http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80077
Archive Number 20091112.3924
Published Date 12-NOV-2009
Subject PRO/EDR> Meningitis, meningococcal - USA (04): (MA) lab-acquired
MENINGITIS, MENINGOCOCCAL - USA (04): (MASSACHUSETTS) LABORATORY-ACQUIRED
*************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Tue 10 Nov 2009
Source: The Boston Globe [edited]
<http://www.boston.com/news/local/massachusetts/articles/2009/11/10/bu_student_caught_bacterial_infection_from_lab_tests_show/>
Sophisticated genetic fingerprinting confirmed that a laboratory
experiment was the source of a bacterial infection that sickened a
graduate student on Boston University's [BU] medical campus, city
disease investigators said yesterday [9 Nov 2009].
The genetic tests, conducted at the state laboratory in Jamaica Plain,
compared a blood sample from the researcher with bacterial matter
recovered from the lab where he was working on BU's South End campus.
"The bottom line,'' said Dr Anita Barry, top disease tracker at the
Boston Public Health Commission, "is they matched.'' The analysis
erased any doubt about what caused the researcher to become sick last
month [October 2009] and intensified investigations into precisely how
he was exposed to a germ known as _Neisseria meningitides_, which can
cause meningitis.
The city's biological lab safety division will review safety
procedures in BU's medical labs, to ensure that the school is doing
everything possible to minimize researchers' exposure to pathogens,
Barry said. Investigators will examine what kind of protective gear
the researcher was wearing, what kind of training he received, and how
thoroughly he was supervised, Barry said.
The city strengthened its regulation of labs after 3 BU scientists
became infected with tularemia in 2004, an episode that revealed
sloppy lab practices and a failure to report those illnesses in a
timely fashion. This time, the university has pledged to operate
transparently, promising to share findings of an internal
investigation with scientists across the university and even
researchers at other schools. "We want others to learn if there are
ways we identify that this could be prevented,'' said Ara Tahmassian,
associate vice president for research compliance at Boston University
School of Medicine. "When I look at this incident, it's one too
many,'' said Tahmassian, who joined BU after the tularemia cases. "But
if some of the other institutions can utilize what went wrong and hear
the lessons learned, fantastic.'' Tahmassian has convened a panel of
specialists to review the incident and said he expects them to report
expeditiously. "This is not going to be months,'' he said. "This is
going to be within a week or 2, pinpointing the best we can.''
The infection of the researcher, who has recovered, came at an awkward
moment for BU. A federal health agency is conducting what is probably
the final safety review of a controversial USD 200 million lab project
the university has built to work with the world's deadliest agents,
including [_Ebolavirus_] and plague. The centerpiece of that project,
a high-security biosafety level-4 lab, is in a completed but
unoccupied building on Albany Street.
The exposure of the graduate student -- the university has not
identified him, citing patient confidentiality rules -- happened in a
building next door to the contentious project. He was participating in
the hunt for a vaccine against the form of meningitis caused by the
germ.
The researcher was working in a biosafety level-2 lab, which has less
stringent safety procedures than level-4 labs. When he became ill, the
graduate student sought medical attention and notified the director of
the lab, concerned that his symptoms might be related to his research.
Unlike with the tularemia infections, BU alerted city disease
investigators of their suspicions about the student within hours of
learning about his illness. He is the only person who has become sick,
Barry said.
[Byline: Stephen Smith]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The following was extracted from a Journal Watch report on
laboratory-acquired meningococcal disease
(<http://infectious-diseases.jwatch.org/cgi/content/full/2002/322/1>):
"_Neisseria meningitides_ causes bacterial meningitis and sepsis.
Diagnosis is usually made by culturing the organisms on standard
microbiologic media. Disease is most often acquired by inhalation, and
microbiology personnel may be exposed when processing lab isolates.
