AP story reminds us that disease can be self-inflicted.

An Associated Press story from today deals with the dozens and dozens of lab accidents and Series of Unfortunate Events since 2003 in American research labs.

AP IMPACT: More than 100 incidents reported at labs handling deadly germs

2007-10-02 06:36:25 -
WASHINGTON (AP) - American laboratories handling the world's deadliest germs and toxins have experienced more than 100 accidents and missing shipments since 2003, and the number is increasing steadily as more labs across the country are approved to do the work.
No one died, and regulators said the public was never at risk during these incidents. But the documented cases reflect poorly on procedures and oversight at high-security labs, some of which work with organisms and poisons so dangerous that illnesses they cause have no cure. In some cases, labs have failed to report accidents as required by law.
The mishaps include workers bitten or scratched by infected animals, skin cuts, needle sticks and more, according to a review by The Associated Press of confidential reports submitted to federal regulators. They describe accidents involving anthrax, bird flu virus , monkeypox and plague-causing bacteria at 44 labs in 24 states. More than two-dozen incidents were still under investigation.
The number of accidents has risen steadily. Through August, the most recent period covered in the reports obtained by the AP, labs reported 36 accidents and lost shipments during 2007 _ nearly double the number reported during all of 2004.
Research labs have worked for years to find cures and treatments for diseases. However, the expansion of the lab network has been dramatic since President George W. Bush announced an upgrade of the nation's bio-warfare defense program five years ago. The National Institute of Allergy and Infectious Diseases, which funds much of the lab research and construction, was spending spent about $41 million (¤28.81 million) on bio-defense labs in 2001. By last year, the spending had risen to $1.6 billion (¤1.12 billion).
The number of labs approved by the government to handle the deadliest substances has nearly doubled to 409 since 2004. Labs are routinely inspected by federal regulators just once every three years, but accidents trigger interim inspections.
«It may be only a matter of time before our nation has a public health incident with potentially catastrophic results,» said Rep. Bart Stupak, chairman of the House Energy and Commerce investigations subcommittee. Stupak's panel has been investigating the lab incidents and will conduct a hearing Thursday.
Lab accidents have affected the outside world: Britain's health and safety agency concluded there was a «strong probability» a leaking pipe at a British lab manufacturing vaccines for foot-and-mouth disease was the source of an outbreak of the illness in livestock earlier this year. Britain was forced to suspend exports of livestock, meat and milk products and destroy livestock. The disease does not infect humans.
Accidents are not the only concern. While medical experts consider it unlikely that a lab employee will become sick and infect others, these labs have strict rules to prevent anyone from stealing organisms or toxins and using them for bioterrorism.
The reports were so sensitive the Bush administration refused to release them under the Freedom of Information Act, citing an anti-bioterrorism law aimed at preventing terrorists from locating stockpiles of poisons and learning who handles them.
Among the previously undisclosed accidents
_In Rockville, Maryland, ferret No. 992, inoculated with bird flu virus, bit a technician at Bioqual Inc. on the right thumb in July. The worker was placed on home quarantine for five days and directed to wear a mask to protect others.
_An Oklahoma State University lab in Stillwater in December could not account for a dead mouse inoculated with bacteria that causes joint pain, weakness, lymph node swelling and pneumonia. The rodent _ one of 30 to be incinerated _ was never found, but the lab said an employee «must have forgotten to remove the dead mouse from the cage» before the cage was sterilized.
_In Albuquerque, New Mexico, an employee at the Lovelace Respiratory Research Institute was bitten on the left hand by an infected monkey in September 2006. The animal was ill from an infection of bacteria that causes plague. «When the gloves were removed, the skin appeared to be broken in 2 or 3 places,» the report said. The worker was referred to a doctor, but nothing more was disclosed.
_In Fort Collins , Colorado, a worker at a federal Centers for Disease Control and Prevention facility found, in January 2004, three broken vials of Russian spring-summer encephalitis virus. Wearing only a laboratory coat and gloves, he used tweezers to remove broken glass and moved the materials to a special container. The virus, a potential bio-warfare agent, could cause brain inflammation and is supposed to be handled in a lab requiring pressure suits that resemble space suits . The report did not say whether the worker became ill.
