The MDH Laboratories Administration, in its role as an Advanced Level Reference Laboratory, provides resources to the Sentinel Laboratories through their Biosafety Outreach Program and the Office of Laboratory Emergency Preparedness and Response (OLEPR). In an effort to better serve the Sentinel Laboratories in the State of Maryland in their biosafety needs, we have established this webpage with appropriate links, resources, and contact information for the Lab Administration.
Sentinel Laboratories are the foundation of the LRN and play an important role in early detection of biological agents by providing routine diagnostic services, rule-out, and referral steps in their identification process.
Recognize – Rule-Out – Refer Biological Select Agents
As Sentinel Labs are the first line of defense in recognizing biological select agents, it is important that they have the required resources to follow LRN-established guidelines in what is called Recognize – Rule-Out – Refer. To test suspected biological select agents, the Sentinel Labs should follow Biothreat Agent Bench Cards for the Sentinel Laboratory, provided by the Association for Public Health Laboratories (APHL) and American Society of Microbiology (ASM). APHL has also created a poster for these Biothreat Agents, which serves as a quick reference for laboratory staff.
If a Sentinel Laboratory is unable to “rule-out” an isolate as a Select Agent, it must be “referred-in” to the MDH Laboratories Administration. The Isolate Submittal Policy: Clinical Isolates That Cannot Be Ruled-Out As Select Agents provides detailed instruction on isolate/specimen submission, packaging & shipping information, and contact details for the MDH Labs.
Prior to shipping the isolate/specimen, the Sentinel Labs MUST CONSULT the MDH LABORATORIES ADMINISTRATION
(Phone numbers are listed in the Isolate/Specimen Submittal Policy)
Packaging and Shipping Isolates/Specimens
For guidelines on packaging and shipping diagnostic and clinical specimens, infectious substances, and biological agents to the Reference Laboratory (MDH Laboratories Administration), please refer to the ASM Sentinel Laboratory Guidelines for Suspected Agents of Bioterrorism-Packaging and Shipping Diagnostic and Clinical Specimens located on the OLEPR webpage.
MDH is developing an informational guide for the best practices for shipping of potentially hazardous materials, which will be added in the Resource section at a later date. Recommended training for laboratorians is available through the CDC Packaging and Shipping Division 6.2 Materials.
Biosafety Outreach Program
Biological agents pose significant risk of exposure to the laboratorian/staff person performing the test, or the environment, if not handled or manipulated appropriately. Risk assessments for pathogens tested, and the procedures used in the testing, is highly recommended by all involved (Sentinel Labs, Reference Labs and National Labs) in LRN testing. APHL also provides guidance for performing risk assessments.
'MDH – Biosafety Risk Assessment SOP', used by the MDH Laboratories Administration, provides detailed information on the factors involved in risk assessment for biological agents and the process of addressing and mitigating risks associated with biological testing in Sentinel Labs.
'Procedure specific Risk Assessment' is a sample risk assessment that can be used as a template. The sample risk-assessment is specific to the ELISA-EIA assay routinely performed at the MDH Laboratories Administration. Additional sample risk-assessments for other procedures can be requested from the MDH Laboratories Administration.
The Biosafety Outreach Program can provide additional on-site training to assist your facility in addressing biosafety needs. Topics for this training include:
- General Biosafety (MDH Biosafety Training)
- Preparing Risk Assessments (links above)
- Hands-on Shipping demonstration
Web-based trainings recommended for Sentinel Labs: