Conference organized by:

Center for Biosecurity of UPMC

World Health Organization Communicable Disease Surveillance and Response Office

Conference sponsored by:

The Nuclear Threat Initiative

Emerging Infections: How Can Laboratories Prepare?
Presenter: Dr. Wilina Lim

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In 1997 Hong Kong experienced the first human outbreak of H5N1, and in 2003 it was hit with SARS. These outbreaks imposed considerable strain on Hong Kong's public health laboratories. Dr. Lim, a consulting medical microbiologist from Hong Kong's Department of Health, recounted her experience and the lessons learned.

Both outbreaks posed the same major challenges�not enough manpower and a high volume of samples to be processed. In each instance, workload increased four-fold, and highly trained and specialized personnel were required to work long hours for prolonged periods. To help with the load, they borrowed staff from other labs and employed junior technicians and workmen to assist with simple lab work. Safety was also an issue, since prior to these events Hong Kong had no BSL3 lab. Other challenges included lack of space, lack of equipment, difficulty in transferring specimens, and communication. As a result, a new lab with new equipment was built, staff training was improved, and safety and security practices were enhanced.

Lim also discussed findings related to SARS-CoV in a laboratory setting, noting that the highest concentration of virus shedding they found was in stool, and that it was relatively lower in nasopharygeal secretions and serum. SARS-CoV at high concentration was stable in the environment and was more stable on non-absorbent surfaces such as disposable gowns.

She offered the following as lessons learned from these experiences:

• SARS-CoV was easily inactivated by disinfectants and detergents.
• A preparedness plan was needed.
• Continuous personnel training was needed.
• Laboratory quality assurance was essential.
• Lab safety and security needed to be enhanced.
• An enhanced information system was needed.
• There must be a consensus between labs on testing protocols.
• Labs assessed to have the capacity must be recruited.
• One must network with local and international partners.

- Summary by Eric Toner, M.D.

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