From petri dish to people? Lab infections can spread illness, even death

Centers for Disease Control and Prevention

Yersinia pestis, the bacteria responsible for the plague, caused the death of a renowned vaccine researcher in 2009, raising fears about laboratory-acquired infections. Though rare, they can be devastating, prompting health experts to remind lab workers of the importance of following protocols.

The death of a University of Chicago scientist who contracted plague while working in his lab is a reminder of the rare –- but real –- risks to researchers who work with potentially dangerous bugs, a new review of the fatality  finds.

An estimated 500,000 workers are employed in laboratories in the United States, where they’re routinely exposed to a range of bacteria, viruses, molds and other infectious agents. No one knows how many get sick each year, mostly because there’s no systematic reporting of laboratory-acquired infections, health experts say.

In the last several months, however, federal health officials have investigated an outbreak of salmonella infections tied to dozens of microbiology students and workers across the country -- and, in several cases, their children and other family members -- who fell ill from a lab bug likely spread by contaminated cell phones, car keys and other personal items.

And now the latest issue of the New England Journal of Medicine updates the case of Malcolm Casadaban, 60, a professor of molecular genetics, who died in September 2009 after falling ill following experiments using a weakened strain of the Yersinia pestis bacteria that cause plague.  It was the first time a lab worker had contracted plague in 50 years and the first reported death tied to a lab, according to the Centers for Disease Control and Prevention.

In both situations, investigators said that said lack of attention to lab protocols might have contributed to the illnesses. Failure to consistently wear gloves when required, or bringing personal items like car keys and MP3 players into the lab environment raises the risk that infections move beyond the petri dish -- and into people.

University of Chicago Medical Center

Malcolm Casadaban, a University of Chicago professor, died in 2009 after working with the plague bacteria in his lab.

“It’s not the lab strain, it’s bad practice,” said Dr. Karen Frank, an assistant professor in the department of pathology at the University of Chicago and author of the latest research letter.

In Casadaban’s case, investigators also concluded that the vaccine researcher had a genetic condition that made him particularly susceptible to infection from the bacteria. He suffered from undetected hemochromatosis, a condition in which too much iron builds up in the body. The plague bacteria had been engineered to be safer by removing some of the germ's iron, but the scientist’s condition added it back.

“He had extra iron, which allowed this organism to make him sicker,” said Frank. It’s not clear how Casadaban was infected, but investigators suspect it was transmitted through contact with skin or mucous membranes.

Casadaban wasn’t identified by name in the NEJM letter or in a previous CDC report, but news accounts at the time and a university obituary indicate he was the respected lab worker who died after an infection.

Such incidents raise public fears of lab bugs escaping to infect the general population, but those fears are unwarranted, Frank said.

“There’s less risk coming from lab workers than from all the people visiting patients in the hospital,” Frank said.

In both of the cases in question, the lab strains of bacteria were found to be as safe as expected, she said. She characterized the level of lab workers’ personal worry about infections as “almost none.”

“As long as you’re doing what you’re supposed to be doing, you should be fine,” she said.

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Discuss this post

Every lab, hospital or research, public, private or government, has rules governing how things are done when dealing with pathogenic organisms. The rules differ according to the seriousness of the possible diseases they are encountering. But basic sterile techniques are, or should be, pretty much the same everywhere, and are supposed to be used to not contaminate both the results and the techs. People get infected, and spread the infections, when they either get careless, or aren't trained properly for the situation. Human error.

    Reply#1 - Wed Jun 29, 2011 5:44 PM EDT

    I cannot tell you how often doctors visit patients with contagious diseases wearing their street clothes. Hospitals need to take these issues of cross contamination seriously. Any physician found visiting patients with his street clothes on or not disinfecting his stethoscope between patients should be immediately suspended.

    Doctors with direct patient care, lab techs, nurses, etc should not be allowed to wear their scrubs out into the public after seeing ANY patient or working with a contagious specimen. We often don't know if a patient is contagious immediately. If you see a doctor in scrubs at a restaurant stay as far away as possible. I would get up and leave the restaurant.

    • 6 votes
    Reply#2 - Wed Jun 29, 2011 5:55 PM EDT

    I see persons everywhere in scrubs, I don't know if the people are medical workers, dental workers, veterinary assistants, nursing home assistants, etc. I assume that their clothing can't possibly be clean (unless they are on their way TO work, but there is no way to tell that). Scrubs aren't street clothes.

    • 2 votes
    #2.1 - Wed Jun 29, 2011 7:45 PM EDT
    Reply

    As a lab technologist I fully support your argument. It is sickening to see every one that works in a high risk area prancing around in the public domain exhibiting their lab coat or scrubs. The rule of thumb is if you must wear a scrub outside of you area, you should replace the contaminated one with a clean pair. So much for that rule. Even in the hospital cafeteria, everyone displays their department or their, profession by their clothing. Rule again leave all external clothing in your office or lab. Do they listen? No. Why should they. Authority goes a long way. In life everything is harmful. it is up to you the public to contain, and curtail such behavior.

    • 1 vote
    Reply#3 - Wed Jun 29, 2011 7:25 PM EDT

    Why was a PI working in the lab anyways???

      Reply#4 - Wed Jun 29, 2011 7:25 PM EDT

      This is very much a non story. You work in a lab you need to follow protocol...nothing new.

        Reply#5 - Wed Jun 29, 2011 7:52 PM EDT

        Hi,but do they. You tell me.

        • 1 vote
        #5.1 - Wed Jun 29, 2011 9:30 PM EDT

        Labs are very serious about saftey. Especially those handling truly virulent organisms and virus. It is rare that something serious happens.

          #5.2 - Wed Jun 29, 2011 9:47 PM EDT
          Reply

          I'm a biology major and I ALWAYS scrub down after working in the lab and I ALWAYS wear protective gear including gloves. Also, I NEVER bring personal items into the lab and I don't even drink bottled water in there. My graduate degree will be in microbiology and I expect to never contaminate myself like these people did... This was nothing more than an example of both laziness and stupidity.

            Reply#6 - Wed Jun 29, 2011 9:34 PM EDT

            how can you say that was laziness. He had an UNDIAGNOSED medical condition that made him susceptible. Learn to read you idiot!

              #6.1 - Thu Jun 30, 2011 2:24 AM EDT
              Reply

              " ... spread illness, even death" says the headline. How does one spread death? Everyone will die in time - we can hasten or delay death (for a given individual), but not spread it - it is ubiquitous. The contamination can cause death, but not spread death.

                Reply#7 - Wed Jun 29, 2011 10:48 PM EDT

                .

                  Reply#8 - Thu Jun 30, 2011 11:31 AM EDT

                  Dr. Karen Frank; asstnt. professor @ U. of Chicago Path. lab said "It's not the lab strain, It's bad practice". That's a scary thought. People handling such dangerous & sometimes deadly strains of bacteria or virus!

                    Reply#9 - Wed May 2, 2012 6:14 PM EDT
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