Other reports describe leaks of contaminated waste, dropped containers with cultures of bacteria and viruses, and defective seals on airtight containers. Some recount missing or lost shipments, including plague bacteria that was supposed to be delivered to the Armed Forces Institute of Pathology in 2003. The wayward shipment was discovered eventually in Belgium and incinerated safely.
The reports must be submitted to regulators whenever a lab suffers a theft, loss or release of any of 72 substances known as «select agents» _ a government list of germs and toxins that represent the horror stories of the world's worst medical tragedies for humans and animals.
A senior CDC official, Dr. Richard Besser, said his agency is committed to ensuring that U.S. labs are safe and that all such incidents are disclosed to the government. He said he was unaware of any risk to the public resulting from infections among workers at the high-security labs, but he acknowledged that regulators are worried about accidents that could go unreported.
«If you're asking if it's possible for someone to not report an infection, and have it missed, that clearly is a concern that we have,» Besser said.
Texas A&M's laboratory failed to report, until this year, one case of a lab worker's infection from Brucella bacteria last year and three others' previous infection with Q fever _ missteps documented in news reports earlier this year. The illnesses are characterized by high fevers and flu-like symptoms that sometimes cause more serious complications.
«The major problems at Texas A&M went undetected and unreported, and we don't think that it was an isolated event,» critic Edward Hammond said. He runs the Sunshine Project, which has tracked incidents at other labs for years and first revealed the Texas A&M illnesses that the school failed to report.
Rules for working in the labs are tough and are getting more restrictive as the bio-safety levels rise. The highest is Level 4, where labs study substances that pose a «high risk of life-threatening disease for which no vaccine or therapy is available.» Besides wearing wear full-body, air-supplied suits, workers undergo extensive background checks and carry special identification cards.
«The risk that a killer agent could be set loose in the general population is real,» Hammond said.
In other lab accidents recounted in the reports, the Public Health Research Institute in Newark, New Jersey, was investigated by the FBI in 2005 when it couldn't account for three of 24 mice infected with plague bacteria. The lab and the CDC concluded the mice were cannibalized by other plague-infested mice or buried under bedding when the cage was sterilized with high temperatures.
The lab's director, Dr. David Perlin, told the AP it would be impossible for mice to escape from the building and said a worker failed to record their deaths.
«I feel 99 percent comfortable that was the case,» Perlin said. «The animals become badly cannibalized. You only see bits and pieces. They're in cages with shredded newspaper. You really have to search hard with gloves and masks.
A worker at the Army's biological facility in Fort Detrick, Maryland, was grazed by a needle in February 2004 and exposed to the deadly Ebola virus after a mouse kicked a syringe. She was placed in an isolation ward called «The Slammer,» but the Army said she did not become ill.
In other previously undisclosed accidents
In Decatur, Georgia, a worker at the Georgia Public Health Laboratory handled a Brucella culture in April 2004 without high-level precautions. She became feverish months later and tested positive for exposure at a hospital emergency room in July. She eventually returned to work. The lab's confidential report defended her: «The technologist is a good laboratorian and has good technique.
In April this year at the Loveless facility in Albuquerque, an African green monkey infected intentionally with plague-causing bacteria reached with its free hand and scratched at a Velcro restraining strap , cutting into the gloved hand of a lab worker. The injured worker at the Lovelace Respiratory Research Institute received medical treatment , including an antibiotic.
The National Animal Disease Center in Ames, Iowa, reported leaks of contaminated waste three times in November and December 2006. While one worker was preparing a pipe for repairs, he cut his middle finger, possibly exposing him to Brucella, according to the confidential reports.
A researcher at the CDC's lab in Fort Collins, Colorado, dropped two containers on the floor last November, including one with plague bacteria.
A worker at Walter Reed Army Institute of Research-Naval Medical Research Center in Silver Spring, Maryland, sliced through two pair of gloves while handling a rat carcass infected with plague bacteria. The May 2005 report said she was sent to an emergency room, which released her and asked her to return for a follow-up visit.

