Lab Matters Winter 2018 - Page 14

from the bench Preventing History from Repeating: The Evolution of Risk Assessments Since 1918 by Michael Pentella, PhD, MS, D(ABMM), chair, Biosafety and Biosecurity Committee (BBC); Russell W. Currier, DVM, past-president, American Veterinary Medical History Society; and Sean Page, associate specialist, Public Health Preparedness and Response For many Americans today, influenza seems like an annoying disease that can be easily prevented by obtaining a flu shot, frequent handwashing and, if infected, quarantining oneself until the symptoms dissipate. However, in 1918, influenza showed the world that the flu can be deadly for populations if not properly prepared for. With estimates placed at 675,000 American deaths from the outbreak, the 1918 influenza killed more people globally than World War I. 100 years later, biorisk management is now recognized as an important component of the laboratory quality management system, which should include mitigation, evaluation and continuous improvement. The 100th anniversary of the 1918 influenza pandemic offers an excellent opportunity for public health laboratorians to reflect on the risk posed to the scientists who were working with specimens from patients infected with this deadly agent. Using lessons learned from the 1918 pandemic and other major outbreaks through the decades that followed, state and territorial public health laboratories have developed and integrated biosafety practices into bench work, with the goal of protecting laboratorians from known and unknown pathogens. One tool that has been exceptionally beneficial in improving laboratory safety in the past century is the risk assessment. A Revolutionary Concept: Biosafety As the deadly 1918 virus was spreading, medical scientists were at a loss as to how to identify the cause of the outbreak, let alone how to create a vaccine or therapeutic agent to combat it. At the time, microbiology was essentially 12 LAB MATTERS Summer 2017 One Tool, One System, One Brighter Future In 2015, APHL established the Biosafety and Biosecurity Committee in 2015 with the goal of: • urging laboratories to enhance biosafety practices via routine risk assessments and standardized training • identifying true risk and best practices The committee has assembled a variety of laboratory biorisk resources including risk assessment documents, webinars, and a biosafety and biosecurity website. It has established a biosafety officer community of practice and fields a yearly biosecurity survey to assess the evolving needs of laboratorians. • developing consensus standards and guidelines • improving laboratory reporting of exposure events. bacteriology, since viruses were not yet commonly recognized in the laboratory. In culturing sputum from infected patients, bacteriologists identified the bacterium Haemophilus influenza in many specimens and erroneously concluded that it was the causative agent. Eventually the work of Dr. Richard Shope in 1930 uncovered that “swine flu” was due to a virus, not H. influenza. In 1933, Shope and a team of researchers in the United Kingdom established the pathogenicity of human influenza virus using the ferret model. In 1918, scientists did not have an essential tool—the risk assessment— to help protect them from a laboratory- acquired infection while they performed testing. High-risk behaviors such as mouth-pipetting were normal practice, and personal protective equipment (PPE) was not always available given the severity of the outbreak. 100 years later, PublicHealthLabs @APHL