Montana Laboratory Sentinel

Updates from the MT Laboratory Services Bureau
Phone: 800-821-7284 Fax: 406-444-1802
Lab Website

Lab Manual 

(Please reference this for testing or submission questions.)

April, 2025

News and Updates

Molecular

• Borrelia- Relapsing Fever No Longer Available

  • MTPHL has been notified that the CDC will no longer perform the tests for Borrelia Molecular Detection – Relapsing Fever (CDC-10532) and Borrelia Serology - Soft Tick Relapsing Fever (CDC-10399) for diagnosing, treating, or managing individual patients. As a result, both tests will be removed from MTPHL’s testing menu.

  • Molecular testing for the Borrelia species causing relapsing fever is available through ARUP. Other reference laboratories, such as Mayo and Quest, also offer molecular testing for Borrelia miyamotoi, which is linked to hard tick relapsing fever. However, these assays may cross-react with soft tick relapsing fever species.

  • The Centers for Disease Control and Prevention (CDC) Laboratories have discontinued or paused various tests that were previously available. The Montana Public Health Laboratory will do its best to notify our partner laboratories about these changes as soon as we are aware.

• Measles Testing

  • MTPHL is currently performing Measles PCR testing in-house on a daily basis. Effective communication is crucial for our operational success; therefore, please notify us prior to sending any specimens for testing. The expected turnaround time (TAT) for results is one to two days. For guidance regarding specimen requirements, please consult the MTPHL Measles Testing Guidance.

  • Additionally, please be advised that Measles IgM testing is currently a send-out test. The TAT for this test may vary, though it typically ranges from two to three days.

  • Remember, per administrative rule, all positive Measles PCR or IgM specimens are required to be submitted to MTPHL. If you have any questions about testing, please give us a call.

IT Corner

• OKTA Account Deadline May 1st. 

  • We have been working diligently to get users transitioned to OKTA for signing in to the lab portal. Over half of our users have made the transition. The deadline for users to have their OKTA accounts created is May 1^st. 

  • If you have not done so already, please create your OKTA account now using the instructions found here.

  • There are TWO steps to this process that need to be completed before you will be able to sign in with OKTA–

    • (1) Notify us by sending an email to HHSLIMS@mt.gov once you have created your OKTA account. If you have a problem during the OKTA account creation process, you will need to contact our IT Help desk at 406-444-9500. If you previously had an EPASS account for secure file transfers with the state, you may already have an OKTA account and may need to contact the help desk to get it re-activated.

    • (2) We will notify you by email when access to the lab portal app has been linked to your OKTA account. You Won't have access to the lab portal with OKTA until you receive that e-mail. Until then, you can continue to sign in to the portal the way you do now. The IT Help desk cannot link the lab portal to your OKTA account, so only contact them for OKTA account creation or password issues. 

  • Soon after the May 1^st deadline, access to the system will be limited to the OKTA authentication method only, so it is in your best interest to make the transition now to avoid the risk of losing access when the transition is complete.

  • Also, once you have an OKTA account, you can pay your MTPHL bill online with that same account! Similarly, for those who have already set up an OKTA account to pay your bill online, you can use that account for lab portal authentication. Just let us know you already have an OKTA account by sending an e-mail to HHSLIMS@mt.gov and we will get your OKTA account linked to the lab portal.

Preparedness

• Rapid Toxic Screen for a Suspected Chemical Exposure Event

  •  A Chemical Exposure Event may be accidental (a train derailment with cars containing chemicals) or intentional (nerve agent release in a public area).

  • Emergency room personnel, trained to recognize the symptoms of a possible chemical exposure event, will order specific specimens. The laboratory personnel will obtain specimens from up to the first 40 patients, package them appropriately, and send them to the MTLSB at the appropriate temperatures. The MTLSB is the LRN-C (Chemical Agent) Laboratory for the state of MT. These specimens will be repackaged according to FBI and CDC specifications as forensic evidence and forwarded to the CDC for the initial Rapid Toxic Screen testing.

  • More information on Specimen Requirements, Shipping information, and Legal documentation can be found on RTS for a Suspected Chemical Event.

  • Attached is a CDC flow chart for Chemical-Exposure Incident Specimen Collection. 

  • In the case of a suspected Chemical Exposure Event: call the MTLSB 1-800-821-7284, 24/7, for consultation, coordinating specimen acquisition, and shipping/courier logistics.

  • For non-emergency inquiries, please contact Kim Newman, Laboratory Preparedness Specialist, at 1-406-444-3068.

Dear Labbey, If we have been taught to use universal precautions when handling blood and other patient specimens, how are we able to ship blood following no regulatory requirements at all? Sincerely and seriously, Concerned   Dear Concerned, The US Department of Transportation (DOT) Hazardous Materials Regulations (HMR), 49 CFR Parts 171-180, apply to materials that are determined to be capable of posing an unreasonable risk to health, safety, and property when transported in commerce (i.e., by commercial carriers.) An infectious substance is a material known or reasonably expected to contain a pathogen that can cause disease in humans or animals. These substances are classified based on the level of harm the pathogen can do to otherwise healthy humans or animals when exposure occurs. The more we know about a sample, i.e., the patient's symptoms and endemic conditions where the patient is from, the more clues we have about which pathogens might be present. For example, suppose a feral cat has bitten a patient, resulting in an infected wound and fever. In that case, we can logically assume that a slow-growing organism is a higher classification than a urine sample collected from a pregnant person in for a glucose check. Likewise, if a patient has a high fever and is traveling from the Democratic Republic of Congo, we can assume that the patient may have a high-consequence infectious disease. Other examples of using your professional judgment include assessing risk based on the sample or information you may have about a patient’s history. For example, if you are transporting a cholesterol sample from a health screening facility, you would be less likely to consider an infectious disease than if someone were coming in for a Hepatitis C test or if one of your regular patients were coming in for a CD4 count. Classification of samples also takes into account the type of sample (patient specimen or culture) to determine how exposures might occur (mucous membrane, respiratory, ingestion). In addition, all samples must be triple packaged, including a leakproof inner packaging with a biohazard label, a rigid outer packaging to minimize the risk of exposure, and an emergency response number for support in the event of package damage. Regardless of the sample's classification (Category A, Category B, exempt when shipping by FedEx or UPS, or not subject to regulations), universal precautions still apply. We continue to wear gloves and use engineering controls when collecting and manipulating samples, and we always use a biohazard symbol when shipping samples. That is because, while this portion of the Code of Federal Regulations (49 CFR, DOT) may not always be applicable, other portions, such as the OSHA Bloodborne Pathogen Standard (29 CFR 1910.1030), are. Shipping samples does indeed carry a level of risk, but this can often be mitigated through knowledge of the regulations, appropriate packaging and labels, and having competent staff completing the process.

Reminders:

• Lab Portal Information

  • All of our lab portal procedures and access paperwork can be found on our website. Here is the link to the direct page with all of our forms and procedures: https://dphhs.mt.gov/publichealth/LaboratoryServices/onlineorderingandresults.

  • There is also a link in our lab portal that will take you directly to this page. This link can be found under quick links. "MT PHL Lab Portal Procedures and Forms". 

• Courier 

  • Please click here for our full courier schedule.

• Previous Laboratory Sentinels 

  • All previous Laboratory Sentinels can be found on our website on the column on the left hand side by selecting "Public Health Laboratory Newsletter". Here is a link to all our previous Laboratory Sentinels.