This is so timely because of the recent University of Wisconsin revelation that their superstar researcher, Dr. Yoshi Kawaoka, committed a "DOH!"

Wisconsin: Ebola Research in Unsecured Lab

Research at the University of Wisconsin, Madison, on the deadly Ebola virus was conducted for a year in a less-secure laboratory than required, until the National Institutes of Health alerted the school to the problem. The virus itself was never present in the laboratory, said Jan Klein, a university biological safety officer. Instead, DNA copies of the virus were being studied to understand one of the world’s most dangerous pathogens.

From the Wisconsin State Journal:

RYAN J. FOLEY
Associated Press
September 19, 2007

UW-Madison allowed a star researcher to study material that could be used to produce the Ebola virus in a lab less secure than what's required under federal guidelines.

The study was stopped last fall after a National Institutes of Health official told the university the material must be contained at labs with the highest level of security, or Biosafety Level 4.

Researcher Yoshi Kawaoka, his colleagues and the public were never at risk because the deadly virus itself was never present in the lab, said UW-Madison biological safety officer Jan Klein.

"It's more of a technical violation than a safety violation. No one was at risk," she said. "It was a matter of how you read the guidelines. NIH took a broader read of the guidelines than we were aware of and we were using."

A NIH spokesman said he was looking into the matter and had no immediate comment.

Kawaoka, a professor of virology in the School of Veterinary Medicine, was at a meeting in Chicago on Wednesday and did not immediately return an e-mail message.

Kawaoka is a leading researcher on infectious diseases such as bird flu and Ebola. The university retained him last year by promising to build a $9 million research institute after he received a lucrative offer from the University of Pittsburgh.

The federally funded study aimed to better understand the Ebola virus, one of the most dangerous pathogens on Earth. To do so, researchers were studying DNA copies of the virus. Klein said scientists could produce an infectious virus if they combined the material with "additional components."

"But that was not part of any planned experiment and would not be done by accident," she said.

Still, a watchdog group said Wednesday the case illustrates lax university and federal oversight of research involving potentially dangerous agents.

"The UW looked federal guidance in the face and ignored it," said Edward Hammond, director of the Austin, Texas-based Sunshine Project. "If the federal government isn't keeping careful tabs on Ebola labs, I'm a bit scared. I think others should be as well."

The group, which works to limit access to biological weapons agents, on Wednesday released documents related to the study obtained through an open records request.

Hammond questioned whether the university allowed the research to go forward out of favoritism to Kawaoka.

"The University of Wisconsin is willing to go to great lengths to keep Kawaoka there," he said. "Maybe that influenced their review of his research."

Klein denied that was the case. She said a university committee approved Kawaoka's research for a Biosafety Level 3 lab after performing a required risk assessment.

She said the university has about a dozen Level 3 labs but none that are Level 4, which have the most stringent guidelines meant to ensure pathogens cannot escape.

Kawaoka was actually pressing to relax the safety guidelines further by asking whether the study could take place in a Level 2 lab, Klein said. That's when the university asked NIH for guidance and learned the material was restricted to a Level 4 lab. (bold mine)

UW-Madison spokesman Terry Devitt said the research was immediately stopped in Madison and relocated to a higher security Canadian lab.

Klein said the episode has had no other repercussions.

"He is a very compliant researcher. He understands that his credibility is in jeopardy for doing anything that might jeopardize the safety of his personnel and those of his colleagues in his community," she said. "He's always been extraordinarily responsive and a pleasure to work with."

All-righty then!  A rock star researcher wanted to lessen -- not strengthen -- the conditions under which a fax of a virus would be analyzed! Seems perfectly logical to me.

None other than the Pope of Influenza himself, Dr. Robert Webster, has stated publicly that the 1977 age-specific influenza pandemic that reintroduced H1N1 into society was the direct result of a Soviet lab accident. And we understand that since 9/11, the government has funded a ton of new research into emerging potential biological threats to Americans.  But that is no excuse for lax oversight by the recipients of the research dollars.  Nor does the government concede shortcuts to research, such as was the case at U. Wisconsin.  

Now you may say that this is no biggie, there is little chance that lab techs would ever pass disease to civilians.  I offer this in rebuttal:

Parents say lab technician bit their son

Wed Sep 26, 5:49 PM ET

A laboratory technician has been fired after the parents of a 3-year-old boy claimed she bit his shoulder while drawing blood from his arm, a hospital spokesman said.

Faith Buntin took her son Victor to St. Vincent Hospital on Friday for a blood test because of recent recalls of toys involving lead. She said she saw the worker put her mouth on Victor's shoulder.

"I looked at her like that was the craziest thing that I'd ever seen," Faith Buntin told television station WRTV. "She looked at me and smiled and said, 'Oh, it was just a play bite. He's not hurt.'"

After they returned home, the boy's mother said, she saw teeth marks on his left shoulder, and her husband drove the child back to the hospital, where he was prescribed antibiotics.

"Taking a bite out of him like he's an apple, this is heinous," said James Buntin, the boy's father.

St. Vincent fired the technician after the incident was reported and is "reviewing the capabilities" of the employees of the subcontractor that does blood work for the hospital, spokesman Johnny Smith said.

"We're tying to determine the best approach," he said. "It's just an unfortunate and sad situation and our thoughts and prayers go out to the family."

No charges have been filed.

And a final cautionary tale that labs can, indeed, spread disease, even if human interaction is not responsible.  We all know the recent British outbreak of foot and mouth disease.  But we may not have read the conclusion: 

Damaged pipe at lab caused foot-and-mouth outbreak, BBC reports

The Associated Press

Wednesday, September 5, 2007

LONDON: Investigators have determined a pipe at a research laboratory facility in southern England caused last month's outbreak of foot-and-mouth disease, the British Broadcasting Corp. reported Wednesday.

Britain's Health and Safety Executive found there were biosecurity lapses at the facility in Pirbright, Surrey, the BBC reported. The investigators' official report is due to be published Friday.

The Environment Department would not comment on the report Wednesday.

The lab complex houses vaccine-maker Merial Animal Health — the British arm of U.S.-French pharmaceutical firm Merial Ltd. — and the government's Institute of Animal Health.

Virus traces were found in a pipe running from Merial's lab to a treatment plant operated by the government-run lab, the BBC reported, adding the pipe may have been damaged by tree roots.

Investigators found contractors working at Pirbright traveled to and from the site using a country road next to the farm where the first outbreak occurred, the BBC said.

Foot-and-mouth disease affects cloven-hoofed animals including cows, sheep, pigs and goats. It does not typically infect humans, but its appearance among farm animals can have a far-reaching economic impact.

After the outbreak was detected on Aug. 3, Britain suspended exports of livestock, meat and milk products for nearly three weeks.

About 600 animals were slaughtered as a result of the outbreak. The National Farmers' Union said restrictions on meat exports cost the industry about 1.8 million pounds (US$3.5 million; €2.6 million) a day since the first case was confirmed.

Though several sites were tested, only two farms — both about 30 miles (50 kilometers) southwest of London — had cattle confirmed with the disease.

Add routine maintenance to the list of issues to be dealt with at labs across the world.  The pipe could have been fixed for an estimated fifty thousand pounds sterling (£50 million).  http://www.timesonline.co.uk/tol/news/uk/article2406565.ece

Pipe repair for £50,000 could have prevented foot-and-mouth disease

This summer’s outbreak of foot-and-mouth disease, which has cost the country almost £50 million, could have been avoided if £50,000 had been spent on repairs to a leaking pipe.

It has also emerged that officials at the Department for the Environment, Food and Rural Affairs knew about the poor state of the drains at the Pirbright research laboratory site in Surrey four years ago.

But wrangling between the government-funded Institute of Animal Health (IAH) and the pharmaceutical company Merial Animal Health, which share the site, over how much each should pay towards repairs reached a deadlock and the work was not carried out. The issue is expected to be decided in the High Court.

Such a lax approach at a scientific establishment handling live viruses that could devastate livestock farming was revealed yesterday, after the publication of two official inquiries into the cause of the outbreak.

A culture of complacency at the IAH and scant regard for biosecurity measures emerge from the reports. As well as the leaky drains there was no system for disinfecting vehicles that could have picked up viruses at the plant. Although terrorism and sabotage have been ruled out as a cause of this outbreak, the inquiries suggest that it would be easy for an intruder to get into the high-risk laboratories.

The failings are considered to be so serious that an urgent system of inspections will now take place at each of the 432 British laboratories that deal with deadly and highly infectious human and animal disease pathogens. Hilary Benn, the Rural Affairs Secretary, made clear however that no official would face disciplinary action.

