CDC: Press Conference Transcript, Audio & Timelines For Lab Incidents

H5N1 Photo Credit – CDC PHIL

 

 

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For those who missed yesterday’s bombshell press conference on recent government lab biosafety incidents involving anthrax, smallpox and  avian H5N1, the CDC has posted the audio file, transcript, and some timeline graphics. 

 

While there has been a great deal of excellent media coverage over the past 18 hours (including Helen Branswell’s  What happened at the CDC’s flu lab? & Lisa Schnirring’s More problems shutter CDC labs, prompt review for CIDRAP News), many will still want to hear this press conference in its entirety.

 

Press Briefing Transcript

CDC Press Conference on laboratory quality and safety after recent lab incidents

Friday, July 11, 2014 11:30 a.m. ET

• Audio recording  [MP3, 10.3 MB]

 

 

These incidents are still under investigation, and so there are still large gaps in our understanding of how they occurred.  The H5N1 cross-contamination incident in particular has two large and critical holes in the timeline (see below) that will require filling in. 

 

The first is what transpired between March 12, when the (presumed H9N2) samples are shipped from the CDC to the USDA lab in Athens, Ga and May 23rd, when the USDA determined they were working not with H9N2, but with the highly pathogenic H5N1 virus.  

 

How the virus sample became cross contaminated, and how that went undetected for 40 days, remain open questions.

Even more troubling is how the discovery of this mistake could have been made on May 23rd - and shared between two major government agencies (USDA & CDC) - and yet senior management at the CDC were not informed until July 7th, a gap of more than six weeks.

 

March 12

• CDC Influenza Division (ID) shipped low pathogenic avian influenza H9N2 to USDA SEPRL in Athens, Ga
  Genetic analysis confirmed identity of H9N2
• Shipment delivered on March 13 to USDA Southeast Poultry Research Laboratories (SEPRL) (Athens GA)
  SEPRL observed pathogenicity in chickens inconsistent with H9N2 virus
  SEPRL performed molecular analyses on SEPRL virus stock and material sent by CDC
  SEPRL confirmed highly pathogenic H5N1 contamination and destroyed all SEPRL virus stocks in biosafety level 3
  (BSL-3) enhanced

May 23

• SEPRL notified CDC ID that SEPRL virus stock was contaminated and destroyed

May 23

• CDC ID confirmed H9N2 virus was contaminated by H5N1 virus

July 9

• CDC Responsible Official was notified; investigation is ongoing

 

The H5N1 flu incident, while apparently contained, could have been an economic disaster had the virus escaped the USDA lab and entered the poultry and/or wild bird population of the United States. 

 

Regarding the Anthrax investigation, you’ll also find a graphic timeline available at this link.

 

Although none of these incidents resulted in the infection of lab personnel, or the release of a pathogen outside of the lab, they all had the potential to do so – and in the words of the CDC’s Director, `These events should never have happened.’  

An obviously anguished Dr. Frieden went on to say:

`Together, these events I’m sure have many people asking and questioning government labs.  They may be wondering whether we're doing what we need to do to keep our workers and our communities safe.  And I think it's fair to raise those questions.  I’m disappointed by what happened, and frankly, I’m angry about it.'

 

The post mortem on all of this is likely to be long and messy, and the fallout is likely to extend well beyond the CDC and USDA labs. These incidents show that no matter how sophisticated the laboratory, no matter how detailed the safety protocols, there is always the risk of human error.

 

Something which is sure to re-ignite the debate over the wisdom and safety of GOF (`Gain of Function’) and DURC (`Dual Use of Concern’) research has been simmering for several years.  While I’ll have more on that in future blogs, for now you may wish to revisit:

 

The Call For Urgent Talks On `GOF’ Research Projects

U.S. Issues New DURC Oversight Rules

Nature: H5N1 viral-engineering dangers will not go away

Transcript & Audio On CDC Press Conference On Imported MERS Case

Credit CDC

 

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For those who missed yesterday’s MERS press conference (see CDC : 2nd Imported MERS Case Confirmed In Florida)  by the CDC and the Florida Department of Health, the transcript and an mp3 audio recording are now available on the CDC Newsroom website.

