- Hello Jeff - This article does not answer so many questions
about this infection. First of all, it does mention "gross environmental
contamination at the lab." There is no mention in which lab this
incident took place. Also, we are left wondering if the lab worker sickened by
the virus was actually working on cowpox...or was just infected by contamination
on the surfaces in the lab. Also, if the pathogen was on being stored
in a freezer and not worked on, how did the contamination occur? Was someone
working on it clandestinely?
-
- It appears it took 3 months for the patient to have the
finger lesion biopsied, and how many people have been exposed to the disease
in 3 months? The lab worker probably has a family, goes shopping
etc, etc. To me, this is a very scary situation and it begs for an investigation
and public report of that investigation.
-
- Patty
-
- Date: Sat 6 Feb 2011
- Source: IMED 2011: International Meeting on Emerging
Diseases and
- Surveillance, via Medscape [subscription required, edited]
- <http://www.medscape.com/viewarticle/737030>http://www.medscape.com/viewarticle/737030
-
-
- The 1st human cowpox virus infection in the United States
has been documented in an unvaccinated laboratory researcher, according
to a report by investigators from the US Centers for Disease Control
and Prevention (CDC) in Atlanta, Georgia.
-
- The findings were reported by Andrea McCollum, MPH, an
epidemiologist from the Mycotic Diseases Branch of the CDC at the
IMED 2011: International Meeting on Emerging Diseases and Surveillance.
-
- "Current recommendations by the CDC's Advisory Committee
on Immunization Practices include vaccination of laboratory workers
who handle cultures or animals infected with non-highly attenuated
orthopoxviruses that infect humans, including cowpox virus," Dr.
McCollum told Medscape Medical News at the conference. "This patient
was offered a vaccination but declined ... because the patient was
not intentionally conducting work with an orthopoxvirus."
-
- According to Dr. McCollum and colleagues, cowpox infections
occur rarely, even in Eurasia where the virus is endemic. "Laboratory
exposures to vaccinia virus have been documented, but, to date, there
have been no reports of accidental laboratory-acquired cowpox infections,"
the authors note.
-
- The unvaccinated lab worker became infected in July 2010
while working with a nonhuman pathogenic poxvirus and developed a
suspicious, painful, ulcerated lesion on a finger that lasted approximately
3 months. In October 2010, biopsy specimens of the suspected orthopoxvirus
were submitted to the CDC for testing. Real-time polymerase chain
reaction assays on the biopsy tissue showed positivity for a non-variola
orthopoxvirus and cowpox DNA and negativity for vaccinia virus. "Further
sequencing identified the strain as cowpox Brighton," Dr. McCollum
and colleagues note. "The investigation revealed cowpox virus
stocks in the laboratory's freezer but no known or intentional use
of cowpox in the patient's laboratory in the previous 5 years,"
they add.
-
- Sequencing of an isolate from the laboratory worker revealed
a recombinant region consistent with recombinant cowpox strains stored
in the freezer. In addition, cowpox was detected in multiple viral
stocks and 2 viral lines, including the viral stocks used by the
patient prior to the onset of illness. Orthopoxvirus DNA was also
found in environmental swabs of several surfaces in the laboratory
and a freezer room, although no live virus was recovered from the swabs.
-
- According to Dr. McCollum, the patient described noticing
a small cut at the site of the lesion a few days before lesion onset.
"The patient had no recollection of an accidental needle stick,"
she said. "Evidence suggests that the patient was likely infected
by handling laboratory reagents or environmental surfaces that were
contaminated with cowpox virus."
-
- Dr. McCollum said that orthopoxvirus infections can be
severe, particularly in individuals with a risk factor for severe
complications, including those with an immuno-compromising condition,
eczema, or other similar skin conditions, and pregnant women. "Cowpox
infections are transmissible by contact with lesions or matter from
lesion exudates, and lesions are considered capable of producing
infectious virus until a scab falls off and a fresh layer of skin
forms," she said. "Prompt recognition, diagnosis, and reporting
of orthopoxvirus infections to appropriate public health agencies
can help reinforce appropriate infection control practices."
-
- Independent commentator Prof. Hermann Meyer, from the
Institut fur Mikrobiologie der Bundeswehr in Munich, Germany noted
that infection with cowpox virus from an injury is relatively common.
There have been several cases in Europe of human cowpox cases in
people who have had close contact with pet cats or rats, luckily
without dire consequences. However, Dr. Meyer points out that upon
infection with a genetically modified virus, it is unclear whether
a foreign gene will be expressed and whether it might lead to unexpected
clinical signs; fortunately, that was obviously not the case with
this patient. It is important to "stick to good laboratory practice
rules: wear protective gloves; frequently disinfect hands and surfaces;
and avoid working directly with these agents if you are pregnant,
immuno-compromised, diabetic, etc."
-
- Byline: Emma Hitt
-
- --
- Communicated by:
- ProMED-mail <mailto:promed@promedmail.org>promed@promedmail.org
-
- Cowpox virus is a misnomer. Cowpox virus is not normally
present in cows. The natural hosts are probably rodents, but it has
been isolated from a variety of animals, including domestic and wild
felines and canines, elephants and humans. Human infections have
usually been traced to handling of cowpox-infected animals, or, as in
this case, gross environmental contamination. Infections in humans
are usually benign, isolated lesions which slowly resolve without
deleterious consequences. Cowpox virus isolates exhibit unusual genetic
diversity. - Mod.CP
-
-
- Patricia A. Doyle DVM, PhD Bus Admin, Tropical Agricultural
Economics Univ of West Indies Please visit my "Emerging Diseases"
message board at:http://www.emergingdisease.org/phpbb/index.php Also
my new website: <http://drpdoyle.tripod.com/>http://drpdoyle.tripod.com/ Zhan
le Devlesa tai sastimasa Go with God and in Good Health
-
- Benjamin Franklin said, "They that
- can give up essential liberty to obtain a little temporary
safety deserve
- neither liberty nor safety."
|
