Louisiana - Investigation ongoing on bacterium Burkholderia pseudomallei released from a high-security laboratory at Tulane National Primate Research Center

[Pathfinder]

By Juan Sanchez

Woman becomes ill while investigating death of monkey at Tulane research center
Health officials: Bacteria confined to research center

UPDATED 7:50 AM CST Feb 09, 2015

COVINGTON, La. ?A woman is being monitored after possibly being exposed to a bacteria that was found and resulted in the death of a monkey at the Tulane National Primate Research Center.

The Governor's Office of Homeland Security was joined by Louisiana Department of Health and Human Services, and other various federal and state agencies to announce the results of their ongoing investigation Saturday afternoon in Mandeville.

During the news conference, health officials said that a woman is being monitored after becoming ill while investigating the death of a monkey at the Tulane research center in Covington. She is currently being treated with antibiotics, while other members of the investigative team are currently being tested and monitored as a precautionary measure.

According to GOHSEP, the investigation began in November when two monkeys became ill at the Tulane research center. Several days later, the condition of one of the primates deteriorated and resulted in its death.

Health officials with the Centers for Disease Control and Prevention identified an illness known as melioidosis, which is caused by a bacterial strain known as burkholderia pseudomallei. Tests were being conducted on the strain by the research center, which may have been the cause for the primates contracting the illness.

DOWNLOAD: Press Release from Health Officials on Investigation

Shortly after learning of the monkey's death, state, and federal officials sent an investigative team to conduct a study and review the research center's lab practices. The woman that fell ill was part of the team that was sent to investigate.

Currently, the CDC and the United State Department of Agriculture are working to determine whether the woman contracted the illness at the research center or elsewhere. She had been a member of investigative teams in other locations that may have provided an opportunity for exposure.
...

http://www.wdsu.com/news/local-news/...enter/31154340

[Pathfinder]

Communication over bacteria infection questioned

A possible public health concern is prompting air and water testing at a primate research center in Covington.

Ashley Rodrigue, Northshore Bureau Chief, WWL 7:16 a.m. CST February 10, 2015

MANDEVILLE, La. - A possible public health concern is prompting air and water testing at a primate research center in Covington.

Those were among several updates local and state leaders provided media Monday, after it was announced over the weekend that a USDA investigator may have contracted an illness from her visit to the Tulane National Primate Research Center last month.

Officials say soil testing is also expected to begin this week. Results from all three kinds of tests are being analyzed by the CDC in Atlanta, and should be complete in a week.

Groups with clipboards and out of state license plates could be seen going in and out of the facility Monday. The activity comes on the heels of a hastily-called press conference Saturday regarding a possible health concern following the investigator's illness.
...

http://www.wwltv.com/story/news/local/northshore/2015/02/09/communication-from-primate-center-questioned/23149457/

[Pathfinder]

Tulane University / Primate Center / Community Advisory Board / Updates / CAB Update - Feb 08, 2015

CAB Update Feb 08, 2015

Posted: 02/09/2015

Feb 08, 2015

Dear members of the TNPRC Community Advisory Board (update 3)

I write to update you on a situation at the TNPRC.

As you know, two animals presented to the TNPRC hospital in November with nonspecific illness. After extensive clinical workups, including exploratory surgeries and bacterial cultures and assistance from the Centers for Disease Control and Prevention (CDC), we determined that the animals were infected with the bacteria Burkholderia pseudomallei (which can cause melioidosis). One animal was euthanized on November 26 and the remaining animal has recovered. No additional cases have been recognized.

TNPRC personnel contacted the CDC to assist in investigating this matter and we have been working with the U.S. Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture (USDA), the U.S. Environmental Protection Agency (EPA), and state and local officials to assess the situation including environmental testing.

Preliminary antibody testing from the home cages of the two animals indicates none of the other animals in these cages have been exposed to Burkholderia pseudomallei. Further, a sample from one of the animals taken two days before admission to the hospital was negative. This raises the distinct possibility that the animals were infected with Burkholderia pseudomallei after hospital admission. Additional testing in the coming days should help further clarify this issue.

