Thinking outside the box on Ebola testing

Professionals in laboratories across the UNMC campus are on the front line in helping physicians get the information they need to treat Ebola patients.

Pete Iwen, Ph.D., director of the Nebraska Public Health Laboratory and professor of pathology and microbiology, and colleagues, recently published an editorial in a top journal, the American Journal of Clinical Pathology. The paper provides guidance on the essential list of laboratory tests needed to support a patient infected with Ebola virus — and how to perform the tests safely.

This required professionals to think outside the box.

“We had to brainstorm to come up with alternatives,” said Dr. Iwen, first author of the editorial. “Some tests were requested that couldn’t be done safely with equipment available, so alternatives were developed. We had one goal in mind throughout — to provide optimal testing and keep laboratory employees safe.”

The template helps health professionals define what tests may be needed and how they can be run safely.

They turned to the journal so they could share the information with many laboratories across the country seeking guidance.

“Normally it takes months to get a paper approved through the peer review process, additional months to get the galley proofs back with editing changes and potentially more months before it’s published,” Dr. Iwen said. “It took the editor of the journal about 18 hours to get the paper approved, which in my experience is unheard of. It was available electronically in about 10 days. I’ve never had that happen.”

Dr. Iwen said dealing with the Ebola virus in recent months has been like a whirlwind.

“We were prepared for the possibility that something like this could happen, but we were thinking more along the lines of pandemic flu,” Dr. Iwen said. “The technologists who work in the clinical laboratories on campus are a great group of professionals.”

The Nebraska Public Health Laboratory, the state’s testing lab located at UNMC, became the first state public health laboratory in the U.S. to test specimens that were positive for the Ebola virus. It also was the first lab to commercially ship these specimens within the U.S.

“When we called couriers, the phone went silent, followed by, ‘You want to do what?'” Dr. Iwen said. “We had to educate the shippers on how they could handle our specimens while meeting federal guidelines. We even had the airlines calling us asking, ‘What’s in the box?'”