Packaging and Shipping of COVID-19 Specimens

Thank you to Hanna Allie and Public Health Laboratory of East Texas for permitting use of this presentation

Purpose

To provide guidance on proper submission of COVID-19 samples to the Nebraska Public Health Laboratory (NPHL)

To provide a quick reference in regards to packaging and shipping of COVID-19 Samples

CoVID Testing at NPHL

Testing will be performed at the NPHL by the Molecular Team. Laboratory specific questions, coordination and updates should be directed to 402.559.3590, the 24/7 phone 402.888.5588 or by emailing nphl@unmc.edu

Before sending any samples for testing, please call your local health department to coordinate testing. http://dhhs.ne.gov/Pages/Local-Health-Departments.aspx

Testing is available free of charge if NPHL criteria are met

Specimen Collection

CDC recommended specimen type is a Nasopharyngeal swab. Nasal or nasal mid-turbinate swabs are now acceptable along with oropharyngeal. Send a single specimen to maximize resources.

Specimen Collection

Place swabs immediately into sterile tubes containing 2-3 ml of viral transport media (VTM)

Bacterial transport media CANNOT be used as an alternative

Universal (UTM) transport media may be used if there is no VTM

Specimen Identification

All specimens must be marked with the patient’s first and last name as it appears on the paperwork along with a secondary unique identifier (i.e., date of birth or medical record number)

Samples that are not labelled properly WILL NOT be tested

After Collection

Once collected, specimens should be stored at 2°to 8°C

Specimens must be shipped with cold packs and received within 72 hours of collection

If they can not be shipped/received within that time frame, they must be frozen at -70ºC and then subsequently shipped on dry ice to keep the specimen frozen

Paperwork Needed

Paperwork Needed

Completed NUlirt Submission (Electronic Data Entry)

* Patient information must match what is on the sample

To be found at:http://nphl.org/phlip.cfm

Order Supplies Needed

ICS 213rr Form

Found here: https://www.dshs.texas.gov/co

ronavirus/public-health.aspx

Submitted to local health department for approval BEFORE submitting specimen

Paperwork Needed *IF shipping by air!

Air WaybillMust have:

Text: “UN3373 Biological Substance Category B

Proper shipping name

Name and number of responsible official

The number of packages

Class or division

Net quantity per package

Dry Ice, if includedPictures found at https://www.ehs.washington.edu/system/files/resources/09_PI650_inst.pdfand https://intranet.birmingham.ac.uk/hr/documents/public/hsu/hsuguidance/Guidance-Note-5-Transport.pdf

Packaging

Specimens must be packaged, shipped, and transported in accordance with the proper shipping guidelines for dangerous goods as:

Category B

Materials Needed

Materials Needed

Rigid fiberboard box with Styrofoam insulation

Pass a drop test from the height of 4 feet

Materials Needed

Cold Packs or Dry Ice

Pictures found at https://www.health.state.mn.us/diseases/idlab/labep/hazmat/collectionpackship.pdf

Materials Needed

Secondary container

May be a box, container, or double-zipped bag: leak-proof or sift-proof. Able to withstand a series of 4 foot drop tests

Samples placed in rigid containers may need to be fortified with packaging material to keep it from shifting

Materials Needed

Absorbent material

Sufficient to absorb entire contents if necessary

Materials Needed

Insulating Material

-bubble wrap; wrapping paper

*IF needed to keep the sample from shifting

Packing Order

Specimen and absorbent material into secondary container (with packing material if needed)

Secondary container into Styrofoam fiberboard box with ice packs (or dry ice) and packing material if needed

All paperwork between secondary container (or Styrofoam container) and fiberboard box, keeping dry

Pictures found at https://www.royalmail.com/sites/default/files/Guidance-Document-Infectious-Substances-171012.pdf

Ice packs or dry ice

Labeling

Name, facility name, complete shipping address and telephone number of shipper

Name, facility name, complete shipping address and telephone number of recipient

Name and 24 hr telephone number of person responsible for shipment

Labeling

Class 6.2: UN 3373 diamond-on-point label in contrasting color from box ANDlabeling indicating Biological Substance, Category B placed nearby

UN3373Biological

Substance, Category B

At least 2”by 2”

+

Labeling

Orientation Label

Ground Shipping Form

NPHL Category B

Use when shipping by NPHL Ground courier only

Complete FULL name and address

Tape to top of box

Keep copy for your records –attach copy of batch list

Ice packs

Pictures found at https://www.ehs.washington.edu/system/files/resources/09_PI650_inst.pdfand https://www.serpac.it/en/insights/pratical-information/dangerous-goods/examples-of-labelling-and-marking/

Final Packaging ExampleWith Ice Packs

Labeling for Dry Ice ONLY

IF sending in Dry Ice

Class 9 with UN 1845, amount label (convert to kg: divide pounds by 2)

Final Packaging ExampleWith Dry Ice

Pictures found at https://www.ehs.washington.edu/system/files/resources/09_PI650_inst.pdfand https://www.serpac.it/en/insights/pratical-information/dangerous-goods/examples-of-labelling-and-marking/

Checklist for Category B Shipping

NPHL Category B Shipping Form, completed with:

Shipper name and address (City, State, Zip)

Consignee name and address (City, State, Zip)

Name and Phone of person responsible (24 hour)

Signature at bottom of Form

“Biological Substance, Category B”

UN3373 diamond-on-point label, in contrasting color from box, must be placed near the “Biological Substance, Category B” label

Dry Ice label with Class 9 diamond-on-point, if specimen already frozen

Orientation arrows

NUlirt Batch List (between secondary and outer packaging)

Waybill, if shipped by FedEx or UPS - must state “Biological Substance Category B, UN3373” and Dry Ice (if included)

Contact us

Nebraska Public Health Laboratory

The University of Nebraska Medical Center

985900 Nebraska Medical Center

Omaha, NE 68198-5900

phone 402.559.9444 (main)

phone 903-559.3590 (shipping)

fax 402.559.7799

24/7 on call phone 402.888.5588