No Reason to Panic
As I followed the stories on the accidental use of the 1957 H2N2 influenza strain in test kits manufactured by Meridian Bioscience Inc., I noticed that some of the headlines seemed to be worded to incite panic. The Guardian had "Labs scramble to destroy deadly flu virus". AP headlines screamed "Countries destroying vials of deadly flu strain" and "WHO says killer flu strains still sought". USA Today ran "Samples of pandemic flu virus found in 3 foreign warehouses of shipper". If someone read the headlines, (deadly, killer, pandemic), without reading the articles; he or she would want to stay home and avoid all contact with the outside world.
Most people have been desensitized to panicky headlines, but it did get to some susceptible individuals. The following comments appeared on a liberal website: "has anyone entertained the notion that the vials were sent on purpose, with the intention of starting an epidemic? I mean, a few on accident is one thing, but 5,000 vials?" First, a few vials would seem more suspicious. Biological manufacturing works like any other manufacturing operation. Manufacturers make large batches or lots and then fill individual vials. How cost effective would it be if Coca-cola only manufactured enough CokeÒ to fill one can and repeated that process for thousands of cans? In Meridian’s case, the H2N2 influenza strain was taken from a virus "library" purchased from another company and was, apparently, unaware that it was the virus that caused the 1957 epidemic. That strain was used in one or several lots. If only a few vials contained the strain it would imply that someone retrieved material meant to be destroyed or had deliberately made those vials.
If someone were trying to start an epidemic, he or she probably would have used something more lethal. The A/Singapore H2N2 "Asian" flu strain did cause between one and four million deaths worldwide. In the US, it caused 70,000 deaths in a 1957 population of 171,984,130. That was 0.041% of the US population or 41 deaths per 100,000 people. In 2001 there was no flu epidemic in the US, but 21.8 people per 100,000 died from influenza or pneumonia from secondary infections, (the usual cause of influenza deaths). It is true that the mortality rate during the 1957 "Asian" flu was twice that of a normal year, but death tolls from other diseases are higher. In 2001, there were 245.8 deaths per 100,000 due to heart disease and 194.4 deaths per 100,000 due to cancer.
If an epidemic of the H2N2 strain of flu were to happen now, the mortality rate may be lower than it was in 1957. The 1957 "Asian" flu pandemic may have infected more people than the 1918 H1N1 "Spanish" flu pandemic did. However, the mortality rate was lower in 1957 than in 1918 because antibiotics were available to treat secondary bacterial infections. Today, we have newer drugs such as Amantadine, Rimantidine, Zanamivir (RelenzaÒ ) and Oseltamivir (TamifluÒ ) to shorten the duration of influenza infections. There is also the possibility that some older people, the most susceptible group, may have some immunity to that influenza strain because that strain circulated in humans until 1968.
Another reason it is unlikely that someone released this flu strain in hopes of starting an epidemic is that it was only sent to laboratories experienced in viral testing. Laboratories have to have appropriate certification to receive infectious agents. Laboratories are highly regulated, (often by more than one agency), controlled environments. The virus was only used under Biosafety Level 2 conditions in which laboratory access is limited to authorized personnel, appropriate safety attire is worn, waste is decontaminated and work with this type of agent is performed in biological safety cabinets. Infection of a laboratory worker is highly unlikely under these conditions. I have worked in biotechnology for 15 years and know no one who has had a laboratory acquired infection. In fact, I don’t even know anyone who knows somebody who got an infection from working in a lab. Laboratory workers don’t want to get sick any more than anyone else does. This flu strain was shipped to labs in September and no laboratory infections occurred yet. If someone wanted to start an epidemic, he or she would release an agent in an aerosol form in a crowded, public place.
Additionally, the biotechnology industry is so regulated that it is relatively easy to track and account for the virus. The H2N2 strain was detected on March 26 by a Canadian laboratory that identified influenza viruses by strain, (the strain was used as a kit control to confirm that tests were detecting influenza type A). Less than a month later, almost all of the vials of H2N2 influenza have been destroyed. Two missing shipments have been tracked to shipper’s warehouses and one shipment is still being traced. Overall, the CDC, WHO and the laboratories did a very good job of tracing and destroying the vials
Remember that agents sent to laboratories are shipped, used and disposed of under controlled conditions. Safety is a priority. Incidents like this don't always indicate terrorism - sometimes things are accidental. Also, it’s the flu, not the plague.
