Scientific Casualties – Infectious disease research can be life threatening

ResearchBlogging.org

Before this weeks post I would like to make an announcement. At this stage I am claiming victory in the debate. You can check out the results on the poll itself here. First I would like to thank myself for putting up such an amazing argument. I would also like to thank Thomas for putting up an insufficient fight, I’ll save some cake for you buddy. I would like to thank my wife and our dogs whose love and support get me throu………..<music plays me off stage>.

I don’t want to sound like I’m brave or a hero or anything but each and every day I, alongside my lab-mates aka ‘the league of extraordinary scientists’, stare down pathogens like S. pneumoniae, E. coli, S. flexneri and L. monocytogenes. We go into battle to try and work out how it is that we can tackle these bad guys on a global scale, developing vaccines and anti-microbials or simply understanding their weaknesses better.

So how do we protect ourselves from these harbingers of death in the lab? A gown, gloves and glasses when appropriate and ethanol on everything all the time to ensure it’s sterilised regularly. Really doesn’t seem like much of a barrier when I think about it.

Thomas wearing his lab coat to protect himself from his work… Thomas. Are you in a bar? Bad Thomas!

In some cases we specifically work on weakened strains to help protect ourselves further but we do rely heavily on our ability to handle these bacteria carefully and with common sense. However, despite all the precautions we take in the lab I’m reasonably sure some of us would be carrying the bugs we work on.

Even though I’m unlikely to get sick playing with my pneumo strains it has been playing on my mind ever since I heard Prof. Patrice Nordmann speak at that conference I keep name dropping. Prof. Nordmann was an excellent speaker who gave a presentation regarding the rise in antibiotic resistance levels in French hospitals (not because they are particularly notable, just because he works in France). During his talk though he mentioned a paper he had written and had published in the New England Medical Journal regarding a lab induced injury.

The researcher/patient developed acute paronychia (inflammation of the skin around the fingernails) after handling a strain of Staphylococcus aureus that produced a nasty toxin called Panton–Valentine leukocidin. These strains have started to become more and more prevalent recently and are normally associated with nasal infections and subsequent swabbing of the nasal passages of the patient showed the presence of the same strain.

Its wasn’t a Mickey Mouse infection either, this patient had 2 rounds of surgical drainage, 3 weeks of daily finger baths in antiseptic agents, a one month course of antibiotics, 3 times a day nasal decontamination for a week and twice a day full body showers in 4% chlorhexidine gluconate.

Unfortunately this isn’t an isolated incident. Accidents happen and when you work on infectious disease those accidents can be a big deal.

Another highly publicised case was that of a researcher in Germany who gave herself Ebola. Whilst the Staph patient probably just spilt some on his hand and was unlucky this woman gave herself a needlestick injury whilst inoculating mice with the deadly virus. It took a team of experts and an experimental vaccine that had never previously been tested on humans to save her life.

We can even look closer to home (well, my home at least) where we had the ‘lab bungle’ involving Q fever at the SA Pathology in Adelaide. Q fever is caused by Coxiella burnetii, a bacterium found naturally in the soil in both vegetative and spore forms. Most human cases of disease are associated with animal handling. Apparently some protocols may have been breached resulting of the release of the bacterium resulting in a handful of researchers testing positive and at least one requiring hospitalisation.

Too much love for this guy can also induce Q fever, weird unhealthy Q fever. If you don’t get the reference just let me know in the comments and I shall let the internet judge your worth <http://commons.wikimedia.org/wiki/File:Desmond_Llewelyn_01.jpg&gt;

Finally there is the case of the Edinburgh Outbreak. During the 1960-1070’s in Scottish hospitals increased rates of Hepatitis B infection were observed in staff and home contacts of patients. Over a 13 year period 15 staff or home contacts developed viral hepatitis including 4 cases that were ultimately fatal including a surgeon, a receptionist, a technician and a house officer. The outbreak had many sources caused largely by breaks in protocol but the spread of the infection was possible as of the 15 staff or home contacts that became patients; 5 had blood on glass or needle-stick injuries, 2 were exposed during a surgery and resuscitation procedure on a HepB patient in some unidentifiable way, 2 were directly contaminated with patient blood, 3 handled contaminated material and 3 patients, despite having no accident or direct contamination developed viral hepatitis this included a technician who cleaned the dialysis machines and the specimen receptionist in haematology.

