Considerations After 9/11

1
Ginevra de Benci Update
2
(No Transcript)
3
Death Rate in Florence, 1430-1560
Morrison. et al. Am. J. Public Health 75 528,
1985
4
(No Transcript)
5
(No Transcript)
6
Single door entry Or no door Door can remain
open Sink (eyewash optional) Open Window OK
(if screened) Easy to clean No rugs!
Countertops easy to clean
Biosafety Level 1
7
Dont Eat It
E. coli K12 Simian Virus 40
8
Single door entry Close when working Biosafety
Cabinet Eyewash and sink. Open Window OK (if
screened) but not a good idea Easy to clean No
rugs! Countertops easy to clean
Biosafety Level 2
9
Dont Touch It
Eastern Equine Enceph -alitis virus Bacillus
anthracis Burkolderia maili Clostridium
boltuminum Yersinia pestis
10
A Class II Biosafety Cabinet
11
Double door entry Self-closing Changing Room
Air flows inward HEPA Filtered exhaust
Pass-through autoclave Washable walls,
ceilings..
No windows Sink near door Impermeable benches
Biosafety cabinet Exhaust through HEPA Hard
ducted (thimble) Some equipment HEPA
exhausted
Biosafety Level 3
12
Dont Breath It
Rift Valley fever Flexal virus Venezuelan Equine
Encephalitis virus Yellow fever
virus Brucella spp. Francisella
tularensis Coxiella burnetii Rickettsia
rickettsii Coccidioides immitis
13
A BL3 Lab
14
Dont Do It
Ebola virus Lassa fever virus Marburg virus Jujun
virus Kyasanur Forest disease virus Omsk
hemorrhagic fever virus Smallpox virus Hanta
virus et cetera.
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
(No Transcript)
19
These definitions of Biosafety Level Containment
and Procedures are accepted throughout the world.
20
Which BL to Use?

• Decision made by local IBC
• Institutional Biosafety Committee
• Consult NIH/WHO Risk Group suggestions
• IBC can raise or lower BL level
• Means of transmission
• Genetics of specific agent
• Vector
• Hybrid BL levels possible

21
3 Factors to Consider

• Infectious agent.
• Infectious dose
• Transmission.
• Contact, Percutaneous, Respiratory
• Illness.
• Prevention, Treatment, Survival

22
NIH Risk Group Definitions

• Risk Group 1 No hazard to healthy people.
• Risk Group 2 Some hazard to healthy people
• Prevention and/or treatment is available.
• Risk Group 3 Hazardous to healthy people
• Some prevention and/or treatment is possible.
• Risk Group 4 Lethal hazard to healthy people
• NO prevention and/or treatment is available.

23

• The NIH Guidelines require BL RG
• So if it is in Risk Group 3 ? Biosafety Level 3.
• Each organism is given an RG in the guidelines.
• A completely inflexible system.

24
WHO Risk Group Definitions

• Risk Group 1
• Low individual, low community risk.
• Risk Group 2
• Moderate individual risk, low community risk.
• Risk Group 3
• High individual risk, low community risk.
• Risk Group 4
• High individual risk, high community risk.

25
WHO relates BL to RG

• So if Risk Group 3 ? Biosafety Level 3.
• But the WHO Risk Group Definition is completely
  different from the NIH definition!

26
WHO Risk Group Definitions

• But
• The concept and classification of risk groups
  are being reevaluated and will be addressed in
  the third edition of the Laboratory biosafety
  manual.

27
(No Transcript)
28
Risk
Benefit
Acceptable
Dangerous
Safe
29
Benefit
Risk
Acceptable
Dangerous
Safe
30
Risk
Biocontainment
Benefit
Acceptable
Dangerous
Safe
31
Change Protocol
Benefit
Risk
Acceptable
Dangerous
Safe