Ó Eva Ellsworth, 04/20/05, all rights reserved
Most people have been desensitized to panicky headlines, but it did get to some susceptible individuals. The following comments appeared on a liberal website: "has anyone entertained the notion that the vials were sent on purpose, with the intention of starting an epidemic? I mean, a few on accident is one thing, but 5,000 vials?" First, a few vials would seem more suspicious. Biological manufacturing works like any other manufacturing operation. Manufacturers make large batches or lots and then fill individual vials. How cost effective would it be if Coca-cola only manufactured enough CokeÒ to fill one can and repeated that process for thousands of cans? In Meridian’s case, the H2N2 influenza strain was taken from a virus "library" purchased from another company and was, apparently, unaware that it was the virus that caused the 1957 epidemic. That strain was used in one or several lots. If only a few vials contained the strain it would imply that someone retrieved material meant to be destroyed or had deliberately made those vials.
If someone were trying to start an epidemic, he or she probably would have used something more lethal. The A/Singapore H2N2 "Asian" flu strain did cause between one and four million deaths worldwide. In the US, it caused 70,000 deaths in a 1957 population of 171,984,130. That was 0.041% of the US population or 41 deaths per 100,000 people. In 2001 there was no flu epidemic in the US, but 21.8 people per 100,000 died from influenza or pneumonia from secondary infections, (the usual cause of influenza deaths). It is true that the mortality rate during the 1957 "Asian" flu was twice that of a normal year, but death tolls from other diseases are higher. In 2001, there were 245.8 deaths per 100,000 due to heart disease and 194.4 deaths per 100,000 due to cancer.
If an epidemic of the H2N2 strain of flu were to happen now, the mortality rate may be lower than it was in 1957. The 1957 "Asian" flu pandemic may have infected more people than the 1918 H1N1 "Spanish" flu pandemic did. However, the mortality rate was lower in 1957 than in 1918 because antibiotics were available to treat secondary bacterial infections. Today, we have newer drugs such as Amantadine, Rimantidine, Zanamivir (RelenzaÒ ) and Oseltamivir (TamifluÒ ) to shorten the duration of influenza infections. There is also the possibility that some older people, the most susceptible group, may have some immunity to that influenza strain because that strain circulated in humans until 1968.
Another reason it is unlikely that someone released this flu strain in hopes of starting an epidemic is that it was only sent to laboratories experienced in viral testing. Laboratories have to have appropriate certification to receive infectious agents. Laboratories are highly regulated, (often by more than one agency), controlled environments. The virus was only used under Biosafety Level 2 conditions in which laboratory access is limited to authorized personnel, appropriate safety attire is worn, waste is decontaminated and work with this type of agent is performed in biological safety cabinets. Infection of a laboratory worker is highly unlikely under these conditions. I have worked in biotechnology for 15 years and know no one who has had a laboratory acquired infection. In fact, I don’t even know anyone who knows somebody who got an infection from working in a lab. Laboratory workers don’t want to get sick any more than anyone else does. This flu strain was shipped to labs in September and no laboratory infections occurred yet. If someone wanted to start an epidemic, he or she would release an agent in an aerosol form in a crowded, public place.
Additionally, the biotechnology industry is so regulated that it is relatively easy to track and account for the virus. The H2N2 strain was detected on March 26 by a Canadian laboratory that identified influenza viruses by strain, (the strain was used as a kit control to confirm that tests were detecting influenza type A). Less than a month later, almost all of the vials of H2N2 influenza have been destroyed. Two missing shipments have been tracked to shipper’s warehouses and one shipment is still being traced. Overall, the CDC, WHO and the laboratories did a very good job of tracing and destroying the vials
Remember that agents sent to laboratories are shipped, used and disposed of under controlled conditions. Safety is a priority. Incidents like this don't always indicate terrorism - sometimes things are accidental. Also, it’s the flu, not the plague.
Ó Eva Ellsworth, 04/20/05, all rights reserved
2 Comments:
Thats understating it a bit dont you think? The fact is that lab accidents do happen and just because YOU dont know anyone in 15 years, does not mean it has not happened. How stupid do you think your reading public is?
Even in BSL-4 labs mistakes can happen, and some of these mistakes have been fatal -- to the experimenter. In addition to three laboratory escapes of the SARS virus in 2003 and several resultant fatalities, a number of Russian researchers at the Vektor laboratories in Siberia have died of Ebola, and several scientists at Boston University contracted tularemia, or rabbit fever, in recent years.
