The Centers for Disease Control and Prevention, seen as perhaps the least likely place for safety lapses, admits that back-to-back laboratory accidents were part of a pattern of unsafe practices. That stunning revelation came from the CDC chief as the agency investigated the possible exposure of dozens of people at its laboratories in Atlanta to deadly anthrax spores and the mishandling of samples of a dangerous H5N1 bird flu strain.
That such potentially deadly lapses could occur at the nation’s premier medical research facility is deeply troubling. The agency must restore confidence in its work, and can start by once again adhering to the highest safety standards that made it the model for labs across the country and the world.
To his credit, Dr. Thomas R. Frieden, the head of the CDC, has reacted with anger and disgust, declaring he has lost sleep over the matters and has taken disciplinary steps.
Still, it hardly mitigates the serious mistakes that were made by those who should have been more careful, considering they work in what Frieden called “the reference laboratory to the world.”
In one incident last month, CDC employees may have been exposed to live anthrax bacteria after potentially infectious samples were sent to laboratories unequipped to handle them. The New York Times reported that employees not wearing protective gear worked with bacteria that were supposed to have been killed, but may not have been. They were all offered a vaccine and antibiotics and the agency said it believed no one was in danger.
Also, a CDC lab accidentally contaminated a relatively benign flu sample with a dangerous H5N1 bird flu strain. That strain has killed 386 people since 2003. The consequences could have been very serious except that a Department of Agriculture lab realized that the strain was more dangerous than expected and alerted the CDC. That lapse was compounded when CDC leadership was not notified until weeks later.
If that wasn’t enough to shake confidence in the government’s handling of pathogens, Frieden also announced that two of six vials of smallpox recently found stored in a National Institutes of Health laboratory since 1954 contained live virus capable of infecting people. Smallpox was declared eradicated in 1980, and officials had believed the only known samples left were safely stored in super-secure laboratories in Atlanta and in Russia.
Worse, the anthrax incident seems to have been discovered by accident, and Frieden said the CDC failed to activate its emergency operations center that would have coordinated the appropriate response to the find. Also, videotapes being examined to determine who might have been exposed showed another safety violation, this time staffers often following colleagues through doors without using their own ID cards.
Frieden has appointed Dr. Michael Bell, a 19-year CDC veteran, to a new position overseeing laboratory safety. The anthrax and flu labs will remain closed until new procedures are in place. Frieden seems open to the multitude of ideas that such incidents tend to generate, including sweeping changes at the agency and at the research labs that have grown in number since the 2001 terror attacks.
It will be vital to instill a new culture of safety at the CDC and get its labs operating again. To that end, at least a brief period of independent oversight should be considered.
These are troubling revelations, especially in a post-9/11 world in which the average person understands the potential for microbes to be used as deadly weapons. We shouldn’t also have to worry about our own government releasing those agents.