Georgia lab workers exposed to bioterror agent 

By ALISON YOUNG
The Atlanta Journal-Constitution
Published on: 01/30/08 

Hundreds of laboratory workers across the country -- including 57 in 
Georgia -- were potentially exposed to a weakened bioterrorism agent 
when samples were mishandled as part of a voluntary readiness test, 
state and federal health officials said.

At 16 of Georgia's 27 clinical labs participating in the test, 
workers failed to follow proper handling procedures and were 
potentially exposed to a vaccine strain of Brucella abortus RB51. 
Brucella bacteria, which are classified as a bioterrorism agent, 
primarily infect animals, but also can sicken people.

Although the vaccine strain used in the test can infect humans, no 
illnesses have been reported in Georgia or nationally.

Officials at the Atlanta-based Centers for Disease Control and 
Prevention, which is investigating, said that while such tests are 
important, the widespread handling problems illustrate the need for 
hospital and other private labs to establish and follow safety 
procedures when working with suspected bioterrorism agents.

"We want laboratorians to be aware and vigilant," said Dr. Lisa 
Rotz, director of CDC's Division of Bio-terrorism and Response. 
"This is an opportunity for us to go back and look into why these 
practices weren't followed."  

So far, the CDC has identified 916 workers in 254 clinical labs who 
were potentially exposed to Brucella during the nationwide Laboratory 
Preparedness Survey last fall.

The chairman of a congressional committee investigating bioterrorism 
lab safety said Tuesday these lapses raise "serious concerns."  

"We are all fortunate this recent failing was only a test. Next time,
we might not be so lucky," said U.S. Rep. John Dingell (D-Mich.), 
chairman of the House Committee on Energy and Commerce.

While lab workers were at risk, the general public was not, health 
officials said. Brucella infections cause flu-like symptoms, but 
severe cases can involve the lining of the heart. In some cases, 
infections can cause chronic problems, such as recurrent fevers, 
joint pain and fatigue.

Clinical laboratories, which perform tests on samples taken from 
patients in doctors' offices and hospitals, are the nation's front 
line for detecting bioterrorism events and outbreaks of other 
infectious diseases. The anthrax attacks of 2001 showed the 
importance of these labs being prepared to quickly identify 
specimens containing unusual and deadly germs.

The preparedness survey -- a joint project of the College of American 
Pathologists, CDC and the Association of Public Health Laboratories --
is one of the few exercises that specifically tests labs' ability to 
respond to bioterrorism agents.

Twice a year, labs that voluntarily participate in the program are 
sent samples of various disease-causing organisms. Since 2006, the 
tests have included weakened bioterrorism organisms after the labs 
said they needed more realistic exercises of their preparedness, 
CDC officials said.

To participate in the tests, labs had to confirm they had proper 
safety equipment.

The test kits containing Brucella samples were sent to 1,316 
clinical labs in the U.S. and Canada in October and November, CDC 
officials said. Even though it was a weakened strain used to 
inoculate cattle, the strain has the potential to cause human illness.

The test simulated the arrival of samples where a bioterrorism agent 
is suspected, but not identified. The labs were to conduct tests to 
identify or rule out various agents. The testing kits included 
written instructions stating the samples should be handled inside a 
special safety cabinet and within the protective barriers of a 
Biosafety Level 3 lab.

Despite these instructions, some lab workers handled the samples in 
high risk ways, even sniffing open culture plates as they sought 
clues to what was growing on them, records show. Certain odors are 
associated with some bacteria.

"This is a wake-up call for some of these laboratories," said 
Frances Pouch Downes, president of the Association of Public Health 
Laboratories. "We have work to do on safety-awareness," she said.

In November, New York's health department alerted CDC it had 
discovered problems in the handling of some test samples in the 
state. That prompted CDC last month to question all states .

The mishandling of Brucella samples at seven Georgia labs placed 15 
workers at "high risk" of exposure, Dana Cole, a Georgia Division of 
Public Health epidemiologist, said. These workers were urged to take 
antibiotics last month as a precaution.

The other 42 Georgia workers had "low risk" exposures, she said.

In a response to an AJC request under the Georgia Open Records Act, 
the state declined to name the labs that mishandled samples, saying 
their identification "could potentially jeopardize security." They 
said no state-or county-run labs mishandled samples.

The test is not graded and is only designed to help labs assess 
their ability to identify potential bioterrorism agents, not their 
safety practices, said Dr. Paul Valenstein, vice chairman of the 
council on scientific affairs for the College of American 
Pathologists.

The good news is that labs across the country generally did a good 
ob identifying that the sample was something that needed to be 
referred to a public health laboratory for further analysis, he said.

"We have no plans to change the survey whatsoever. We don't believe 
it poses any risk," Valenstein said. "It's an important educational 
exercise."





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