January 19, 2005
By Stephen Smith
The Boston Globe
Three Boston University researchers became ill in 2004 after being exposed in a laboratory to a potentially lethal disease called tularemia, university and public health authorities said on Tue 18 Jan 2005. It was the 1st known instance of researchers in a Boston lab becoming infected with a biological agent they were studying, according to a city public health official. And it came at an awkward time for BU, as it was seeking local and federal approval for a high-security lab to study the most feared infectious diseases in the world.
How the workers became infected remains unclear, although BU officials said that researchers had violated procedures intended to protect them from exposure. 2 researchers became ill in May 2004, and a 3rd in September 2004, apparently after separate exposures. But their illnesses were not linked to tularemia until October 2004.
BU reported the cases to city, state, and federal health authorities in November 2004, about the time public hearings on the high-security lab were being held. But neither the university nor the government agencies disclosed the cases to the public at the time, saying there was no risk to public health, because tularemia is not transmitted from person to person.
Boston Mayor Thomas M. Menino, who learned of the cases from BU and city public health officials, also decided against telling city residents. "Right from the moment that he was made aware of the situation, the Public Health Commission assured him there was no public threat whatsoever, and he's made it clear that if there was any public threat whatsoever, the public would have been advised immediately," said Seth Gitell, the mayor's spokesman.
With Menino's enthusiastic backing, the city Zoning Commission gave its final approval to the high-security biolaboratory last week [2nd week of January 2005]. The lab still must be approved by the National Institute of Allergy and Infectious Diseases, which is considered likely, because it's the same agency that, in 2003, selected BU as one of 2 sites nationally for sophisticated new labs able to study anthrax, plague, and other deadly pathogens.
BU and public health officials discussed the cases publicly for the 1st time yesterday, 18 Jan 2005, after media inquiries. The 1st exposures happened last spring [2004], with 2 researchers falling ill in late May 2004. They complained of flu-like symptoms, and one was hospitalized overnight. The 3rd infected researcher fell ill in September 2004 and required hospitalization for several days, Moore said. All 3 recovered fully after receiving antimicrobial agents.
They worked in a lab that, in 2003, received a 5-year grant from the federal government to develop a vaccine against tularemia, an illness spread by insects and animals, including rabbits. Often called "rabbit fever," it is also viewed as a potential agent of bioterrorism. [Tularemia, a disease caused by the bacterium _Francisella tularensis_, is indeed a Category A bioterrorism disease - Mod. LL]. In 2000, an outbreak of tularemia on Martha's Vineyard ignited panic, after a laborer died and about a dozen other people became infected. [Cases still occur on Martha's Vineyard - Mod.LL].
The scientists at BU believed that they were working with a strain of the germ that had been altered specifically for vaccine research so as not to cause illness. But a highly infectious strain of tularemia was mixed with the harmless variety. The source of the contamination is being investigated by federal health officials.
The tularemia linked with the illnesses was supplied by a laboratory in Nebraska that federal authorities, citing security concerns, declined yesterday [18 Jan 2005] to identify.
Because the researchers assumed that they were working with a form of tularemia not known to cause illness, they did not immediately link their symptoms to their research. It was after the 3rd researcher became ill that faculty members began to suspect that something could be seriously wrong in the laboratory inside the university's Evans Biomedical Research building on Albany Street in the South End.
Subsequent DNA tests on the tularemia being studied in the BU lab showed that the bacteria identified as coming from Nebraska contained the harmless strain and a highly infectious type.
"The deck was stacked against [the researchers], because they were working with something they had no idea they were working with," Moore said. But Moore acknowledged that researchers in the lab had violated policies requiring them to work with tularemia inside an enclosed box, called a hood, that sends air through sophisticated filters. Instead, the tularemia samples were sometimes worked with in the open, in part because the enclosed research boxes were sometimes filled with material that should not have been kept there, Moore said.
Blood tests were performed on about 60 university researchers, and those tests showed that only the 3 workers who had become ill tested positive for tularemia. After the exposure was determined, BU, in November 2004, shuttered the lab for decontamination. The part of the lab where the tularemia research was conducted remains closed.
The investigation into how the exposure happened continues. Samples of _F. tularensis_ were sent directly from the Nebraska lab for CDC analysis, and those tests showed no presence of the dangerous strain, deepening the mystery around the episode.
"At this time, it seems to me there's no evidence conclusively to link the contamination to Boston or to Nebraska," said Jennifer Morcone, a CDC spokeswoman. "Certainly, everyone would like to determine the source of the contamination to make certain nothing like this could happen again."
As a result of the exposures, BU, as well as the Boston Public Health Commission, are moving to tighten oversight of research. To improve safety in the dozens of public and private research labs in Boston, the Public Health Commission intends by this spring [2005] to start a mandatory training program for lab workers, emphasizing the reporting of illnesses in researchers. The commission also plans to hire a lab safety inspector who will make unannounced visits to research sites to make certain they are following safety protocols, said John Auerbach, Public Health Commission executive director.
http://www.boston.com/news/local/articles/2005/01/19/bacterium_infected_3_at_bu_biolab/