FROM THE BENCH
from page 13
non-susceptible isolates are shared with
CDC for whole genome sequencing and
phylogenetic analyses.
Future Quality Improvement
initiatives
MHDL is actively improving and
enhancing current GC surveillance by
offering patient options for specimen selfcollection,
conducting quality assurance
reviews to reduce wait times in clinics,
and culture-independent molecular
analyses. Advanced molecular projects
with CDC will aid in understanding strain
relatedness, identification of resistance
markers, virulence markers, outbreaks,
and cluster analysis. In partnership with
local, state, and CDC partners, real-time
detection of GC resistance, and use of
molecular methods for strain typing
will contribute to reducing community
transmission, and the need for evidencebased
modifications to existing antibiotic
treatment guidelines and alternate
treatment regimens. •
References
1. L. Amsterdam, and S. Bhattacharyya. 2020.
Strengthening United States Response to Resistant
Gonorrhea in Wisconsin. APHL Summer Lab Matters
2. Papp, J.R., et al. (2016). Recovery of Neisseria
gonorrhoeae from 4 commercially available transport
systems. Diagn Microbiol Infect Dis. http://dx.doi.
org/10.1016/jdiagmicrobio.2016.06.019
3. Public Health Partnership in Response to Resistant
Gonorrhea: Role of Laboratories in Enhancing Local
Capacity Towards Improved Gonococcal Surveillance.
2019. M. Khubbar, R. Gomez, J. Weiner, K. Keuler,
N. Leigh, T. Dasu, T. Maher, J. Katrichis, J. Dalby, P.
Hunter, J. Pfister, D. Shrestha, L. Amsterdam, and S.
Bhattacharyya
4. CDC. Abstract submitted for 2020 STD Conference.
Extragenital Cultures from Women and Men with
Opposite-Sex and Same-Sex Sexual Exposure Are
Important for Antibiotic-Resistant Gonorrhea (ARGC)
Surveillance. J. Pfister, L. Amsterdam, D. Shrestha, C.
Steward, M. Khubbar, R. Gomez2, J. Weiner, T. Dasu, J.
Dalby, H. Hermus, J. Katrichis, S. Bhattacharyya.
Acknowledgements:
• STD and Non-STD Grant Partners, Milwaukee
jurisdiction
• WI DPH Program Staff
• MHD Clinic and Laboratory Program Staff
• CDC Division of STD Prevention SURRG Program Staff
• CDC ELC Grant # CK19-1904
Decontamination and Reuse
of N95 Masks During Times
of Shortage
By Mohammad Karim, PhD, Environmental Microbiologist III, City of Santa Cruz Environmental
Laboratory and Akin Babatola, MSc, laboratory and environmental compliance manager, City of
Santa Cruz Environmental Laboratory
Although N95 mask decontamination and
reuse are not approved routine standard
care procedures, it may be necessary
during high-demand periods such as
infectious disease outbreaks. During the
current COVID-19 pandemic, the N95
mask shortage prompted considerations
such as extended use, reuse without
decontamination and reuse with
decontamination to ensure availability
and first responder protection.
While waiting for N95 mask supplies
to be restocked by commercial and
state supplies, the City of Santa
Cruz Environmental Laboratory, in
collaboration with the city’s emergency
officer, developed a procedure to
sanitize masks based on US Centers for
Disease Control and Prevention (CDC)
recommendations to reduce or eliminate
risks associated with reuse of untreated,
contaminated N95s.
Safety and Treatment Efficacy
Ultraviolet germicidal irradiation (UVGI)
has been shown to effectively inactivate
a wide range of human pathogens,
including coronaviruses and other human
respiratory viruses. According to CDC,
mask filtration and fit performance were
not affected by up to three cycles of UVGI
doses of 0.5 to 950 J/cm 2 . UVGI doses of 0.5
to 1.8 J/cm 2 inactivated at least 99.9% of all
the tested respiratory viruses.
UVGI can be associated with
adverse health effects. Safety
precautions are needed to
avoid exposure to skin and
eyes. With appropriate
safeguards, UVGI can be safely
administered for mask
decontamination. The UVGI
treatment efficacy is dose dependent.
Not all UV lamps provide the same
irradiance intensity and thus treatment
times need to be adjusted accordingly.
Due to shadow effects produced by the
multiple layers of the mask construction,
UVGI may not inactivate all the
microorganisms on a mask.
UV Disinfection of Masks
1. Use appropriate personal protective
equipment (PPE) (disposable lab coat,
N95 mask, safety goggles, face shield,
long sleeve gloves) before handling
soiled masks.
2. Place the soiled masks with chain-ofcustody
(COC) on a designated cart
outside the microbiology laboratory.
3. Receive the soiled masks through the
window and place the masks with
bags in the cooler on the designated
cart inside the microbiology lab. Sign
the COC and make a copy for the
courier.
4. Bring the cart in the lab next to the
biosafety hood (BSL-2).
5. Transfer bags containing masks into
the biosafety hood.
14 LAB MATTERS Summer 2020
PublicHealthLabs
@APHL APHL.org