A recent event is that one of the federal investigators who visited the Center January 20-24 as part of the response fell ill with nonspecific symptoms. An antibody test was performed and results on February 7, 2015 indicated possible current or prior exposure to the bacteria. The individual has a history of travel that could have resulted in exposure to this organism, and is doing well at present. Most infections with this organism do not result in symptoms and the organism doesn’t generally spread from person to person. CDC has recommended that other members of the investigative team be evaluated for possible exposure to the bacteria. In addition, we have suspended all research with this organism and similar organisms known as “select agents” until the investigation is complete.

Additional information about melioidosis is available at http://www.cdc.gov/melioidosis

I would be happy to talk with you individually or as a group to discuss this further. Also, as more information becomes available, we will provide updates.

Andrew A. Lackner, D.V.M., Ph.D., Dipl. A.C.V.P.
Director and Chief Academic Officer, Tulane National Primate Research Center

http://tulane.edu/tnprc/community-ad...e-20150208.cfm

[Pathfinder]

Case of human illness could stem from bacteria at primate center in Covington

FAIMON A. ROBERTS III| FROBERTS@THEADVOCATE.COM
Feb. 09, 2015

The Tulane National Primate Research Center in Covington has suspended work on biological agents and toxins classified as ?select agents? by the federal government after an investigator who was at the center for a few days in January tested positive Friday for antibodies related to a type of bacteria studied there.
...
The investigator was at the TNPRC to study the infections of two Rhesus macaque monkeys in November. Both of them were infected with Burkholderia pseudomallei, according to Andrew Lackner, the center?s director....

Lackner said he didn?t know how the bacterium might have gotten out of the lab.

?We work with infectious agents all the time,? he said. ?That?s what we do.?

The center is working or has worked at one time with anthrax, AIDS, tuberculosis, Lyme disease and any number of other pathogens, he said.

Current stocks of those select agents will be used up or destroyed, and no new shipments will be taken until the investigation is complete and any problems corrected, he said.

This is the first time something like this has happened in the 30 years the lab has been handling dangerous pathogens, Lackner said.?
...
The Tulane National Primate Research Lab opened in 1964. It employs about 300 people and houses some 5,000 primates on 500 acres.

http://theadvocate.com/news/11542330-172/case-of-human-illness-could

[Emily]

Protection of non-human primates against glanders with a gold nanoparticle glycoconjugate vaccine

• Protection of non-human primates against glanders with a gold nanoparticle glycoconjugate vaccine
  
  AG Torres, AE Gregory, CL Hatcher, H Vinet-Oliphant? - Vaccine, 2015 - Elsevier
  ... University of Exeter, Devon, UK; d Division of Microbiology, Infectious Disease Aerobiology, Tulane
  National Primate Research Center, Covington, LA, USA; ... Workshop on treatment of and
  postexposure prophylaxis for Burkholderia pseudomallei and B. mallei infection

Received 24 September 2014, Revised 21 November 2014, Accepted 28 November 2014, Available online 19 December 2014

http://www.sciencedirect.com/science...64410X14016144

[Pathfinder]

Two more monkeys at Tulane center exposed to bacterium; investigation to focus on veterinary clinic
...
BY FAIMON A. ROBERTS III| FROBERTS@THEADVOCATE.COM
Feb. 20, 2015
...
A federal investigator who visited the center in January to look into how the first two monkeys became infected reported symptoms consistent with infection by the bacterium Burkholderia pseudomallei, but subsequent testing has showed that the woman likely was not infected while at the center.

Last week, a parish spokesman said a third monkey had shown an immune response consistent with having been exposed to the bacterium but had not shown signs of melioidosis, or Whitmore?s disease, which is caused by infection with Burkholderia pseudomallei. A fourth monkey also has shown antibodies consistent with exposure to the disease, parish spokesman Ronnie Simpson said Thursday.

The fourth monkey?s only contact with the three others was at the center?s veterinary clinic, and the investigation by officials from the federal Centers for Disease Control and Prevention and the U.S. Department of Agriculture will focus there, Simpson said.
...
Since the investigation began, numerous tests of the air, water and soil around the center, which is adjacent to a school and near three neighborhoods, have been conducted. Nine air samples have been tested; none have shown the presence of Burkholderia pseudomallei. Air and water testing is ongoing, Simpson said.

