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Lab procedure breaches led to fatal meningitis in microbiologist
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An investigation identified several breaches in laboratory practice that led to fatal serogroup B meningococcal disease in a microbiologist working with Neisseria meningitidis isolates, according to a report in MMWR.
The 25-year-old developed symptoms, including headache, fever, neck pain and stiffness, in April 2012 and visited the ED at the hospital where he worked as a researcher. He presented with petechial rash and was suspected to have meningococcal disease and began treatment with ceftriaxone. He had respiratory arrest and was declared dead 3 hours after arriving at the hospital.
The hospital notified the local health department and the California Department of Public Health (CDPH) of the suspected meningococcal disease. It also notified the federal Occupational Safety and Health Administration that the patient had worked in a laboratory conducting research on N. meningitidis vaccines. Other potentially exposed laboratory employees and ED staff were assessed for symptoms and offered postexposure chemoprophylaxis. No other cases were identified.
The California division of OSHA, the CDPH and the federal OSHA inspected the laboratory and interviewed employees about their training and laboratory practices. They found multiple breaches, including manipulation of N. meningitidis isolates on an open laboratory bench. The officials made recommendations to safely handle these isolates and on the appropriate use of personal protective equipment. They also found that microbiologists working with these isolates had not been offered the quadrivalent meningococcal vaccine that is recommended by the Advisory Committee on Immunization Practices.
“Employers should be familiar with laboratory biosafety recommendations and ensure that a laboratory biosafety program is in place,” investigators with the CDPH wrote. “Employers should also ensure that laboratory staff are trained, adhere to recommended biosafety practices and procedures, and are offered recommended vaccines.”
Disclosure: The researchers report no relevant financial disclosures.
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