 

Media Announcements and Events - CDC announces second imported case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in the United States

CDC and Florida Department of Health officials are investigating the second case of MERS-CoV infection in the United States. MERS-CoV, a virus relatively new to humans, was first reported in Saudi Arabia in 2012. On May 2, 2014 CDC reported the first case of MERS in the United States. More »

Monday, May 12 at 2:00PM ET

Transcript | Audio

CDC Transcript: Second case of Middle East Respiratory Syndrome Coronavirus infection (MERS) in the United States - Transcript

Monday, May 12, 2014, 5:00 PM
Transcipt of the telebriefing detailing a second imported case of Middle East Respiratory Syndrome (MERS) which was confirmed late night on May 11 in a traveler to the United States. This patient is a healthcare worker who resides and works in Saudi Arabia.

 

 

And lastly, the CDC summarizes the information provided in yesterday’s press conference in the following statement:

 

CDC announces second imported case of Middle East Respiratory Syndrome (MERS) in the United States

MERS case in traveler from Saudi Arabia hospitalized in Florida

CDC : 2nd Imported MERS Case Confirmed In Florida

Coronaviruses as viewed under an electron microscope. (CDC)

 

 

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Given the incidence of recent MERS infections on the Arabian Peninsula, and the amount of international travel between that region of the world and the United States, it isn’t altogether surprising that a second imported case of MERS has been reported here – and this time in Florida.

With an incubation period that can often exceed a week, and sometimes extend to two weeks, it is perfectly possible for someone to become exposed in the Middle East and travel to virtually anyplace in the world before the first signs or symptoms appear.  

At today’s press conference held by the CDC and representatives of the Florida Department of Health we learned that this latest case – like the one reported in Indiana 2 weeks ago – was a healthcare provider, recently returned from Saudi Arabia.

 

The unidentified HCW left Jeddah, Saudi Arabia and flew to London on May 1st, and began to feel unwell on that flight.  He then flew on to Boston, then Atlanta, and finally arrived in Orlando Florida. The CDC is doing airline contact tracing for those who may have had  exposure to this patient (a number that could approach 500 contacts on US flights alone).

The patient  went to a local Emergency Room on May 8th, was admitted, and state public health testing subsequently identified this patient as being infected with the virus.  

The CDC confirmed the results last night.

 

The press conference was conducted by CDC director Dr. Tom Frieden, Dr. Anne Schuchat, and Florida Surgeon General John H. Armstrong, who all stressed that the risk to the general public is extremely low. 

 

Most secondary infections with this virus appear to have been among close contacts – healthcare workers and family members – and the risk to casual contacts is considered low.

The Florida Health Department is investigating contacts on the ground during the week before the patient went to the hospital, and when the patient first presented to the hospital. The patient is described as being in stable condition, and his close contacts (family) will stay home (voluntary quarantine) for the duration of the incubation period.

 

Dr. Armstrong indicated that additional information would be forthcoming from local officials.

 

The CDC is actively encouraging clinicians to look for cases that may fit the MERS profile (see CDC: MERS-CoV COCA Call ), and the expectation is that we will see additional MERS case importations in the future. 

Dr. Frieden closed the press conference stressing the need for `meticulous’ infection control, including the furloughing of any HCWs who might have been exposed before the patient is identified as infected.  At the same time, he stated that the risk to the general public from this virus is considered to be very low.

A transcript to this briefing will be posted on the CDC Media Relations website later today.

IDSA Video Conference: What’s The Next Big Problem?

 

 

 

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As the weekend progresses I’m working my way through the IDSA press conferences conducted over the past two days from the IDSA’s 48th Annual meeting held in Vancouver.