The CDC has ordered Tulane to suspend its work with so-called ?select agents,? defined by the CDC as those that ?have the potential to pose a severe threat to public, animal or plant health or to animal or plant products.? Other select agents include ricin, anthrax, tuberculosis and bird flu.
...

http://www.theneworleansadvocate.com/news/11646331-172/two-additional-monkeys-at-tulane

[Emily]

but subsequent testing has showed that the woman likely was not infected while at the center.

So far they are just going by antibody fluctuations - no molecular analysis of the infecting bacteria strains yet:

By Kim Chatelain, NOLA.com | The Times-Picayune

on February 13, 2015 at 4:40 PM, updated February 14, 2015 at 7:18 AM
...
But later blood tests revealed that the investigator who had tested positive for antibodies to the bacteria indicated a stable level of immune response, which leads CDC officials to believe she was not infected at the Tulane research center during the investigation in January but most likely during travel to a country where the bacteria is endemic.

http://www.nola.com/health/index.ssf...scientist.html

I wonder how much is known about how the immune system initially responds to Burkholderia pseudomallei infection?

14th September 2004
Getting a Grip on the Great Mimicker

Secrets of a Stealth Organism

For a doctor it is all about signs - the clues to a disease lie in how the patient feels, where it hurts and what is affected. For many diseases, diagnosis can be swift and sure.
But what happens when we are infected by an organism that can strike anywhere, at any time and cause almost any symptom? Diagnosis is denied.
Living amongst the roots of tropical plants is a soil bacterium with the unwieldy name Burkholderia pseudomallei - or often 'The Great Mimicker'. This organism can cause blood disease, abscesses, lung disease, kidney disease, heart disease and more. In some areas of the world, half of teenagers with blood infections die. Sometimes it lays dormant for years before striking...

http://www.sanger.ac.uk/about/press/2004/040914.html

Southeast Asian J Trop Med Public Health. 1998 Jun;29(2):410-5.
Burkholderia pseudomallei: the unbeatable foe?

Leelarasamee A¹.


Abstract

Although melioidosis has been recognized in Thailand for many years and considerable progress in term of diagnosis and treatment was achieved, B. pseudomallei is still "the unbeatable foe", for several reasons as outlined here: under-recognition, high case-fatality rate, unacceptable relapse rate and a "time-bomb" for sero-positive patients. Melioidosis is largely restricted to certain geographical areas. In Thailand, it had long been considered a rare disease in Thailand until ten cases with culture-proven melioidosis were reported by Sompone Punyagupta and his associates at a meeting of the Infectious Disease Group of Thailand. Since then awareness of young physicians and laboratory personnel for melioidosis has been increased. The most dramatic consequence was seen at Sappasitprasong Hospital in Ubon Ratchathani where over 100 strains of B. pseudomallei are isolated each year. But the frequent isolation of B. pseudomallei is surprisingly restricted to some provinces in the northeast, namely Khon Kaen and Ubon Ratchathani provinces and only 1-10 cases or none from adjacent provinces....

So it is possible that the investigator has had a stealth infection for years that suddenly reactivated. (There has been no alternative diagnosis offered for her illness.) I hope she will regain her health. I've read that USDA/FDA veterinary regulators are very overworked and bullied by the industries they oversee.

http://www.ncbi.nlm.nih.gov/pubmed/9886137

[Emily]

One of the monkeys believed to have been successfully treated in January got sick again and they killed it rather than attempting more treatment.

Update: Animal at Tulane primate center euthanized

Posted: Feb 20, 2015 4:44 PM PST Updated: Feb 20, 2015 4:59 PM PST Written by: FOX8Live.com Staff
...
?Over the past week,? Simpson said ?the animal demonstrated decreased appetite and was examined by the veterinarian in charge on Thursday,? which revealed skin lesions and swelling. He said that several veterinarians were consulted and ?a decision to humanely euthanize the animal was made.?...

http://www.fox8live.com/story/281635...ter-euthanized

We've had no updates on the health of the federal select agent investigator. She was supposed to have had a third serum antibody test by now to better determine if her infection was caught at Tulane or not.

