Tuesday, December 08, 2015

Korean CDC: S. rectivirgula Likely Cause Of Konkuk Pneumonia Outbreak




Saccharopolyspora rectivirgula, a bacterium commonly found in hay bales, animal feed, and soil and known to produce a condition called `Famer’s lung’ , has been pegged as the likely cause of an outbreak of pneumonia at the Animal Life Sciences Building at Konkuk University last October that hospitalized more than 50 people (see WHO Update On Korea’s Unidentified Pneumonia Outbreak).

Between the syntax challenged press release from Korean Investigators (below) and a report in today’s Korea times (see here), it appears the bacteria may have propagated through the ventilation system from bags of animal feed being studied in the laboratory. 


The Korea Times reports that in some cases the feedstuffs were improperly stored, sometimes in areas where researchers ate and slept.

Farmer’s lung is normally a hypersensitivity pneumonitis (cite) caused by the inhalation of dust, bacteria, or mold from hay or feedstuff – not a true infection as these cases appeared to be.  This unusual presentation leaving some questions still unanswered, meaning the investigation is not over. Meanwhile plans are to sterilize feedstuffs being analyzed at the laboratory when the building reopens.



Konkuk University respiratory disease epidemiological investigation and follow-up action plan

Konkuk University Animal Life Sciences respiratory disease dynamics under investigation Centers for Disease Control (General Manager Yang byeongguk) and private Epidemiology Advisory Group (Advisory Director, Korea University cheonbyeongcheol professors) are investigated and disease characteristics and propagation path estimation causes based on whilst advanced analysis The results are presented.

(Patient occurrence), this respiratory disease showed a peak October 19 patients since the first generation October 26, Building closed since the patient occurs rapidly decreases occurred November 2 to 55 people could have occurred after patients.

(Human nature) patients were both Konkuk University College of Life Sciences laboratory animal workers, 21.7% out of the total of 55 laboratory workers 254 people in the same building were identified as patients, 69.5% male, mean age was 27.2 years.

(Clinical features) All patients showed mild symptoms of pneumonia, November 06, until all things are symptoms improved and he was discharged.

(Disease characteristics) Centers for Disease Control and advisory panel is that this respiratory illness were the following characteristics:

① no propagation between people, a few days my symptoms are atypical pneumonia has been a militant.

After 1 month follow-up period being some scars remain on the findings of pneumonia was suspected on the radiographs.

② pathogen causing pneumonia and often known to date * notes were not detected.

* 8 kinds of respiratory viruses such as influenza, Legionella bacteria, such as respiratory five kinds, MERS, Brucella and other pathogens causing pneumonia voice confirmed all five species.

- Patients suspected of microorganisms actinomycetes (Saccharopolyspora rectivirgula) were observed in the sample microscopic examination, hayeoteum confirmed actinomycetes (S. rectivirgula) in environmental samples.

③ Konkuk University was the study of animal life at the Science Museum in feed is carried out, the researchers (experimenter) during the course of the experiment are microorganisms, organic dust, chemicals, etc. hayeoteum possible exposure to various pollutants.

- Has detected a number of safety violations in the laboratory safety checks.

④ food self-handling is about 2.5 times the incidence of pneumonia was higher compared to non-operator.

⑤ copper layer 4-7 occurs in patients with building the lab was able to be a source of contamination spreading through the ventilation system.

In more detail touches such observation and analysis

(Propagation path) This disease is made a lot of organic dust in a lab environment to treat (Organic dust) * proliferation of pathogens associated with feed, ** this was through the ventilation system downtime, it is spreading to other laboratory workers outbreaks were presumed (Annex 1).

* Fungi, bacteria and their by-products, such as dust containing means, and feed and various fungi and certain actinomycetes (S.rectivirgula) has been detected in a laboratory environment

Confirmed that the interlayer air is diffused through the gas diffusion experiments ** ventilation

- (Probable cause) actinomycetes in patient samples microscopic examination * (S.rectivirgula) by microorganisms in environmental samples was observed that the estimated laboratory confirmed the same strain shelved this point, such as one of the causes whilst move actinomycetes were not reported in the country There is doubt (Annex 2-3).

* Bacteria are found in soil and plant cells and is connected to the threaded end of the spores that belongs there is a morphological mold (fungi) and similar bacteria. Hay, and there are many sugar cane growing well in the 50 ~ 60 ℃ temperature, known to cause pulmonary hypersensitivity enteritis in many environmental exposure.

The Centers for Disease Control and advisory panel was estimated to actinomycetes with suspected pathogen, depending on the clinical findings and pathogen test results of the disease, the existing case reports * different, microbiological identification results are not in one of the currently probable cause pathogens rather than confirmed While regulations

* Respiratory disease caused by the known Streptomyces is inflammation due to infection, if being a major characteristic of the present case will by allergic immune response.

- Unlike a conventional exposure in the laboratory of the closed space is also considering the possibility of a complex microbial variety of organic dusts, said that the ongoing pathogenesis clear identification through animal experiments *.

* Actinomycetes (S.rectivirgula) and then collected antigen (fungi) my prayer in the environment compared to mice administered the rat lung tissue and lung tissue changes seen in hwanrye and is expected to take approximately three months period.

College of Life Science, Konkuk University Animal Disease Control in connection with the re-building is action to be in accordance with the policies '先 ensure safety, 後 normalization principle'

Review the National University of requests after the new semester begins (March '16) prior to the completion of the facility improvements * and my work building ever re-use and pollutant removal,

* ① the entire building inside and disinfection of collecting, ② supply air conditioning systems always efficient supply air heating installations provided for the operation, ③ feed grinding and processing only designated lab management, ④ establish systems to monitor the laboratory fume hood operation status at all times.

Adverse symptoms for at least six months whether or not students and workers in order to reaffirm the safety of students and workers after re-building is also planned to be monitored.

In addition, the Centers for Disease Control and Prevention is the Ministry of Education, Science, etc. Future Creation Laboratory Safety management for ministries and councils to operate the configuration ‧ (the Ministry of Education organized) said it would cooperate in the provision of a safe environment Improvement university laboratories ('16 Until February).

* Safety geomgeom progress for the future creation Sciences in November Bhutto in December this year, the National University of livestock by the end of the lab (25 229 university labs).