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High risk samples

It is important to identify high risk specimens because extra precautions are needed; these specimens may pose an additional risk to ward staff, porters and laboratory staff.

A high risk specimen is one from a patient known to have been infected with or suspected to be infected with:

  • Hepatitis B or C
  • HIV
  • HTLV-1
  • Creutzfeldt-Jacob disease (CJD)
  • Viral haemorrhagic fever (e.g. Ebola)
  • Other hazardous pathogens such as TB, Typhoid and Brucella

This includes all febrile travellers returning from areas high risk for Typhoid and Brucella.

Note: MRSA colonisation/infection is not high risk.

How to handle high risk specimens

Each specimen must be labelled 'DANGER OF INFECTION' and sealed in its own separate plastic bag.

The request card or tab at the top of the specimen bag should also state 'DANGER OF INFECTION'.

The request card should not be sealed in the same pocket as the specimen.

Precautions for a patient with risk factors for viral haemorrhagic fever

If viral haemorrhagic fever (e.g. Ebola) is suspected, the case should be urgently discussed with the

Infectious Diseases Consultant on call (via Switchboard); or

Infectious Diseases SpR on

  • Bleep 5039 (during working hours); or
  • via Switchboard (out of hours).

Samples from these patients require individual packaging and transportation based on a risk assessment that will be made on a case-by-case basis by the Infectious Diseases team in collaboration with the Microbiology Laboratory and Public Health England.

Samples should only be handled by these teams.

If you are unsure of your patient's risk status, please discuss with the Microbiology SpR.