Laboratory-acquired infections

A survey conducted 20 years ago and based on a total of 3921 cases showed 59% of laboratory-acquired infections had occurred in research laboratories (1). The majority of infections were of laboratory personnel but, in some cases, staff working outside the laboratory were also affected. Other events have emphasized the need for effective biosafety measures. These include two escapes of smallpox virus from laboratories that resulted in members of the public becoming fatally infected the emergence of new viral diseases with high case-fatality rates and the recognition that laboratory-based investigations would need to be made on viruses for which no prophylactic or therapeutic measures were available. Table 1 lists some viruses that have been identified as causal agents of laboratory-acquired infections (2-4). 

Factors that can influence the risk of laboratory-acquired infection include the vims under investigation, laboratory practices being used and the host. The consequences of release of the vims into the environment must also be considered. 

Procedures The most commonly reported types of activities associated with laboratory-acquired infections are listed in Table 3. 

Pike, R. M. (1976) Laboratory-acquired infections. Summary and analysis of 3921 cases. Health Lab. Sci. 13, 105-114. 

Collins, C. H. (1993) Laboratory-Acquired Infections. Butterworth-Heinemann Ltd., Oxford, UK. 

Sewell, D. L. (1995) Laboratory-acquired infections and biosafety. Clin. Microbiol. Rev. 8, 389 105. 

Practices that are most helpful for preventing laboratory-acquired infections are as follows ... 

Few cases of laboratory-acquired infection have been reported in the... 

Collins, C.H. (1987). Laboratory-acquired Infections. Butterworths London. 

Schlech, W.F., Turchik, J.B., Westlake, R.E., Klein, G.C., Band, J.D. and Weaver, R.E. (1981). Laboratory-acquired infection with Pseudomonas pseudomallei (melidiosis). New England Journal of Medicine, 305, 1133-1135. 

Mempel, M., Isa, G., Klugbauer, N., Meyer, H., Wildi, G., Ring, J., Hofmann, F., and Hofmann, H. (2003). Laboratory acquired infection with recombinant vaccinia virus containing an immunomodulating construct. J. Invest. Dermatol 120, 356-358. 

From 1900 to 1978, only 18 cases of inhalation anthrax were reported in the United States, two of these being laboratory-acquired infections. But if BW armaments of any consequence are ever used against large populations, it is the inhalation form of the disease that is most likely to be deployed. 

The Centers for Disease Control and Prevention (CDC) reported that 41 persons who developed infections from Salmonella Typhimurium were linked to exposure in clinical and college and university teaching microbiology laboratories. About 1/3 of those had to be hospitalized but no deaths were reported. Behaviors associated with illnesses included not wearing lab coats or gloves, not washing hands, using the same utensils and notebooks outside the laboratory. CDC developed a list of precautions to prevent laboratory-acquired infections (LAI). 

As pointed out in Section 4.3.2, containment is the most important practice when handling biological materials. To achieve containment requires strict adherence to standard microbiological practices and techniques. Failure to follow these standard practices can result in laboratory-acquired infections (LAIs) as illustrated in Incidents 4.3.2.1, 4.3.2.2, 7.3.4.1, and 7.3.4.2. 

CDC, Fatal Laboratory-Acquired Infection with an Attenuated Yersinia Pestis Strain - Chicago, Illinois, 2009, Morbidity and Mortality Weekly Report (MMWR), 60 ( 07) 201-205, February 25,... 

Edward Sulkin and Robert Pike published the first comprehensive survey on laboratory-acquired infections in 1949 (446) and in 1951 they published the results of a survey of 5,000... 

The occurrence of laboratory-acquired infections in research workers is not the only problem in biosafety. The other major concern is the potential for release of infectious agents that may cause secondary infections in nonlaboratory workers and other contacts. Fortunately, the potential for such serious outbreaks of laboratory-acquired disease seems to be small. Data derived from studies at the U.S. Department of Agriculture National Animal Disease Center showed that, during the years from 1960 to 1975, no instances of secondary infection in other laboratory workers or in nonlaboratory contacts occurred as the result of the laboratory-acquired infections of 18 research workers who used animal pathogens that were also infective for humans (448). However, the potential for outbreaks of laboratory-associated disease does exist as there are reports in the literature of instances of secondary transmission of laboratory-acquired Marburg disease (283), Q fever (38), and smallpox (105,518). Fortunately, the low level of occurrence of such incidents suggests that... 

Reduce risk of laboratory-acquired infection through the use of appropriate immunizations. When protective immunizations are available and are appropriate for the individual and the degree of risk to be encountered, they should be required as part of the medical program. 

Biological hazards Laboratory-acquired infections Oncogenic viruses Recombinant DNA Chemical hazards... 

Collins, C.H., E.G. Hartley, and R. Pillsworth. 1974. The Prevention of Laboratory Acquired Infections. Public Health Laboratory Service Monograph Series No. 6. London Her Majesty s Stationery Office. 

Pike, R.M., S.E. Sulkin, and M.L. Schulze. 1965. Continuing importance of laboratory-acquired infections. Amer. J. Public Health 55 190-199. 

Sullivan, J.F., J.R. Songer, and I.E. Estrem. 1978. Laboratory-acquired infections at the National Animal Disease Center, 1960-1976. Health Lab. Sci. 15 58-64. 

Williams, J.E. 1983. Warning on a new potential for laboratory-acquired infections as a result of the new nomenclature for the plague bacillus. Bull World Health Org. 61 545-546. 

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