Accidental laboratory release and action to be taken
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- Hilary Hensley
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1 Atelier / workshop Mise en œuvre des mesures de biosécurité dans les laboratoires implementation of biosecurity and biosafety measures in laboratories Accidental laboratory release and action to be taken Dispersion accidentelle à partir d un laboratoire et conduite à tenir Sébastien ALLIX Biorisk officer Maisons-Alfort laboratory for animal health OIE and National reference laboratory for FMDV and brucellosis French Agency for Food, Environmental, Occupational Health & Safety France sept Tunis
2 Accidental release No volontary release Environment control (Facilites, lab) No environment control (outside lab) crisis Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 2
3 Accidental release No volontary release Voluntary releas = malice, bioterrorism, agroterrorism Environment control (Facilites, lab) No environment control (outside lab) crisis Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 3
4 Laboratory Lab s area Conntainment II out containment out lab s site Containment I vector Breakage of a element of biological safety Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 4
5 April 2, 1979 : B ANTHRACIS Unusual anthrax outbreak which affected 94 people and killed at least 64 of them in the Soviet city of Sverdlovsk (now called Ekaterinburg), roughly 850 miles east of Moscow. The first victim died after four days; the last one died six weeks later Rupture of the secondary containment with mass aerosolization Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 5
6 6, JUNE 2014: B ANTHRACIS Total of 41 individuals identified as being potentially at risk. Breakage in the trial of decontamination Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 6
7 June, 2015: B ANTHRACIS Live spores send to five countries and 19 US states Breakage in the trial of decontamination 7
8 AUGUSTE, 2007 Symptoms of foot and mouth disease on a farm near Guildford IAH, Mérial Rupture failure of inactivation + primary containment Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 8
9 Bio waste deconta Effluents EXIT DOORS: VECTORS Air Filters Air Containm ent SAS Materials Package Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 9
10 EXIT DOORS: VECTORS Personnal PPE, shower Barrier animals Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 10
11 EXIT DOORS Accidental releases/dispersion = accident in laboratory = breakage of any component of safety Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 11
12 IMPACT ON THE BASIS OF THE DANGER - Nature of the host: human / animals - Risk to the environment: Disease present or eradicat Vector(s) - Economic: loss of production,embargo... Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 12
13 RISK ASSESSMENT When a proven release should assess risks according to objective criteria: - What? - Where? - Who? - When? - How many? - Easily controllable or not? - Consequences immediate, medium and long term Implement plan of action without delay Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 13
14 WHAT? CONSEQUENCES FOR HUMAN Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 14
15 WHAT? CONSEQUENCES FOR THE ANIMAL Criteria Ea0 Ea1 Ea2 Ea3 Geographic importance Limit Limit Major Inter species distribution Existence and nature of the vectors or carriers Economical / medical incidences Lab containment Causes no disease in animals Weak or No Can be important Yes, known Non Possible Yes, identifed Limit Limit Major No Yes, level 2 ou 3 OMS Yes, niveau 3 OMS Existence of prophylaxis or effective treatment Yes Yes No treatment massive slaughter of animals in the area concerned Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 15
16 QUOI? CONSÉQUENCES POUR L ANIMAL Group Ea1 Ea2 Ea3 Risk of infection for animals Biological agents that can cause diseases in animals and which are to varying degrees of the following characteristics: limited geographical importance, transmissibility inter species little or no, vectors or non-existent carriers. The medical and/or economic impact is limited. They need no special containment measures. There is usually a prophylaxis or effective treatment Biological agents that cause serious outbreaks in animals. The inter species distribution may be important. This requires implementing sanitary regulations for species listed by the authorities of each country concerned. Medical prophylaxis or health regulations exist Biological agents that cause of panzootics or extremely serious outbreaks in animals with a rate of high mortality and possibly dramatic consequences in the areas of livestock. In general, there is no medical prophylactic treatment known; a policy of containment, mandatory if necessary, is the only possible measure Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 16
17 ASSESS THE SITUATION Provide quantitative tools to assess the level of dispersal Risk = Where x What x How many x Other factor Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 17
18 RISK ASSESSMENT FOR ACCIDENTAL RELEASE NOT confuse - Evaluate the risks of accidental release/dispersal (what are the consequences?) Action plan - Evaluate the risks of danger (how can I avoid?) Prevention plan Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 18
