Fort Detrick mishaps risked exposing workers to dangerous microbes

Two laboratory accidents at the US Army Medical Research Institute of Infectious Diseases (USAMRIID) within the past 16 months may have exposed nine workers to a bacterium and a virus regarded as potential bioweapons, according to a report yesterday in The Frederick (Md.) News-Post.

In one incident, six people were potentially exposed to Burkholderia mallei, which causes glanders, when a plastic tube in a boiling-water bath popped open on Sep 19, 2013, according to the story. It is based on reports obtained from USAMRIID and other government labs at Fort Detrick, Md., through requests filed under the Freedom of Information Act.

One worker stayed in the room for 10 minutes as the staff discussed what to do, the story says, but it does not mention any illnesses associated with either accident.

Glanders mainly affects horses but can also strike humans. It has been eliminated from the United States and much of the world, but the story says B mallei was used as a biological weapon in World War II. The Centers for Disease Control and Prevention (CDC) classifies it as a category B bioterrorism agent.

In the other incident, a USAMRIID microbiologist was working with TC-83, a virus derived from Venezuelan equine encephalitis virus (VEEV), on May 23, 2014, when tubes of the virus broke and released the contents while spinning inside a centrifuge, according to the News-Post.

The microbiologist, a lab technician, and a postdoctoral fellow were potentially exposed to the virus, the story says. The mishap was blamed on use of the wrong tubes.

VEEV is spread by mosquitoes and infects both horses and humans, mainly in South and Central America, according to background information on Medscape. The CDC lists it with certain other encephalitis viruses as category B bioterrorism agents.

The personnel involved in both incidents received additional training in the aftermath, and those exposed to B mallei were given antibiotics, the story says.
Jan 4 News-Post story
CIDRAP information on glanders
Medscape information on VEEV
CDC classification of bioterrorism agents

Saudi Arabia reports 3 new MERS cases, 2 deaths

Saudi Arabia's Ministry of Health (MOH) reported 1 new MERS-CoV case today and 2 cases on Jan 3, bringing the country's total to 828 cases.

The case-patient reported today is a 69-year-old Saudi man from Najran who is in stable condition. He has an underlying medical condition and is not a healthcare worker (HCW). The man did not have exposure to animals or contact with MERS-CoV (Middle East respiratory syndrome coronavirus) patients in clinical or community settings.

The first case reported on Jan 3 occurred in a 76-year-old Saudi man from Taif who had exposure to animals. He is not an HCW and had no contact with MERS patients in clinical or community settings. He has an underlying medical condition and is hospitalized in critical condition.

The second case-patient reported on Jan 3 is a 45-year-old Saudi man from Dammam who is in stable condition. He is not an HCW and had no contact with MERS-CoV cases in clinical or community settings. The man has no pre-existing disease, and the MOH is investigating whether he may have been exposed to animals.

The MOH reported today that a 70-year-old male expatriate from Dammam had died of MERS-CoV. The man had an underlying medical condition and was not an HCW. The MOH also reported the death of an 84-year-old Saudi man from Najran on Jan 1. The man was not an HCW and had no preexisting disease.

Yesterday, the MOH reported that a 70-year-old Saudi man from Qurayyat had recovered from MERS. The man had an underlying medical condition and was not an HCW.

Five Saudi MERS cases remain active, 466 people have recovered, and 357 people have died, the MOH said.
Jan 5 MOH update
Jan 4 MOH update
Jan 3 MOH update
Jan 1 MOH update

Saudi Arabia's MOH announces changes for command center

In related news, Saudi Arabia's MOH announced on Jan 2 several changes to the leadership, location, and work of the ministry's Command and Control Center (CCC).

Saudi Arabia's Minister of Health, Dr. Muhammad bin Ali Alhayaza, said that the CCC will move from its current location in Jeddah to the capital city of Riyadh, where its activities will be better integrated into national health efforts and priorities. As part of this move, the MOH will also institute local CCCs at each health affairs directorate.

The Riyadh-based CCC will now be under the direction of the Deputy Minister of Health for Public Health, Ziad Memish, MD. It will operate continuously year-round to address the prevention of MERS, Ebola, and other infectious diseases.

The MOH's announcement also reported the resignation of the CCC's current deputy commander, Dr. Anees Sindi.
Jan 2 MOH report

Polio vaccine drive nixed in Pakistan as Africa sees progress

Pakistan's first polio vaccination campaign of the new year was cancelled today because of security concerns after a health worker on his way to a polio-related meeting in Khyber-Pakhtunkhwa (KP) province was critically injured by a remote-controlled improvised explosive device (IED) on the roadside, according to a story in The Times of India.

The vaccine drive, expected to cover some of the Rawalpindi district, Punjab, Sindh, and Balochistan, as well as all of KP and the Federally Administered Tribal Areas (FATA), was to reach 8.5 million children, says the story.

The campaign will be rescheduled to begin Jan 19.

During 2014, more than 60 polio workers or security forces guarding them have been killed in Pakistan. The Taliban controls much of the FATA; certain factions there consider polio vaccination to be a Western plot to sterilize Muslims.

Pakistan is one of only three countries where polio is still endemic, the others being Nigeria and Afghanistan. The most cases by far have occurred in Pakistan, with 297 cases in 2014, the highest number since 1999.
Jan 5 Times of India article

Meanwhile, Nigeria is on the path toward being declared polio-free as soon as this month, according to the country's minister of health, Halliru Alhassan, quoted in a Jan 1 article in AllAfrica. The country has had only 6 cases of polio over the past 6 months, compared with 52 in the comparable period of 2013.

Global standards require that a country have no new cases in a 6-month period to be considered polio-free. Nigeria's most recent case was in July of 2014, in southern Kano state, according to a posting on the Global Polio Eradication Initiative (GPEI) Web site.

"We have eradicated Ebola and Guinea worm, and polio is on the verge of becoming history in Nigeria," stated Alhassan.
Jan 1 AllAfrica article
GPEI Web page

Rapid progress against transmission of wild polio virus (WPV) has been made all across Africa, with only 17 cases in 2014, compared with 74 in 2013, says a recent post from the World Health Organization (WHO).

No cases have been reported in the African region in more than 4 months, the notice states. The 17 cases in 2014 occurred in Nigeria (6), Cameroon (5), Equatorial Guinea (5), and Ethiopia (1).

The WHO estimates that more than 10 million people are curently well who would have been paralyzed without widespread oral polio vaccine campaigns.

Africa has seen a steady decline in polio cases since 2006, largely as a result of eradication efforts stemming from the GPEI.

Referring to the advent of complete polio eradication, the notice says, "Success will mean that no child will ever again suffer the terrible effects of lifelong polio-paralysis."
Dec 24 WHO notice