H1N1 Influenza Virus Biosafety Guidelines for Laboratory Workers

May 13, 2009 7:30 PM ET

Interim Biosafety Guidance for All Individuals Working with Clinical Specimens or Isolates from Patients with Suspected Novel Influenza A (H1N1) Virus Infection

These interim recommendations are subject to change as more information becomes available.

This guidance is for all individuals who may be processing or performing diagnostic testing on clinical specimens from patients with suspected novel influenza A (H1N1) virus infection, or performing viral isolation. 

Rapid Tests (performed in a variety of laboratory and non-laboratory settings)

Many FDA-cleared rapid tests for influenza are available, involving different methods and processing steps and each requiring assessment of the risks for generation of aerosols or contact with infectious material. Most rapid test methods only involve simple steps such as inserting a swab into medium or pipetting specimens and reagents. The appropriate personal protective equipment (PPE) for these types of rapid tests include:  

• laboratory coat 
• gloves
• eye protection
• facemask (surgical, dental, medical procedure, isolation, or laser masks)

For other rapid tests involving more complex test methods that might include steps (e.g., vortexing) that could generate aerosols, additional respiratory protection such as an N95 respirator is needed.

Clinical Laboratory Testing (Laboratory Diagnostic Work)

Diagnostic laboratory work on clinical samples from patients who are suspected cases of novel influenza A (H1N1) virus infection should be conducted in a BSL2 laboratory. All sample manipulations with the potential for creating an aerosol should be done inside a biosafety cabinet (BSC) that is certified annually.  Personal protective equipment should include.

• Gloves
• Laboratory coat
• Eye protection

Viral isolation

Growth of virus in cell culture or embryonated eggs from human clinical specimens that are suspected cases of novel influenza A (H1N1) virus infection should be performed in a BSL2 laboratory with BSL3 practices. All viral manipulations should be done inside a BSC that is certified annually.
Personal protective equipment may include the following based on a site specific risk assessment:

• Respiratory protection – fit-tested N95 respirator or higher level of protection. 
• Shoe covers
• Closed-front gown
• Double gloves
• Eye protection

Laboratory waste

All waste disposal procedures should be followed as outlined in your facility standard laboratory operating procedures.  Steam autoclaving is the preferred method for all decontamination processes.  Alternative methods may be considered based on applicable local, state and federal regulations, as well as on a site specific risk assessment.

Appropriate disinfectants

Several chemical disinfectants, including chlorine, alcohols, peroxygen, detergents, iodophors, quaternary ammonium and phenolic compounds, are effective against human influenza viruses if used at the correct concentration for the appropriate contact time as specified in the manufacturer’s recommendations.

Work surfaces and equipment should be decontaminated as soon as possible after specimens are processed. Studies have shown that influenza viruses can survive on environmental surfaces and can infect a person for up to 2–8 hours after being deposited on the surface.  More information on disinfection and sterilization is provided in Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition Appendix B. 

Occupational Health

All personnel should self monitor for fever and other symptoms such as cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Any influenza-like illness should be reported to your supervisor immediately.

Personnel who have had an occupational exposure to clinical material or live virus from a confirmed case of novel influenza A (H1N1) should immediately report to their supervisor.  Antiviral chemoprophylaxis is available and should be considered.  For additional information on antiviral treatment visit: Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts

For additional information: Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition