title: Evaluation of standardized sample collection, packaging, and decontamination procedures to assess cross-contamination potential during Bacillus anthracis incident response operations.
abstract: Sample collection procedures and primary receptacle (sample container and bag) decontamination methods should prevent contaminant transfer between contaminated and non-contaminated surfaces and areas during bio-incident operations. Cross-contamination of personnel, equipment, or sample containers may result in the exfiltration of biological agent from the exclusion (hot) zone and have unintended negative consequences on response resources, activities and outcomes. The current study was designed to: (1) evaluate currently recommended sample collection and packaging procedures to identify procedural steps that may increase the likelihood of spore exfiltration or contaminant transfer; (2) evaluate the efficacy of currently recommended primary receptacle decontamination procedures; and (3) evaluate the efficacy of outer packaging decontamination methods. Wet- and dry-deposited fluorescent tracer powder was used in contaminant transfer tests to qualitatively evaluate the currently-recommended sample collection procedures. Bacillus atrophaeus spores, a surrogate for Bacillus anthracis, were used to evaluate the efficacy of spray- and wipe-based decontamination procedures. Both decontamination procedures were quantitatively evaluated on three types of sample packaging materials (corrugated fiberboard, polystyrene foam, and polyethylene plastic), and two contamination mechanisms (wet or dry inoculums). Contaminant transfer results suggested that size-appropriate gloves should be worn by personnel, templates should not be taped to or removed from surfaces, and primary receptacles should be selected carefully. The decontamination tests indicated that wipe-based decontamination procedures may be more effective than spray-based procedures; efficacy was not influenced by material type but was affected by the inoculation method. Incomplete surface decontamination was observed in all tests with dry inoculums. This study provides a foundation for optimizing current B. anthracis response procedures to minimize contaminant exfiltration.
authors.affiliation: a US Environmental Protection Agency, National Homeland Security Research Center , Research Triangle Park , North Carolina.
authors.forename: M Worth
authors.initials: MW
authors.lastname: Calfee
authors.affiliation: b Oak Ridge Institute for Science and Education , Research Triangle Park , North Carolina.
authors.forename: Jenia
authors.initials: J
authors.lastname: Tufts
authors.affiliation: b Oak Ridge Institute for Science and Education , Research Triangle Park , North Carolina.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Meyer
authors.affiliation: c Booz Allen Hamilton , Research Triangle Park , North Carolina.
authors.forename: Katrina
authors.initials: K
authors.lastname: McConkey
authors.affiliation: d US Environmental Protection Agency, CBRN Consequence Management Advisory Division , Research Triangle Park , North Carolina.
authors.forename: Leroy
authors.initials: L
authors.lastname: Mickelsen
authors.affiliation: e Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion , Atlanta , Georgia.
authors.forename: Laura
authors.initials: L
authors.lastname: Rose
authors.affiliation: f Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Emergency Preparedness and Response Office , Atlanta , Georgia.
authors.forename: Chad
authors.initials: C
authors.lastname: Dowell
authors.affiliation: f Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Emergency Preparedness and Response Office , Atlanta , Georgia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Delaney
authors.affiliation: f Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Emergency Preparedness and Response Office , Atlanta , Georgia.
authors.forename: Angela
authors.initials: A
authors.lastname: Weber
authors.affiliation: g Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne and Waterborne Diseases , Atlanta , Georgia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morse
authors.affiliation: h Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Preparedness and Emerging Infections , Atlanta , Georgia.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Chaitram
authors.affiliation: a US Environmental Protection Agency, National Homeland Security Research Center , Research Triangle Park , North Carolina.
authors.forename: Marshall
authors.initials: M
authors.lastname: Gray
mesh_terms: D001408:Bacillus anthracis; D003264:Containment of Biohazards / Q000295:instrumentation* / Q000379:methods*; D003666:Decontamination / Q000379:methods*; D017575:Gloves, Protective; D008422:Materials Testing; D013048:Specimen Handling / Q000379:methods*; D013171:Spores, Bacterial
keywords: Bacillus anthracis; cross-contamination; decontamination; sampling