In an article published this month in the Journal of Occupational and Environmental Medicine, Janice M. Rusnak, M.D. and colleagues at USAMRIID note that research on agents of bioterrorism is becoming more widespread. At the same time, institutions beginning such work may have limited clinical experience or procedures in place for the medical management of laboratory exposures to these agents. And while information on preventing occupational exposures to high-risk agents is widely available, literature on medical management of these exposures when they do occur is limited.
To assess the effectiveness of the USAMRIID program--and to provide helpful information to other institutions involved in biological threat agent research--Rusnak and her team reviewed potential laboratory exposures at the Institute between 1989 and 2002.
"We chose this time period for two reasons," said Rusnak. "First of all, treatment protocols can change over time, and we wanted this review to contain more recent information in order to be of use to others in the field. Secondly, the data were most consistent during this timeframe. Prior to 1989, the records were kept in a different format."
The review noted only five confirmed laboratory-acquired infections, out of 234 evaluations of potential exposures and illnesses, in a fourteen-year period. These confirmed cases involved glanders, Q fever, vaccinia, chikungunya and Venezuelan equine encephalitis. All five individuals made a full recovery.
According to Rusnak, potential exposures fell mainly into two categories: percutaneous and aerosolized. Percutaneous exposures included events such as needlesticks, cuts, and animal bites or scratches. Aerosolized exp
Contact: Caree Vander Linden
US Army Medical Research Institute of Infectious Diseases