[Emily]

-Another blood sample will be taken from the USDA/APHIS select agent inspector who visited the research center in January 2015 and whose previous two blood samples indicated a consistent immune response to exposure to Burkholderia pseudomallei. This test result will help CDC experts determine if the inspector?s exposure to the bacterium was at the primate research center in January or from a previous event. The inspector indicated to a CDC epidemiologist on Feb. 7, 2015, that she had traveled previously to a region of the world where Burkholderia pseudomallei is endemic. Test results should be known by Monday, February 23RD.

http://www.stpgov.org/residents/news...esearch-center

[Shiloh]

Source: http://www.usatoday.com/story/news/2...ease/24137053/

Deadly bacteria release sparks concern at Louisiana lab
Alison Young, USA TODAY 6:13 p.m. EST March 1, 2015
Officials are investigating how a deadly type of bacteria was released from a high-security laboratory at the Tulane National Primate Center in Louisiana. Officials say there is no risk to the public.


A dangerous, often deadly, type of bacteria that lives in soil and water has been released from a high-security laboratory at the Tulane National Primate Research Center in Louisiana. Officials say there is no risk to the public. Yet despite weeks of investigation by multiple federal and state agencies, the cause of the release and the extent of the contamination remain unknown, according to interviews and records obtained by USA TODAY.

The incident has raised concerns that bacteria from the lab may have contaminated the facility's grounds and though initial, limited tests didn't detect it, some officials are pressing behind the scenes for more action, records show. The safety breach at Tulane's massive lab complex 35 miles north of New Orleans is the latest in a recent series of significant biosafety accidents at some of the most prestigious laboratories in the country where research is performed on bacteria and viruses that are classified as potential bioterror agents...

[Emily]

That's an excellent article, Shiloh! USA Today did another article last September about an incident at Colorado State University where a loss of containment occurred after a tried and true method for sterilizing test tubes failed on a strain of B. pseudomallei they had genetically engineered to be even more resistant to antibiotics.

http://www.usatoday.com/story/news/nation/2014/09/22/biolab-safety-incidents-lassa-fever-h7n9-burkholderia/15908753/

http://www.documentcloud.org/documents/1302448-colorado-state-nih-incident-report-06-26-2014.html

So maybe these more dangerous pathogens that are engineered are also more environmentally persistent and the sterilization techniques at Tulane did not work either if they were using a modified strain.

Access to the BSL-3 lab is strictly controlled. To enter, staff must have an authorized access card and procedures call for employees to change into protective clothing and use personal protective equipment while in the laboratory. Contaminated gear can't leave a BSL-3 lab without being sterilized. Everything that goes in ? cages, animal bedding, supplies ? can't come out without being sterilized. Research animals that go into the primate center's BSL-3 labs do not come out alive and never go to the hospital, the center said.

But how is the equipment sterilized? And the lab that would have had a breach might not be the primate lab - mice were used in the vaccine experiments there. They were infected with aerosolized B. pseudomallei. How are the mice handled? Are any missing?

Regarding the status of the select agent inspector, there was an independent opinion on that quoted in the article:

Richard Ebright, the Rutgers microbiologist and biosafety expert, is skeptical that the USDA investigator was exposed to the pathogen through travel rather than her job inspecting research laboratories. Select agent program inspectors, just like researchers working with these dangerous pathogens, should regularly have blood serum samples taken and stored so they can be checked if an exposure is suspected. "They shouldn't even need to be speculating that this is probably a prior exposure," Ebright said. "If they don't have reference samples, it's a sign of gross negligence."

[Pathfinder]

Fifth monkey has signs of deadly bacteria in lab mishap

Alison Young, USA TODAY 8:51 a.m. EST March 4, 2015

Tests indicate a fifth monkey had been exposed to deadly bacteria that was somehow released from a high-security lab at the Tulane National Primate Research Center near New Orleans, according to an e-mail circulated among federal and state investigators. The monkey, like the others before it, was not part of an experiment. How the dangerous pathogen got out of its lab remains a mystery.

Preliminary tests on a sample taken from the monkey, a rhesus macaque known as IL88, indicates a possible infection with Burkholderia pseudomallei, the potential bioterror bacteria that was being used in vaccine development research elsewhere on the primate center's 500-acre campus in Covington, La.

