Severe Acute Respiratory Syndrome Interim Guidelines, March 25, 2003
Subsequent to the recent cases of Severe Acute Respiratory Syndrome (SARS) in Canada Footnote 1, we are providing you with the following interim biosafety advisory regarding the laboratory handling of clinical specimens associated with this syndrome.
Note : Precautions for the collection of clinical specimens and other infection control measures are currently being developed by Health Canada as a separate document.
Precautions for laboratories receiving and processing clinical specimens and tissue samples from suspected SARS casesFootnote 1:
- specimens may be processed for packaging and distribution to diagnostic laboratories for further testing in a Containment Level 2 laboratory Footnote2 using the additional operational practices as outlined below
- routine diagnostic testing (including routine viral culture) to rule out SARS may be performed in a Containment Level 2 laboratoryFootnote 2 using the additional operational practices as outlined below (such conventional procedures have not yet been shown to grow the agent)
(Note: laboratories performing routine diagnostics for atypical pneumonia should consider that they may inadvertently be working with specimens from a suspected SARS case)
- laboratory workers should wear protective clothing (e.g. protective solid-front gowns, gloves and N-95 respiratory protection) in accordance with the risk of exposure when handling specimens
- manipulations that may produce aerosols should be carried out in a certified biological safety cabinet
- centrifugation of respiratory and tissue specimens should be carried out using sealed centrifuge cups or rotors that are unloaded in a biological safety cabinet
Precautions for laboratories handling clinical specimens from known probable SARS cases Footnote 1 (ie. samples from patients meeting case definition) for characterization of the agent:
- specimens may be processed for packaging and distribution to laboratories for further testing in a Containment Level 2 laboratory Footnote 2 using the additional operational practices as outlined above
- culture-based attempts to characterize the agent and manipulations involving growth of the agent recovered in cultures of SARS specimens and tissues should be in a Containment Level 3 laboratory Footnote 2 using Containment Level 3 operational practices Footnote 2
- inoculation of animals for potential recovery of the agent should be performed in a Containment Level 3 facility Footnote 2 using Containment Level 3 operational practices Footnote 2
- PCR testing of extracted genetic material may be performed in a Containment Level 2 laboratory Footnote 2
Transportation of clinical specimens:
- Packaging, shipping and transport of specimens must comply with the requirements of the Transportation of Dangerous Goods Regulations, Transport CanadaFootnote3 and the Dangerous Goods Regulations, International Air Transport AssociationFootnote 4.
Further biosafety information may be obtained from the Office of Laboratory Security, Public Health Agency of Canada at (613) 957-1779, fax (613) 941-0596.
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