Mr Benn made it clear that there were no excuses for the escape from the Pirbright facility. He said: “It should not be possible for a live virus to escape from a secure laboratory. It should not have happened even under these extraordinary circumstances and must not happen again.”

Although the precise cause of the outbreak may never be established precisely the inquiries point to a cracked effluent pipe, tree roots and unsealed manhole covers. It is thought that the escaped virus was most likely from Merial, although not because of a breach in biosecurity, which leaked and contaminated surrounding soil. The infected mud was picked up on the tyres of contractors’ lorries that were driven along a lane near to the Normandy farm where the disease was identified 35 days ago.

Brian Spratt, an expert in infectious diseases at Imperial College, London, who headed an independent inquiry, said: “It is very clear that the drainage system was defective, poorly maintained, rarely inspected and could leak.”

The last Defra inspection took place in March but the drainage problem was not regarded as a problem to the work on a foot-and-mouth vaccine.

Professor Spratt highlighted a conflict of interest in Defra’s role as regulator, licenser, inspector and leading funder for research at the IAH. His report said: “The poor state of the IAH laboratories and the effluent pipes indicates that adequate funding has not been available to ensure the highest standards of safety for the work on foot-and-mouth disease.”

Geoffrey Podger, chief executive of the Health and Safety Executive, which led the investigation into the cause, highlighted “long-term damage” of the drainage system, inadequate controls on movement of people and vehicles and poor record-keeping. He said: “It was absolutely essential that the pipework was fully contained. It was not.”

The foot-and-mouth outbreak was declared over yesterday and at noon today restrictions in the surveillance zone near the infected farms and on animal movements are to be lifted.

The earliest date for trade to resume with countries outside of the EU will be November 7.

After much anticipation, the inaugural season of the heralded post-nuke serial drama Jericho is available on region 1 (NTSC) DVD.

What, you say?  You never saw Jericho?  Now is your chance to play catch-up -- and you have almost an entire year to do so!  Just don't wait until then to buy the boxed set.  You can read the backstory on the television show and how its faithful followers brought it back from the dead here: http://www.scottmcpherson.net/journal/2007/7/2/jericho-returns-to-cbs-july-6th.html

Jericho, Kansas is a fictional town near the Colorado border.  Quickly it is caught in the crossfire of a terrorist act, as the terrorists detonate an uncertain number of nuclear bombs across America.  When the Denver nuke explodes, it plunges Jericho into a post-apocalyptic world of uncertainty, rumors, and forced self-reliance.  Where is the government?  What is happening in the adjacent towns?  Who bombed America?  How will they feed all of the townspeople in the winter?  How can they prevent lawlessness and chaos?  Who can they trust?  Who will step up and who will not?

Interspersed within this story are many intriguing subplots, some romantic, some involve deceit, infidelity, intrigue and possible treason, and some involving politics.  In other words, something for the entire family!  One continuing subplot involves the once-mayor, Johnston Greene, played in Emmy-caliber fashion by Gerald McRaney.  Greene has been defeated for re-election, partly because he is so focused on keeping the town together, he did not bother to campaign.  He also had a terrible bout with influenza during this critical post-nuke time, and almost died from the virus.  Thought I would throw that one in there for all us flubies!

The populist themes of his victorious opponent quickly give way to the grim realization that Greene has what it takes to lead and the new incumbent does not.  The new mayor then gives Greene authority to organize and train the Jericho townspeople to defend their territory against interlopers (rogue mercenary types with shadowy, Blackwater-esque tendencies) and, ultimately, against a rival town with a mad leader.

Which is where the first season ended:  With chaos, the fog of war, and the hint of some sort of New American intervention to stop the conflict before it gets any bloodier (see flag at left). 

To tell you any more would spoil the surprise!  And that surprise is how well the writers scripted, and well the actors played their roles, for this groundbreaking television show.   Jericho is a serious television program for anyone who enjoys good apocalyptic fiction, science fiction, or survivalist fiction.  Anyone in a post-9/11 world who speculates on what life would be like if "The Terrorists Win" should view this program.  Anyone who ever read Pat Frank's classic novel "Alas, Babylon" will flock to this show like crazy.  This show is also required viewing for anyone with a passion for emergency management and disaster preparedness.  In fact, one of the featurettes in the boxed set is titled "What If?" The featurette speculates on America's current ability (or lack thereof) to withstand and survive man-made or natural catastrophes. 

