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“Fun” Cases in Biosafety

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“Fun” Cases in Biosafety “Fun” Cases in Carrie Anglewicz, MS Biosafety , Laboratory Outreach Michigan Department of Health and Biosafety Human Services Bureau of Laboratories [email protected] Objectives At the end of this presentation, the learner will be able to: ✓ Recall historical events which impacted the profession of biosafety ✓ List the most common laboratory acquired infections ✓Discuss best practices to reduce the likelihood of exposure to laboratory acquired infections Biosafety “the discipline of addressing safe handling and containment of infectious microorganisms and hazardous materials” -BMBL 5th Edition ▪ Containment ▪ Risk Assessment Risk -How likely is it to occur and what are the consequences if it does? Evaluating Risk Consider: • What is the task? • Engineering controls and other containment strategies in place? • Established work practices • Health of the scientist • Immunocompromised? Evaluating Risk Consider: • Infectious dose • #1 Brucella sp. 10-100 organisms1 • #2 M. tuberculosis <10 organisms1 • #5 Coxiella burnetti approx. 10 organisms1 • Treatment • Vaccine • Antimicrobials / antivirals The Eight Ball https://www.fredericknewspost.com/news/politics_and_government/military/fort-detrick-s-eight-ball----a-relic/article_09a3c63c-fe2b-5950-8f76-79d2c14455b2.html Operation Whitecoat • 1954-1973 USAMRIID, Ft. Detrick, MD. • ~2300 medics / conscientious objectors • Biological warfare tests which determined infectious dose for several pathogens and a vaccine for Rift Valley Fever • Testing performed on agents for which there was treatment: Q fever, F. tularemia, Y. pestis • Informed consent2 http://artnscience.us/jm48.jpg Janet Parker • 1978 • Last person to die from Smallpox infection This Photo by Unknown Author is licensed under CC BY-SA Janet Parker • Naturally occurring smallpox eradicated in 1977 • Photographer with office above the Smallpox laboratory at University of Birmingham, UK • Smallpox rash initially misdiagnosed (2x) • Strain of smallpox consistent with those worked with in lab - collected from patients in Pakistan earlier that year Engineering Controls = Containment • Biosafety Cabinets- functioning properly but not used properly • Cited as lack of space inside cabinet to perform work • Containment: not performed properly • Harvesting of virus done on bench top -use of aspirator generated aerosols • Work practices contributed to XC into animal pox room Ventilation • Tracers were used to look at air flow in building • Transfer of tracer from animal pox room to corridor outside • Small transfer to the subway via the duct from animal pox room • Notable transfer from animal pox room to Telephone room via duct C Likely Route of Infection https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/228654/0668.pdf.pdf Additionally • Janet was vaccinated for smallpox in 1966 • Janet’s mother also acquired Smallpox • Father had a heart attack due to stress • Lab manager committed suicide Reference: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/228654/0 668.pdf.pdf Elizabeth R. Griffin Elizabeth R. Griffin Research Foundation http://ergriffinresearch.org/about/about-elizabeth.php Cercopithecine herpesvirus 1 (B Virus) • Herpes B virus causes persistent latent infections in ≥70% of captive adult macaques, but not other primates. Reactivation includes shedding from some mucosal membranes • History of human infections and one case of human to human transmission • This is the first report of transmission without injury (no bites or scratches) Elizabeth Griffin • 1997 • 22 year old researcher splashed by substance from rhesus macaque • No eye protection as deemed low risk – eye protection required for lab activities, not transportation • Incident not reported. Elizabeth wiped her eye off, irrigated it briefly Elizabeth Griffin • Symptomatic 9 days after exposure • Misdiagnosed and prescribed abotics on 2 separate visits • Diagnosed and admitted to hospital 16 days after exposure • pain, photophobia, anorexia, nausea and abdominal pain • Expired 42 days after exposure Reference: https://www.ncbi.nlm.nih.gov/pubmed/9879633 Elizabeth Griffin Elizabeth’s family set up a foundation to improve education and training for safety in laboratory and scientific research Elizabeth R. Griffin Research Foundation Malcolm Casadaban Malcolm Casadaban • September 2009 • University of Chicago research with attenuated Yersinia pestis • Fever, aches, cough 3 days duration before seeking treatment • Referred to ED for influenza but didn’t go • 3 days later, transported by ambulance to hospital, expired hours later Malcolm Casadaban • Investigation: • Work Practices, PPE • Health • Autopsy • Cause of death Final Thoughts • Perform biosafety risk assessments to find hidden hazards and to make best use of your facilities and staff • Containment is key: Controls like proper use of biosafety cabinets, ventilation controls and work practices will make us safer • Risk is never zero • Don’t “lower your guard” when using an attenuated strain or if vaccinated Additional References 1. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Biosafety in Microbiological and Biomedical Laboratories, 5th Edition, pgs 127,146, 195 2. United States General Accounting Office, Testimony Before the Legislation and National Security Subcommittee, Committee on Government Operations, House of Representatives, Human Experimentation An Overview on Cold War Era Programs, September 28, 1994, accessed 07-16- 2018 https://www.gao.gov/assets/110/105708.pdf 3. American Biological Safety Association, Introduction to Biosafety: Biosafety Curriculum for Undergraduate and Graduate Students https://absa.org/intro/.
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