Summary

Supplement F: Laboratory Guidance

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

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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.