19 RISK ASSESSMENT FOR ACCIDENTAL RELEASE Where 5 Outside of the laboratory, in a rural area 4 Outside of the laboratory, in an urban area 3 On the site of the laboratory, outside the facilites 2 Inside the laboratory in biological containment II area 1 Inside the laboratory, containment I Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 19
20 RISK ASSESSMENT FOR ACCIDENTAL RELEASE 4 Group 4 ou Ea3 3 Group 3 ou Ea2 What 2 Group 2 ou Ea1 1 Group 1 ou Ea0 Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 20
21 RISK ASSESSMENT FOR ACCIDENTAL RELEASE Who many Unknown or very high or long: > 1 l or Kg of fluid or substance / day. > 10 days, leak > 50 persons High: ml or gram of fluid or substance / day days leak 5-50 persons Moderate: 1-10 ml or gram of fluid or substance / day hours trailing 2-5 persons Low: < 1 ml or gram of fluid or material / day. < 1 time, leaked 1 person. Very low: << 1 ml or gram of fluid or material / day. << 1 hour, leak Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 21
22 RISK ASSESSMENT FOR ACCIDENTAL RELEASE Other risk 5 Exhibit a susceptible host 4 Contact with host and /or vector 3 Area with no disease 2 Area with disease 1 Any Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 22
23 RISK ASSESSMENT FOR ACCIDENTAL RELEASE Risk = Where x What x How many x Other 20 «Acceptable» Compris entre 1 et 500: «weak» «Considerable» > 250 «Catastrophic» Report to the BRO Report to : - BRO - Director - Biological commmittee Report to : - BRO - biological commmittee - Director Crisis cell Report to : - BRO - biological commmittee - Director Crisis cell Decision on the need to inform the authorities Report to authorities Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 23
24 Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 24
25 ALERT CHAIN AND CONTROL - BRO - Lab Director / General director - Biological committee - Crisis cell - All competent authorities (Hx, Ax, Env ) - Control communication: - Internal to laboratory - External : - Emergency - competent authorities - Medias Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 25
26 PLAN TO ACT QUICKLY Anticipate before an accidental situation happens : - Identify essential internal stakeholders: - Names - Fonction - Phone N (Gsm) - Crisis cell: - Who? - Where? - Materials at disposal? - Identify external stakeholders - Names - Fonction - Phone N (Gsm) Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 26
27 EXAMPLE OF AN ACCIDENTAL RELEASE CASE STUDY Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 27
28 MANIPULATION OF B. ANTHRACIS Molecular typing for Bacillus anthracis strains NSB3 Culture des bactéries Extraction des acides nucléiques Inactivation 20 mn à 100 C Bain bouillonnant (méthode validée) Laboratoire de biologie moléculaire Typage moléculaire Biosecurity workshop 29 et 30 sept Tunis (Tunisie)
29 SURVENUE DE L INCIDENT Renforcement des EPI NSB3 Culture des bactéries Extraction des acides nucléiques Inactivation 20 mn à 99 C Bain à sec (méthode non validée) Laboratoire de biologie moléculaire Typage moléculaire Biosecurity workshop 29 et 30 sept Tunis (Tunisie)
30 CHRONOLOGY-1 Laboratoire de biologie moléculaire Jo Ensemencement B anthracis J 3 10h00 ouverture des tubes 5 personnes présentes J3 14h30 Lecture du contrôle d inactivation 6 boites (+) / 22 boites ALERTE J2 Lysat de 22 souches pour ext ADN Inactivation des lysats et contrôle par ensemencement mise en culture Sortie des tubes de lysats du NSB3 labo BM Chef d unité Agent du biorisque Direction du laboratoire Pompiers Direction Générale Biosecurity workshop 29 et 30 sept Tunis (Tunisie)
31 CHRONOLOGY-2 - Isolation in the NSB3 of 5 potentially exposed workers - Closure of the area of molecular biology - Support of the situation by a crisis cell - Evacuation secure 5 workers to hospital for observation on 12h + medical traitement - Decontamination of the area of molecular biology (Formalin 8mL/m3 pdt 2h) Biosecurity workshop 29 et 30 sept Tunis (Tunisie)
32 INTERNAL MANAGEMENT OF THE INCIDENT - LABORATORY Information notes intended for the staff of the laboratory
33 INTERNAL MANAGEMENT OF THE INCIDENT Board of inquiry convened to J4 and J5 a) interview with the staff of the laboratory and workers b) tree of the causes
34 IMPACT IN MEDIA > references in Google en 2015 Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 34
35 ACTION PLAN IN THE LABORATORY 1. Confine the source of dispersion (facilites, zoning) 2. Isolate hosts, exposed materials 3. Decontaminate the areas concerned, hosts or device 4. Analysis for understand what happen 5. Retex Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 35
36 CONCLUSION Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 36
37 CONCLUSION Release of infectious biological agents is documented through "accidental" examples It is therefore not only a possibility but a truth It must always be in mind whenever it sets up a new system, a new action... It must be the subject of an assessment based on objective criteria and simple and documented (exercise) Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 37
38 Thank you for your attention Sébastien ALLIX Biorisk officer Maisons-Alfort laboratory for animal health OIE and National reference laboratory for FMDV and brucellosis French Agency for Food, Environmental, Occupational Health & Safety France Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 38
39 LA ZONATION Biosecurity workshop 29 et 30 sept Tunis (Tunisie) 39
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