A confirmation test is being done by the Centers for Disease Control and Prevention. Results are expected later this week or early next week, Tulane spokesman Michael Strecker said Tuesday evening.
...
http://www.usatoday.com/story/news/2...dent/24344585/

[Pathfinder]

Fifth primate contracts bacteria under investigation

Ashley Rodrigue, Northshore Bureau Chief, WWL 6:38 p.m. CST March 4, 2015

COVINGTON, La. -- Last Monday, the Tulane National Research Primate Center euthanized one of its animals after ulcers appeared on its abdomen.

Six days later, the CDC was informed that preliminary tests indicated the primate tested positive for a bacteria, which has been the subject of a mutli-agency investigation at the center. Wednesday, hours after a USA Today report first revealed the possible new infection, the results were confirmed, making it the fifth primate to contract the bacteria and the third to be euthanized due to the symptoms that followed.
...
Testing the environment around the facility is one of two new proactive plans. The other is educating the area's pet community.

...There has been no indication the bacteria has left the property, but local vets say the more action and information, the better.
...
Tests of air, water and soil on the property have been negative, as well as tests of Tulane staff. The investigation has been focused on the facility's veterinary clinic as a possible source of cross-contamination.

http://www.wwltv.com/story/news/local/northshore/2015/03/04/fifth-primate-contracts-bacteria-under-investigation/24402061/

[Emily]

Good find, Pathfinder! This is from the USA Today article referenced in post # 12:

The fifth monkey, IL88, which tested positive in a preliminary test, was admitted to the veterinary hospital on Dec. 30 for treatment of injuries and was cared for in the same treatment room as the two infected and two exposed animals before the hospital was decontaminated, according to an e-mail the CDC sent this week to agencies involved in the investigation. By Feb. 23, the macaque had developed two ulcers on its abdomen, which were cultured.

So this still seems like a problem limited to the hospital, yet the latest article reports:

Testing the environment around the facility is one of two new proactive plans. The other is educating the area's pet community.

Educating them about what?

Appl. Environ. Microbiol. November 2006 vol. 72 no. 11 6865-6875 Environmental Factors That Affect the Survival and Persistence of Burkholderia pseudomallei

• Timothy J. J. Inglis1 and
• Jose-Luis Sagripanti2,*

- Author Affiliations

• ¹Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, Hospital Avenue, QEII Medical Centre, Nedlands, Western Australia 6909, Australia
• ²Edgewood Chemical Biological Center, RDECOM, U.S. Army, Aberdeen Proving Ground, Maryland

...

The military connection.

Melioidosis was first reported by an army pathologist working in Burma in 1912 (85).

...

The frequency of melioidosis in Southeast Asia increased during the Vietnam conflict, when servicemen contracted the infection during their tours of duty. A particularly high incidence was noted among helicopter winch men, leading to the suspicion that inhalation of aerosols was an important means of transmission (26). There are reports of multiple cases of melioidosis in veterans of the Vietnam conflict manifesting as both severe and potentially fatal or as a more subacute infection (18, 74). Toward the end of the conflict, it became clear that melioidosis could remain dormant in patients for prolonged periods (68), the longest recorded being around 29 years after presumed exposure in the theater of operations (7). A late-onset case of cutaneous melioidosis following presumed exposure in the Pacific theater during the second world war has been reported, implying a disease-free interval of 62 years (53). Late-onset septicemic infections are thought to occur in patients with sequestered disease (6, 41). Interestingly, sero-epidemiology studies in British special forces deployed in the endemicity region during the Malayan emergency of 1948 to 1960 showed little evidence of residual infection (61). Moreover, late-onset melioidosis has not been observed in Australian veterans previously deployed in Vietnam. It is not clear why United States forces contracted melioidosis when allied units deployed on similar operations in the endemicity region, and close to locations where the native population currently experiences melioidosis, did not contract the disease..

http://aem.asm.org/content/72/11/6865.short

Very strange.

[Pathfinder]

According to the video presented by wwltv on post #13, Wildlife and Fisheries will be testing animals living around the facility.