A Little Education Goes a Long Way
“Staff education is one of the weakest links in responding to a confirmed or suspected bioterrorism event,” said Snyder, explaining that anthrax and other potential biowarfare agents aren’t usually seen in the clinical setting. “Most microbiology technologists—along with most physicians—have never encountered these organisms or the diseases they produce, and likely have little training or knowledge of the organism characteristics including microscopic and appearance in culture.”

“We were surprised by the number of questions asked of us by physicians, administrators, and the general public,” admitted Mary Ansara, MT, Manager of the Microbiology and Molecular Laboratories for Alliance Laboratory Systems, Cincinnati, Ohio. “A lot of people were looking to the Alliance lab to be able to respond to their needs and answer questions.” Even before September 11 and the recent anthrax incidents, Ansara was attending meetings of a Health Council of Cincinnati working group examining biowarfare preparedness. Looking for ways to apply some of these lessons in her own facility, she developed an in-service training program for staffers in the microbiology lab. These sessions included educational videotapes, videoconferences, technical documents, and professional guidelines on biological pathogens, and they piqued interest in other departments. “Technologists should be familiar with techniques to identify potential biowarfare agents even though these organisms aren’t often seen in a clinical setting,” she explained. “I think the events of September 11 and the anthrax cases should prompt all laboratorians to refresh their knowledge in this area.”

According to Ansara, the latest anthrax cases had an obvious impact in the local community, including health care workers, and created episodes that illustrated how little people understand about the disease. “On one occasion in our lab, a properly sealed and labeled specimen came in from a patient with possible anthrax exposure. People started putting on masks when they came to the microbiology lab, and they didn’t come in any further than they absolutely had to. There was definitely some apprehension, and even fear, among some of the staff members.” In fact, current guidelines suggest that samples from patients with suspected anthrax exposure be treated as a biological hazard, no different from any other blood or tissue sample.

Vincent DeRisio, DO, Vice President and Medical Director at Alliance Laboratory Services, gave his own example of why the lab must make sure they possess the necessary education and planning to act in a bioterrorism emergency. “In early October, we got a call from a physician client whose staff had opened a letter containing a white powder, which was by that time on the floor, on the furniture, and perhaps had even come in contact with a nurse and a patient. This physician wanted to know what to do. I guess the first thing for laboratorians to note here is that this medical professional chose to call us, a laboratory service, which goes to show that the medical community will be looking to us for expertise in a situation like this. At the time, though, your first thought is ‘That’s a good question. What exactly are these folks supposed to do?’”

Fortunately, Ansara’s microbiology lab was prepared to answer these questions, and the Alliance staffers were able to direct the physician to the appropriate authorities and emergency services. As the anthrax furor continued to spread, other inquiries from physicians involved screening for anthrax among populations with varying degrees of risk, while some sent inappropriate nasal swab samples without bothering to find out about sample requirements. “It’s this kind of incident that drives your policy,” said DeRisio. “It’s sobering to think that there is so much information out there, but it just isn’t being communicated effectively to the groups that need it most.”