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.

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Continuing Education Credits

P.A.C.E.® Contact Hours: 1.5 hour(s)
Florida Board of Clinical Laboratory Science CE - General (Microbiology/Mycology/Parasitology): 1.5 hour(s)

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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