Live Anthrax (Rather Than Killed) was Sent to A California Hospital Laboratory J.D. Miller, The Scientist - 6/11/04
US Lab is Sent Live Anthrax: Incident at Oakland, Calif., Children's Hospital Research Lab Exposes Seven Workers
Medical News Today 6/1//-04
Suspected Cutaneous Anthrax in A Laboratory Worker --- Texas, 2002, 2002 Morbidity and Mortality Weakly Reports (MMWR) April 5, 2002 / 51(13),279-281
A researcher at a university reported that a vial of potentially infectious materials "exploded" when she removed it from liquid nitrogen.
Hello.....Accidents happen in the best of places!
Russian Scientist Dies in Ebola Accident at Former Weapons Lab, New York Times Archive abstract, May 25, 2004
Laboratory-acquired Meningococcal Disease - United States, 2000 Morbidity and Mortality Weakly Reports (MMWR) February 22, 2002 / 51(07);141-144
A few years ago the newly discovered arenavirus, Sabia, was being studied by a visiting senior virologist, who was purifying it from 1 litre of tissue culture fluid. At the time of the incident, the virologist was working alone in the biosafety level3 laboratory (negative pressure with HEPAfiltered exhaust system). The researcher used a high speed centrifuge with a large angle head centrifuge rotor with six new plastic bottles in the purification process. During the centrifugation cycle there was a nasty rattling sound that indicated a problem. As soon as the unit stopped, he opened the chamber and removed the bottles from the rotor and placed them in a biological safety cabinet..Only then did he realize that one of the plastic bottles had leaked about 100 ml of infectious tissue culture into the centrifuge rotor. (Subsequently a hairline crack was found.)
The researcher was probably exposed to aerosolized Sabia virus when he opened the chamber. He immediately disinfected the centrifuge rotor, the defective bottle and the centrifuge using 10% Clorox solution. He cleaned the spilled material from the centrifuge while wearing a gown, surgical mask, and gloves. After disinfecting the centrifuge and bottles, he continued to work in the laboratory for 3-4 more hours. He did not inform anyone or report the incident.
About 10 days later he went to the doctor with a 4 day history of fever, malaise, backache, stiff neck, and myalgias that he attributed to another cause. The diagnosis of Sabia Virus was made and confirmed. Although Sabia virus infection is potentially fatal, the researcher recovered after 2 weeks of treatment.
Persons who came into contact with the researcher or with his biological specimens in the hospital laboratories were notified and enrolled in a surveillance program. None of these persons developed the virus.
The above case was a BL2.
Laboratory-Acquired West Nile Infections, United States, 2002, MMWR Weekly, December 20, 2002, 51(50);1133-1135
BATCHELOR BI, BRINDLE RJ, GILKS GF 1992 Biochemical mis-identification of Brucella melitensis and subsequent laboratory-acquired infection. J Hosp Infect 22: 159-162
BRETON I et al. 1995 Laboratory-acquired brucellosis. Med Mal Infect 25: 549-551
GRAMMONT-CUPILLARD, M, BERTHET-BADETTI, L et al. 1996 Brucellosis from sniffing cultures. Lancet 348: 1733-1734.
Well I could go on and on, but you get the picture, don't you?
I guess you spent the last 15 years in isolation to have not seen or known about any lab accidents or infections that happened in those lab accidents.
Wise up buddy, nobody is panic-ing over 5,000 labs having the virus. However there is concern.....cuz....friend.....accidents do happen.
The first comment is a lot of alarmism. Ellsworth makes a solid point - AND - she is a scientist working in the field. I think that makes her more of an authority on the topic than someone pulling stats from an AP search.
There are accidents in labs which do result in infections. But at the risk of sounding like John Stossel, "give me a break!" The number of accidental infections at labs contrasted with the number of accidents is very low. Of course the possibility of epidemics starting from mishandled samples exists. That is not the point. The real issue is whether or not we should be panicked by the mistaken distribution of a certain pathogen. I don't think we should be. Western laboratory controls are sound - and the people that staff those labs are degreed and professional.
Those of you that disagree should stop having anxiety attacks. If labs were as sloppy as the previous writer posits, we would have all been dead long ago. Have faith in a medical/scientific community that continues to keep us safe and produce the best medicine in the world.
Post a Comment
<< Home