Ebola in the Headlines, Lab Safety on the Line

Every time headlines begin mentioning Ebola outbreaks in Africa, many laboratory professionals in the United States have the same reaction: “That’s terrible, but it’s far away.” The recent outbreak activity in the Democratic Republic of Congo should remind us that infectious diseases do not respect borders, flight schedules, or comfort zones. The question for U.S. laboratories is not whether Ebola is likely to arrive at your facility tomorrow. The real question is: if a suspected patient did arrive today, would your laboratory be prepared?
Preparedness in laboratory safety is never about panic. It is about planning, it is about understanding risk before an event occurs so that employees, patients, and the community remain protected. During the height of the COVID pandemic, many laboratories learned difficult lessons about communication failures, PPE shortages, unclear procedures, and inconsistent safety expectations. Those lessons should not be forgotten when discussing high-consequence pathogens like Ebola virus disease.
The College of American Pathologists (CAP) addresses this directly in Laboratory General checklist item GEN.74050, which states that laboratories must safely handle and process specimens suspected of containing highly infectious pathogens. The checklist note goes even further, discussing issues such as tightly sealed containers, spill prevention, gloves, respirator protection, vaccinations, and the hazards of unsafe laboratory behaviors. It specifically states that laboratories must incorporate national, federal, state, and local guidance regarding pathogens such as Ebola, MERS, SARS, avian influenza, and other highly infectious agents. This checklist item is not just a regulatory requirement; it is a warning.
Many laboratories assume they would “figure it out” if a suspected Ebola specimen arrived in the department. That approach is dangerous. High-risk pathogens require pre-planning, competency assessment, communication, and realistic expectations about what a laboratory can safely perform. Not every laboratory should accept every specimen. That is an important statement, and laboratory leaders need to feel comfortable saying it.
If a facility lacks appropriate PPE, engineering controls, training, or procedures for handling highly infectious specimens, then testing may need to be limited or redirected. The laboratory should work closely with infection prevention, emergency department leadership, medical directors, and administration to determine exactly what testing can safely occur on-site and what specimens require referral to designated laboratories such as public health or CDC labs.
Communication is critical. Emergency departments and nursing units need to understand laboratory capabilities before a patient arrives. Too often, laboratorians are the last people informed when a patient is under investigation for a dangerous infectious disease. By then, specimens may already be collected and sent through a pneumatic tube system or hand-carried without proper precautions. That is dangerous for laboratorians, and it cannot happen.
Every laboratory should have a clearly defined communication pathway for suspected high-risk infectious diseases. Who gets notified? Who approves testing? What PPE is required? Where are specimens delivered? Which analyzer(s) can safely be used? What disinfectants are effective? These questions should never be answered during the event itself.
Packing and shipping practices are another area where laboratories can quickly become vulnerable. Ebola specimens intended for referral testing fall under strict Department of Transportation and International Air Transport Association regulations. Employees responsible for packaging and shipping infectious substances must receive proper certification training. This is not optional. Improperly packaged infectious materials place couriers, airline personnel, receiving laboratories, and the public at risk.
Laboratories also need to evaluate physical space and workflow. Can testing occur in a segregated area? Is there access to a certified biological safety cabinet? Are spill kits available? Are employees trained to respond to an exposure event? Do staff know how to properly don and doff specialized PPE? One of the most dangerous moments during any high-risk pathogen event is PPE removal. Training videos are not enough. Employees need hands-on practice.
There is another important issue laboratories must address honestly: fear. Ebola creates anxiety among healthcare workers because of its severity and fatality rate. Leaders should never dismiss those concerns. Instead, they should provide facts, training, transparency, and support. Employees who understand the risks and the protective measures in place are far more likely to respond safely and professionally.
Preparedness does not mean turning every laboratory into a biocontainment facility. It means knowing your risks, understanding your limitations, communicating clearly, and building procedures before an emergency occurs. The laboratories that struggle most during infectious disease events are usually not the ones lacking intelligence or dedication. They are the ones that assumed “someone else” was handling preparedness.
Ebola may currently seem geographically distant, but laboratory safety leaders should understand something important: preparedness has no expiration date. Dangerous pathogens continue to emerge, evolve, and travel. The laboratories that will respond best are the ones preparing now, before the headlines become local. Because when it comes to highly infectious pathogens, safety is never accidental. It is planned.