 

I’ve just finished watching the 45 minute presentation:

 

IDSA: What's the Next Big Problem?

 

The meeting program lists this conference this way:

 

Moderator:
James Hughes, MD, IDSA President-Elect, Director of the Program in Global Infectious Diseases, Emory University School of Medicine, Atlanta

Panelists:

Eleni Galanis, MD, MPH, FRCPC, Physician Epidemiologist, British Columbia Centre for Disease Control, Vancouver

Charles Y. Chiu, MD, PhD, Assistant Professor, Laboratory Medicine and Medicine, Infectious Diseases, Director, UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco

Rangaraj Selvarangan, BVSc, PhD, Director, Microbiology & Virology Laboratories, Children's Mercy Hospital, Kansas City, Mo.

Julie Harris, PhD, MPH, Staff Epidemiologist, Mycotics Diseases Branch, Centers for Disease Control and Prevention, Atlanta

Monika Naus, MD, MHSc, British Columbia Centre for Disease Control, Medical Director, Immunization Programs, Associate Medical Director, Epidemiology Services, Associate Professor, School of Population and Public Health, University of British Columbia
Highlighted Abstracts:

• #196 Identification of a Novel Adenovirus Associated with a Deadly Outbreak in a Titi Monkey Colony [Full Abstract]

• #602 Human Parechovirus- Central Nervous System Infection in Young Children From Midwestern USA [Full Abstract]

• #642 Public Health Surveillance for Cryptococcus Gattii: An Emerging Disease in the United States Pacific Northwest [Full Abstract]

• #685 An Outbreak of Measles in British Columbia, Canada: An Unwelcome Consequence of the 2010 Winter Olympics [Full Abstract]

 

 

The media has picked up on the Novel Adenovirus jumping from monkeys to a researcher over the past 24 hours - giving it considerable play - probably because it reminds one of the discovery of Reston Ebola that was detailed so effectively in `The Hot Zone’.

 

New Virus 'Jumps' From Monkey to Scientist, Causing Serious Illness

Adenovirus strain is under study but experts say there's no immediate cause for alarm

By Jenifer Goodwin
HealthDay Reporter

FRIDAY, Oct. 22 (HealthDay News) -- A never-before detected strain of virus that killed more than one-third of a monkey colony at a U.S. lab appears to have 'jumped' from the animals to sicken a human scientist, researchers report.

(Continue . . . .)

 

 

While it certainly appears that this previous-unknown adenovirus infected a researcher (and unlike Ebola Reston, caused serious illness) it does not appear to have been transmitted from human-to-human outside of the lab.

 

This is the first adenovirus that has been credibly shown to cross species, and certainly gives one pause when you consider the recent emergence of other zoonotic pathogens.

 

Obviously an intriguing story, and one that deserves further investigation, but one that doesn’t appear to have any serious public health implications at this time.

 

Another presentation concerned the emergence of Cryptococcus Gattii, a tropical fungus that has over the past decade, mysteriously shown up in the Pacific Northwest.

 

You may recall I wrote about this infection last April in A Fungus Among Us.  It, like Coccidioidomycosis and Histoplasmosis can produce serious illness – particularly in immunocompromised individuals.

 

 

Other presentations covered Human Parechovirus and a measles outbreak in British Columbia that was likely contracted during outdoor events during the 2010 Winter Olympics.

 

 

These press conferences are a terrific way to get a `short course’ on several fascinating infectious disease studies that were presented this week at the IDSA conference.

 

And serves as a reminder that each year we seem to find new emerging (or sometimes re-emerging) infectious diseases to deal with.

 

You can view the other press conferences using the links below.  Highly recommended:

 

IDSA: When Patients Don't Know They Have HIV

IDSA: The Global Reach of Infectious Disease

IDSA: Influenza, Beyond the Pandemic

IDSA: Protecting the Children

IDSA: Foodborne and Related Diseases

IDSA: What's the Next Big Problem?

IDSA: Battling Superbugs