Following the deaths of 2 microbiologists in 2000 from meningococcal
disease after occupational exposure, the CDC posted an Internet
request for reports of similar cases of occupationally acquired
meningococcal disease [see Laboratory-acquired meningococcal disease -
United States, 2000. CDC MMWR 2002 Feb 22; 51(7): 141-4; available at
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5107a1.htm> &
Sejvar JJ, et al: Assessing the risk of laboratory-acquired
meningococcal disease. J Clin Microbiol 2005; 43(9): 4811-4; available
at
<http://jcm.asm.org/cgi/reprint/43/9/4811.pdf>].
A total of 16 cases were reported; 8 were from the USA. 9 (56 percent)
were caused by _N. meningitidis_ serogroup B and 7 (44 percent) by
serogroup C. 8 patients (50 percent) died. Patients were exposed by
reading plates (50 percent), making subcultures (50 percent), and
performing serogroup identification (38 percent). All patients worked
in microbiology labs. The risk for infection among microbiologists is
estimated to be 7 times that among the general population (95 percent
confidence interval, 1-19).
Comment: Although meningococcal disease is uncommon, microbiologists
working with _N. meningitidis_ should take special care, because their
infection risk is elevated, and the case-fatality rate is high. Most
risk is likely associated with exposure to pure cultures rather than
to patient samples. Precautions should include using a biosafety hood
when manipulating isolates and wearing splash-guards and masks. When
such protections are not available, isolates should be referred to
other labs for serotyping. Vaccination of personnel may also be
considered, but current meningococcal vaccines do not protect against
disease from _N. meningitidis_ type B and thus will not eliminate risk
for infection.
- C Robert Horsburgh Jr, MD"
The state of Massachusetts can be located on the HealthMap/ProMED-mail
interactive map of the USA at
<http://healthmap.org/r/00_U>. - Mod.ML]
[see also:
Meningitis, meningococcal - USA (03): (OH) susp, RFI 20090529.2000
Meningitis, meningococcal - USA (02): (FL) 20090424.1547
Meningitis, meningococcal - USA: (PA) 20090218.0674
2006
----
Meningococcal disease cluster - USA (NY) (02) 20060630.1808
Meningococcal disease cluster - USA (NY): RFI 20060607.1584]
........................................ml/mj/jw
Archive Number 20091112.3924
Published Date 12-NOV-2009
Subject PRO/EDR> Meningitis, meningococcal - USA (04): (MA) lab-acquired
MENINGITIS, MENINGOCOCCAL - USA (04): (MASSACHUSETTS) LABORATORY-ACQUIRED
*************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Tue 10 Nov 2009
Source: The Boston Globe [edited]
<http://www.boston.com/news/local/massachusetts/articles/2009/11/10/bu_student_caught_bacterial_infection_from_lab_tests_show/>
Sophisticated genetic fingerprinting confirmed that a laboratory
experiment was the source of a bacterial infection that sickened a
graduate student on Boston University's [BU] medical campus, city
disease investigators said yesterday [9 Nov 2009].
The genetic tests, conducted at the state laboratory in Jamaica Plain,
compared a blood sample from the researcher with bacterial matter
recovered from the lab where he was working on BU's South End campus.
"The bottom line,'' said Dr Anita Barry, top disease tracker at the
Boston Public Health Commission, "is they matched.'' The analysis
erased any doubt about what caused the researcher to become sick last
month [October 2009] and intensified investigations into precisely how
he was exposed to a germ known as _Neisseria meningitides_, which can
cause meningitis.
The city's biological lab safety division will review safety
procedures in BU's medical labs, to ensure that the school is doing
everything possible to minimize researchers' exposure to pathogens,
Barry said. Investigators will examine what kind of protective gear
the researcher was wearing, what kind of training he received, and how
thoroughly he was supervised, Barry said.
The city strengthened its regulation of labs after 3 BU scientists
became infected with tularemia in 2004, an episode that revealed
sloppy lab practices and a failure to report those illnesses in a
timely fashion. This time, the university has pledged to operate
transparently, promising to share findings of an internal
investigation with scientists across the university and even
researchers at other schools. "We want others to learn if there are
ways we identify that this could be prevented,'' said Ara Tahmassian,
associate vice president for research compliance at Boston University
School of Medicine. "When I look at this incident, it's one too
many,'' said Tahmassian, who joined BU after the tularemia cases. "But
if some of the other institutions can utilize what went wrong and hear
the lessons learned, fantastic.'' Tahmassian has convened a panel of
specialists to review the incident and said he expects them to report
expeditiously. "This is not going to be months,'' he said. "This is
going to be within a week or 2, pinpointing the best we can.''
