safety Protocols
      • Agent Biosafety Level (BSL) Requirements and Laboratory Exposure Risk
      • Automated Systems and Exposure Risk
      • A class II, or higher, biological safety cabinet (BSC) must be used when manipulating potential bioterrorism agents or if aerosols are likely.
  • Likely Clinical Specimens and Gram Stain Morphology of the Primary Agents of Bioterrorism
      • Bacillus anthracis
      • Yersinia pestis
      • Francisella tularensis
      • Brucella species
      • Burkholderia species
      • Gram stains are performed on positive blood culture bottles. Match the organism that MOST closely resembles the description of the Gram stain morpholo...
  • Culture Characteristics, Colony Morphology, and Hallmark Features of the Primary Agents of Bioterrorism
      • Bacillus anthracis
      • Yersinia pestis
      • Francisella tularensis
      • Brucella species
      • Burkholderia species
      • Which of the following organisms display the characteristic "Medusa head" on sheep blood agar (SBA) after 18 hours of incubation at 35°C?
  • Other Diagnostic Tests to Aid in the Preliminary Identification of the Primary Agents of Bioterrorism
      • Bacillus anthracis
      • Yersinia pestis
      • Francisella tularensis
      • Brucella species
      • Burkholderia species
      • 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
      • Commercial identification systems can reliably identify the bioterrorism threat agents.
  • When Should a Sentinel Laboratory Refer an Isolate to a LRN Reference Laboratory?
      • Bacillus anthracis
      • Yersinia pestis
      • Francisella tularensis
      • Brucella species
      • Burkholderia species
      • When following sentinel laboratory procedures and protocols, any isolate that cannot be ruled out as one of the select agents should be immediately re...
  • 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
      • A sentinel laboratory should NOT accept or process environmental or animal samples or culture clinical specimens for viruses or toxins that are potent...
  • References
      • References

Additional Information

Level of instruction: Intermediate to advanced
 
Intended audience: Medical laboratory scientists, medical technologists, and technicians, working in the microbiology section of sentinel laboratories. This course is also appropriate for clinical laboratory science students and pathology residents.
 
Author information: Judi Bennett BSM, MT is a Program Director for MediaLab, Inc. 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: Laura Stowers MBA, MT(ASCP) received her BS in medical technology from the Medical College of Georgia.  She went on to receive her Masters of Business Administration from the University of Georgia.  She began working as a medical technologist as a generalist at Gwinnett Medical Center in Lawrenceville, GA and is currently the Supervisor of Microbiology at Gwinnett Medical Center.
 
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 the associated safety implications.

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B.pseudo at 72h on choc
1B anthracis BA 2
Yersinia for question
Brucella species image courtesy of CDC
Y. pestis