A review of sentinel laboratory performance identification and notification of bioterrorism agents

Elizabeth A. Wagar, Michael J. Mitchell, Karen C. Carroll, Kathleen G. Beavis, Cathy Anne Petti, Robert Schlaberg, Bushra Yasin

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Context.-The anthrax incident of 2001 in the United States prompted the College of American Pathologists (CAP), the Association of Public Health Laboratories and the Centers for Disease Control and Prevention to develop exercises for Laboratory Response Network (LRN) sentinel laboratories. Objective.-To provide an overview of the results of the CAP bioterrorism Laboratory Preparedness Survey (LPS, 2007) and Laboratory Preparedness Exercise (LPX, 2008) and assist LRN sentinel laboratories and public health agencies in planning for bioterrorism events. Design.-Bioterrorism agents and nonbiothreat mimic organisms were provided in 2 mailings per year (2007 and 2008,20 total challenges). Within each mailing, 2 to 3 agents were category A orcategory B bioterrorism agents (total of 10 categoric challenges). Some category A/B isolates were modified/vaccine strains. The total number of laboratories participating in these exercises ranged from 1316 to 1381. Isolate characteristics used to identify the organisms were compiled along with theparticipantś reporting actions. Educational commentary was provided with each exercise. Results.-Acceptable identification responses were as follows: Bacillus anthracis, 90% (2007) and 99.9% (2008); Yersinia pestis, 83.8% (2007) and 87.6% (2008); and Francisella tularensis subsp Holarctica 86.6% (2007) and 91.6%(2008). The time interval between specimen receipt and notification of results to an LRN reference laboratory decreased from more than 10 days in 2007 to 3 or 4 days in 2008 for some challenges. Conclusions.-The bioterrorism challenge program (LPS, LPX) provides importantcomparative data from more than 1300 sentinel laboratories that can be usedby individual laboratories to evaluate their identification and LRN reporting performance.

Original languageEnglish (US)
Pages (from-to)1490-1503
Number of pages14
JournalArchives of Pathology and Laboratory Medicine
Issue number10
StatePublished - Oct 2010

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology


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