The infection of the researcher, who has recovered, came at an awkward
moment for BU. A federal health agency is conducting what is probably
the final safety review of a controversial USD 200 million lab project
the university has built to work with the world's deadliest agents,
including [_Ebolavirus_] and plague. The centerpiece of that project,
a high-security biosafety level-4 lab, is in a completed but
unoccupied building on Albany Street.
The exposure of the graduate student -- the university has not
identified him, citing patient confidentiality rules -- happened in a
building next door to the contentious project. He was participating in
the hunt for a vaccine against the form of meningitis caused by the
germ.
The researcher was working in a biosafety level-2 lab, which has less
stringent safety procedures than level-4 labs. When he became ill, the
graduate student sought medical attention and notified the director of
the lab, concerned that his symptoms might be related to his research.
Unlike with the tularemia infections, BU alerted city disease
investigators of their suspicions about the student within hours of
learning about his illness. He is the only person who has become sick,
Barry said.
[Byline: Stephen Smith]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The following was extracted from a Journal Watch report on
laboratory-acquired meningococcal disease
(<http://infectious-diseases.jwatch.org/cgi/content/full/2002/322/1>):
"_Neisseria meningitides_ causes bacterial meningitis and sepsis.
Diagnosis is usually made by culturing the organisms on standard
microbiologic media. Disease is most often acquired by inhalation, and
microbiology personnel may be exposed when processing lab isolates.
Following the deaths of 2 microbiologists in 2000 from meningococcal
disease after occupational exposure, the CDC posted an Internet
request for reports of similar cases of occupationally acquired
meningococcal disease [see Laboratory-acquired meningococcal disease -
United States, 2000. CDC MMWR 2002 Feb 22; 51(7): 141-4; available at
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5107a1.htm> &
Sejvar JJ, et al: Assessing the risk of laboratory-acquired
meningococcal disease. J Clin Microbiol 2005; 43(9): 4811-4; available
at
<http://jcm.asm.org/cgi/reprint/43/9/4811.pdf>].
A total of 16 cases were reported; 8 were from the USA. 9 (56 percent)
were caused by _N. meningitidis_ serogroup B and 7 (44 percent) by
serogroup C. 8 patients (50 percent) died. Patients were exposed by
reading plates (50 percent), making subcultures (50 percent), and
performing serogroup identification (38 percent). All patients worked
in microbiology labs. The risk for infection among microbiologists is
estimated to be 7 times that among the general population (95 percent
confidence interval, 1-19).
Comment: Although meningococcal disease is uncommon, microbiologists
working with _N. meningitidis_ should take special care, because their
infection risk is elevated, and the case-fatality rate is high. Most
risk is likely associated with exposure to pure cultures rather than
to patient samples. Precautions should include using a biosafety hood
when manipulating isolates and wearing splash-guards and masks. When
such protections are not available, isolates should be referred to
other labs for serotyping. Vaccination of personnel may also be
considered, but current meningococcal vaccines do not protect against
disease from _N. meningitidis_ type B and thus will not eliminate risk
for infection.
- C Robert Horsburgh Jr, MD"
The state of Massachusetts can be located on the HealthMap/ProMED-mail
interactive map of the USA at
<http://healthmap.org/r/00_U>. - Mod.ML]
[see also:
Meningitis, meningococcal - USA (03): (OH) susp, RFI 20090529.2000
Meningitis, meningococcal - USA (02): (FL) 20090424.1547
Meningitis, meningococcal - USA: (PA) 20090218.0674
2006
----
Meningococcal disease cluster - USA (NY) (02) 20060630.1808
Meningococcal disease cluster - USA (NY): RFI 20060607.1584]
........................................ml/mj/jw