OK, here's the deal.  After bringing the show back from the dead (again read my earlier blog on how an Internet campaign brought back the show), CBS ordered up seven new episodes for the Summer of 2008.  CBS also threw down the gauntlet and said, "Show us the fan base is out there."   And CBS will order up more episodes, if they see boxed set sales doing well.  So this is your chance to view the phenomenon firsthand, and help bring back a show that we all can take notes from.

MSF, or what we better recognize as Doctors Without Borders, has posted the complete and ongoing diary/blog from Zoe Young, the healthcare worker at Ground Zero in DRC's Ebola outbreak.  It can be found at: http://www.msf.ca/blogs/ZoeY.php and is required reading.  Here's a passage:

By the time I got back to the isolation unit, the third patient had died. He had been really very bad all day and his family had been outside crying and talking to him. His father had been in for a visit to say goodbye and they had cut two small pieces of string, one around his ankle and one around his wrist. Later in the morning they had asked Barbara to cut the last string which was round his tummy. It was awful to see: they were just waiting for him to die.

I went back to the cemetery and got two coffins into their graves before another torrential storm started with lightening that I could see streaking across the sky.

It was with great sadness that I read an article off the Drudge report this morning.  A young Arizona child died from a very rare (although getting less and less rare) lake-borne amoeba that attaches itself to the brain stem and literally eats away the tissue until the victim dies. The article states, in part:

According to the CDC, the amoeba called Naegleria fowleri (nuh-GLEER- ee-uh FOWL'-erh-eye) killed 23 people in the United States, from 1995 to 2004. This year health officials noticed a spike with six cases—three in Florida, two in Texas and one in Arizona. The CDC knows of only several hundred cases worldwide since its discovery in Australia in the 1960s.

Six cases, six deaths, 100% CFR.  The article can be found at: http://www.breitbart.com/article.php?id=D8RUKBMG0&show_article=1 .

This brings me to the Article of the Month -- a National Geographic article on emerging pathogens that we all should read and absorb.  Besides an excellent map showing the spread of H5N1 across the globe, it illustrates the huge problems confronting public health professionals as they try to discover, diagnose, and destroy these pathogens before they can make a permanent species jump to man.

I had never heard of Hendra virus, named for the location in Australia that spawned equine and human death in 1994.  The article does a great job of introducing readers to monkeypox, Ebola, and other killers.  Be sure to read the article, and better yet, go pick up a copy of this month's NG.  The article can be found at:

http://magma.nationalgeographic.com/ngm/2007-10/infectious-animals/quammen-text.html .

If you are a "flubie," you are very aware of today's announced outbreak of H7N3 avian influenza on the Pedigree Poultry farm near Regina Beach, Saskatchewan.  "Regina Beach" may conjure up scenes of frolic amidst the surf, but remember this town is on a river about 150 miles southeast of Saskatoon (Go Roughriders!).  The town, interestingly enough, sits directly under the Central Flyway, one of the major (perhaps even THE major) migratory waterfowl flyways of North America.  So take a huge waterfowl flyway, coupled with a river, and -- presto! - you have H7N3 emerging on a chicken ranch.

What is also quite interesting about this outbreak is the use of the phrase "highly pathogenic" to describe the infection.  We always shudder when we hear the words "high path," because that is an express ticket to a very, very potentially dangerous strain, even though the Canadian government is saying it poses "little risk" to humans.  Here's why:  As I mentioned several weeks ago in my blog regarding the presence of H7 avian flu in Egypt, the H7 strain loves people.  It loves to jump to humans, and is a suspected agent for human-to-human transmission in multiple outbreaks worldwide.  The last such outbreak just happened -- in Wales -- in May of this year.  Over 250 British subjects were tested, and several wound up in hospital.  If the H7N2 crossover had happened just a month or two sooner, during flu season, the consequences could have been disastrous.

The evidence is strong that in the Netherlands in 2003, for example, several dozen people who never handled poultry became sick with H7N7.  A study confirming this H2H pattern is available for downloading at: http://www.eurosurveillance.org/eq/2005/04-05/pdf/eq_12_2005_264-268.pdf .

Quoting from the study:

Study strongly advises goggles to protect against bird flu