News of the WeekSEVERE ACUTE RESPIRATORY SYNDROME

Lab Accidents Prompt Calls for New Containment Program

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Science  28 May 2004:
Vol. 304, Issue 5675, pp. 1223-1225
DOI: 10.1126/science.304.5675.1223a

While breathing a sign of relief that the latest outbreak of severe acute respiratory syndrome (SARS) in China is over, health officials are still deeply troubled that they have not pinpointed the original source of the infection. They are also questioning whether research on the virus should be restricted to prevent further lab accidents.

Investigators are convinced that the infections in April involved two separate biosafety lapses within the Institute of Virology at China's Center for Disease Control and Prevention in Beijing. But they have been unable to pin down what went wrong. With four separate infections within the last year at three different institutions in Beijing, Singapore, and Taipei, health experts fear that the next SARS epidemic may be more likely to emerge from a research lab than from the presumed animal reservoir.

“We need a global containment program for SARS,” says Julie Hall, the World Health Organization (WHO) coordinator for communicable disease surveillance and response in Beijing. Such a program would involve reducing the number of labs working with the SARS virus and ensuring that the research is done by “fully trained people in proper facilities with the right supervision,” she says. It would be modeled on existing programs for smallpox and polio. She adds that discussions are just getting started and any program will take time to set up.

For the moment, experts from WHO and China's Ministry of Health are trying to clarify the source of the initial infections, which eventually resulted in nine confirmed cases and one death. “We feel reasonably confident that they were infected in the Institute of Virology,” Hall says. “But we have not been able to identify a particular spill, or a single needle stick injury, or any one particular event” that led to infection.

Global controls.

WHO's Julie Hall says more may be needed to prevent lab accidents.

CREDIT: WHO

It is clear that the two researchers became infected in separate incidents. One was working with fragments of the SARS viral genome, which should not be able to cause disease. The other's research did not involve SARS at all. Hall says that the institute's biosafety level 3 lab, which WHO recommends for work involving viral cell cultures and manipulations involving growth or concentration of the SARS virus, is new, well-equipped, and capable of properly containing the virus. But the infections are believed to have occurred outside the biosafety level 3 area, where some research involving the inactivated or killed virus was apparently conducted.

Hall says investigators are looking for contamination or evidence that researchers may have been unknowingly working with live, instead of properly inactivated, virus. But they are dubious about finding a definitive answer. “I don't think we're ever going to get to ‘Aha! It was this day and this time,’” she says. In the meantime, she says, problems uncovered during the investigation “raise questions about the management structure and the training of staff.”

SWAT team.

WHO experts arrive at a laboratory in April in Beijing, where two workers apparently became infected with the SARS virus.

CREDIT: CHINA PHOTOS/REUTERS

Bi Shengli, deputy director of the Institute of Virology, says that conclusions about any management or training problems should await the findings of the expert teams. But the institute has suspended all SARS-related research projects. “We are working together with experts from the Ministry of Health to establish biosafety principles before we restart our lab work,” Bi says. The Ministry of Health has also been sending teams of biosafety experts to check on containment facilities and practices at labs throughout China.

Hall says a global control program is “somewhere between just thoughts and steps being taken.” But it seems to be gathering support within the research community. “This virus has been distributed to too many labs” in the United States and Europe as well as Asia, says Ronald Atlas, a biosafety expert at the University of Louisville, Kentucky. At the least, he says, a network is needed to track who is working with which samples of the virus.

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