While we joke around on the blog a bit about bacteria and diseases it’s sobering to think that in labs and clinics around the world people doing everything they can to research, identify and understand the things that make us sick and are brave enough to work with these very organisms that, given the opportunity, will make them very sick as well.

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References

http://www.adelaidenow.com.au/news/south-australia/lab-bungle-infects-two-with-q-fever/story-e6frea83-1225811472210

http://www.independentweekly.com.au/news/local/news/general/two-sa-pathology-workers-contract-q-fever/1708795.aspx

http://www.msnbc.msn.com/id/29914303/

Marmion BP, Burrell CJ, Tonkin RW, & Dickson J (1982). Dialysis-associated hepatitis in Edinburgh; 1969-1978. Reviews of infectious diseases, 4 (3), 619-37 PMID: 6812192


Burrell CJ, Tonkin RW, Proudfoot E, Leadbetter G, Cowan P, Lockerbie L, Gore S, Lutz W, & Marmion BP (1977). Prevalence of antibody to hepatitits B surface antigen among staff in an Edinburgh hospital. The Journal of hygiene, 78 (1), 57-68 PMID: 264499


Nordmann, P., & Naas, T. (2005). Transmission of Methicillin-Resistant to a Microbiologist New England Journal of Medicine, 352 (14), 1489-1490 DOI: 10.1056/NEJM200504073521418

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21 Comments

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21 responses to “Scientific Casualties – Infectious disease research can be life threatening

  1. Pingback: Tweets that mention Scientific Casualties – Infectious disease research can be life threatening « Disease of the Week! -- Topsy.com

  2. mabs

    love this article! i shall be more careful in the lab now… hmm maybe..

  3. mabs

    :P nope.. erm not yet! but i might share this on facebook? haha

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  5. Michelle

    Not to be too much of a “stickler” (ha, ha) but it’s not quite correct to say that the German researcher actually “gave” herself Ebola. “She was potentially exposed” is the most we can say with certainty. And while I am a big, big fan of vaccines–go vaccines, go!–no one can actually say that the experimental vaccine saved her. She never got sick, which is great, but that could be because her potential exposure didn’t result in infection.

    I’d say a scarier example is Janet Parker, who wasn’t even a lab worker, but died of smallpox after it traveled from a lab through duct work in a building she was working in. So yes, you guys do walk a dangerous line!

    • Your right about the Ebola victim. It’s possible she didnt give herself the disease but I was assuming worst case scenario, as I think all involved were. My point was not the injury per say but the oppourtunity existed and thats scary enough.
      I wasn’t aware of Janet Parker, that’s truly awful. I was under the impression that most labs are kept in positive pressure so bugs can spread by air con ducts. I guess you can never be completely safe.

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  8. Michele

    I hope someone can answer this My husband just found out he has Hepatitis b . Doctor wants to take another blood test to make sure . My question is he just started working in a animal research lab cleaning evering out its under construction. He needed the research lab cleaned were they tested the animals so the guys could start the next faze of the job so he help out and clean and remove tray ,glass box the keep the animals in . when cleaning there was blood animal fetsis. I know what and how you can catch hepatitias b . just wanted know if anyone know if you can containate your self via salva if you touch these things. the past weeks has a sinus infection and feeling sick . He never sick and is been out of work for 2years 7months up until 5 months ago. when here started this job.. Also we never been apart more the 10 minutes I am also out of work longer . Hope can answer this Thanks Michele

    • I’m sorry to say that my only answer is that I have no idea. I’m sorry that I cannot be more helpful but my best advice would be to go to see you local GP and let them know the situation. Of course if the condition increases in severity I would suggest visiting the nearest hospital. Unfortunately without any medical training or a chance to assess either yourself or your husband it would be irresponsible of us to advise beyond saying you GP or local hospital would be good options for proper diagnosis and treatment.

    • I guess I’ll weigh in on this. Hepatitis B (in the vast majority of cases) is passed on via blood-to-blood contact. Saliva may contain some virus and you could theoretically catch it by that route although it is more unlikely than blood transfer.

      Where he caught it, I don’t know. Hepatitis B is a very species-specific disease. That is to say that any animals (that are not chimpanzees) are very, very, VERY unlikely to give you hepatitis B.

      Even WHEN he caught it is a mystery. Hepatitis B can be asymptomatic for months, years, even decades. Currently, most people with Hepatitis B don’t know that they have it.

      Hope this helps and my condolences,
      Thomas

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