"Danger of Infection" labels must be used for specimens which are known or suspected to contain a hazard group 3 or 4 pathogen (see below).
It is the responsibility of the person who requests the examination of the specimen to ensure that both the forms and the container are correctly labelled with a "Danger of Infection" sticker.
Each request form must give sufficient clinical information to enable laboratory staff to know what special precautions are necessary in the laboratory. In the Trust, special arrangements currently apply for specimens from patients with known or suspected HIV infections/AIDS. Please refer to Code of Practice for HIV/AIDS.
Each specimen must be placed into an appropriate leak-proof container and inserted into a self-sealing plastic bag (one specimen per bag). Care must be taken to ensure that neither the container nor the bag are externally contaminated. The accompanying request form must be placed into the pocket of the plastic bag and not inside the bag with the specimen, or stapled or pinned to it.
A supply of appropriate containers, bags and labels may be obtained from the Pathology Laboratories at the Royal Berkshire.
Hazard Group 4 pathogens are viruses which are rarely encountered in the West Berkshire area. They include the "haemorrhagic fever viruses" e.g. Lassa, Mopeia, Marburg, Ebola, Congo-Crimean, Bolivian, Argentine and Omsk haemorrhagic fever viruses as well as the causative gents of Kyasanur Forest disease, Russian Spring-Summer encephalitis and related viruses.
Patients suspected of having an illness caused by any of these viruses must be sent to an appropriate high security isolation hospital (e.g. The Royal Free Hospital, London) and all specimens from such patients sent to a laboratory designated for handling this material.
N.B. For patients with suspected viral haemorrhagic fever, please refer to Control of Infection Code of Practice No. 3 - "Procedure in respect of Suspected Lassa, Marburg and other Acute Viral Haemorrhagic Fevers".
This group contains a range of bacteria viruses, fungi and parasites including the causative organisms of the following diseases:
However, in practice, the infections most likely to be encountered in the West Berkshire area are Hepatitis B, HIV, Psittacosis, Typhoid/Paratyphoid, Toxoplasmosis and Tuberculosis. Although they are included in Hazard Group 3, blood samples from patients with suspected Toxoplasmosis and Psittacosis do not constitute an infection risk.
It should be remembered that patients with these and other infectious diseases may continue to be infectious after death. It is, therefore, essential to warn those who will be responsible for the disposal of the body of this possibility i.e. Porters, Post-mortem technicians and Pathologists, following the appropriate procedure.
Clinical suspicion of an infection must be mentioned when completing the request form for a post-mortem examination.