TABLE 3.

Checklist items for sentinel laboratories^a

Issue or event	Action(s)	Resource(s)	Source(s)
Be prepared for an event	Have an institutional emergency response plan	Local institution (ASPR HPP)	http://www.phe.gov/PREPAREDNESS/PLANNING/HPP/Pages/default.aspx
	Have a specific bioterrorism response plan	Local institution
	Train staff on packaging and shipping	PHLs, APHL, ASM, CDC	DOT (http://www.phmsa.dot.gov/staticfiles/PHMSA/DownloadableFiles/Files/Transporting_Infectious_Substances_brochure.pdf), IATA (http://www.iata.org/training/courses/Pages/tcgp43.aspx), USDA (http://www.aphis.usda.gov/programs/ag_selectagent/)
	Train staff on ruling out select agents/BT organisms	PHL and/or DOT/IATA
	Train staff on select agents	PHL
	Train staff on communications, e.g., who to call	PHL
	Perform proficiency testing/take part in proficiency exercise	PHL or other entity to participate: CAP LPX, PHL	CAP survey catalogue 2014
	Maintain supply of materials for testing to rule out BT organisms
Know what to do if you suspect that you have a BT organism/select agent	Follow procedures for ruling out BT	ASM sentinel laboratory guidelines	ASM (http://www.asm.org/index.php/guidelines/sentinel-guidelines)
	Initiate and maintain communication with departmental/hospital leadership and infection control	Institutional policy
	Contact BT personnel at LRN reference laboratory	LRN reference laboratory (your local or state PHL)	Your local or state PHL
	Ship isolate to reference laboratory (public health laboratory)	LRN reference laboratory (your local or state PHL)	Your local or state PHL
	Document courrier transfer, e.g., institutional or commercial courrier tracking no.	Institutional courier, FedEx, UPS, etc.
	Secure all potential select agent(s) and residual samples	Code of Federal Regulations: 42 CFR Part 73	Select agents (http://www.selectagents.gov/Regulations.html)
	Document personnel (biosecurity) with access to potential select agent(s)	Code of Federal Regulations: 42 CFR Part 73	Select agents (http://www.selectagents.gov/Regulations.html)
	Document personnel (biosafety) who have worked with suspect select agent and those present in laboratory if exposure occurred	Biosafety risk assessment	BMBL, 5th ed. (American Biological Safety Association; http://www.cdc.gov/biosafety/publications/bmbl5/)
Know what to do if you have a confirmed select agent	Follow directions from PHL: destroy or transfer all isolates/specimens	LRN reference laboratory (your local or state PHL)	42 CFR Part 73
	Document identification of select agent(s) (APHIS/CDC Form 4)	42 CFR Part 73, LRN reference laboratory (your local or state PHL)	Select agents (http://www.selectagents.gov/Forms.html)
	Document disposition of select agent using APHIS/CDC Form 4 for destruction or APHIS/CDC Form 2 for transfer to a select agent-registered facility; confirm that select agents must not be transferred without prior authorization from CDC or USDA	42 CFR Part 73, LRN reference laboratory (your local or state PHL)	Select agents (http://www.selectagents.gov/Forms.html)
	Document laboratory exposures; work with PHL or state or local health department for postexposure prophylaxis	42 CFR Part 73, LRN reference laboratory (your local or state PHL)	Select agents (http://www.selectagents.gov/Forms.html)
Keep abreast of updates	Periodically review ASM website for updates on sentinel laboratory guidelines, APHL training on sentinel guideline updates	ASM, APHL, LRN reference laboratory (your local or state PHL)	ASM guidelines (http://www.asm.org/index.php/guidelines/sentinel-guidelines), APHL (http://www.aphl.org/aphlprograms/preparedness-and-response/Pages/default.aspx)

^aBMBL, Biosafety in Microbiological and Biomedical Laboratories; DOT, Department of Transportation; IATA, International Air Transport Association; LPX, Laboratory Preparedness Exercise; UPS, United Parcel Service.