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Summary

Supplement F: Laboratory Guidance

Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2/3

NOTICE

Since 2004, there have not been any known cases of SARS reported anywhere in the world. The content in this Web site was developed for the 2003 SARS epidemic. But, some guidelines are still being used. Any new SARS updates will be posted on this Web site.

Goals

  • Provide the public health community with ready access to high-quality SARS-CoV diagnostics.
  • Ensure that SARS-CoV laboratory diagnostics are used safely and appropriately and that results are interpreted appropriately.

Key concepts

  • Efficient SARS-CoV diagnostic assays have been developed, but they frequently do not provide a definitive diagnosis early in illness.
  • Although the sensitivity of current assays probably cannot be improved significantly, changes in the type, quality, and processing of specimens may improve the ability to detect SARS-CoV infection in patients.
  • The majority of SARS-like illnesses will be caused by other respiratory pathogens; rapid and accurate diagnosis of these infections will make it easier to manage community anxiety about SARS-like illnesses.
  • The possibility of false-positive and false-negative results with both PCR and serologic assays should always be considered when interpreting results; clear strategies to minimize such possibilities and to confirm test results are essential.

Priority activities

  • Improve the ability to detect SARS-CoV infection by optimizing the selection and timing of specimen collection and processing.
  • Provide SARS-CoV assays for RT-PCR testing to Laboratory Response Network (LRN) laboratories and for serologic testing to state public health laboratories.
  • Distribute proficiency panels and questionnaires to participating laboratories to determine the ability of laboratories to provide valid SARS-CoV diagnostics.
  • Provide guidance on laboratory safety for SARS-CoV and other respiratory diagnostic testing and for possible SARS-CoV-containing specimens submitted for other tests.
  • Provide guidance for interpreting test results, taking into account the potential for false-positive and false-negative results and the availability of applicable clinical and epidemiologic information.
  • Identify surge capacity for laboratory testing in the event of a large SARS outbreak.

 

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