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BMBL Section VII - A Agent Summary Statements
Bacterial Agents S through Y and References
Agent: Salmonella - all serotypes except typhi
Salmonellosis is a documented hazard to laboratory
personnel.(84)(85)(86) Primary reservoir hosts include a broad spectrum
of domestic and wild animals, including birds, mammals, and reptiles, all of which may
serve as a source of infection to laboratory personnel. Laboratory
Hazards: The agent may be present in feces, blood, urine, and in food, feed, and
environmental materials. Ingestion or parenteral inoculation are the primary laboratory
hazards. The importance of aerosol exposure is not known. Naturally or experimentally
infected animals are a potential source of infection for laboratory and animal care
personnel, and for other animals.
Recommended Precautions: Biosafety Level 2 practices,
containment equipment, and facilities are recommended for activities with clinical
materials and cultures known to contain or potentially containing the agents. Animal
Biosafety Level 2 practices, containment equipment, and facilities are recommended for
activities with experimentally or naturally infected animals. Vaccines are not currently
available for use in humans.
Transfer of Agent: For a permit to import these agents,
contact CDC.
Agent: Salmonella
typhi
Typhoid fever is a demonstrated hazard to laboratory
personnel.(87)(88)(89) Laboratory
Hazards: The agent may be present in feces, blood, gallbladder (bile), and urine.
Humans are the only known reservoir of infection. Ingestion and parenteral inoculation of
the organism represent the primary laboratory hazards. The importance of aerosol exposure
is not known.
Recommended Precautions: Biosafety Level 2 practices,
containment equipment, and facilities are recommended for all activities utilizing known
or potentially infectious clinical materials and cultures. Biosafety Level 3 practices and
procedures are recommended for activities likely to generate aerosols or for activities
involving production quantities of organisms.
Note: Vaccines for S. typhi are available and should be
considered for personnel regularly working with potentially infectious materials. The
reader is advised to consult the current recommendations of the Advisory Committee on
Immunization Practices (ACIP) published in the CDC Morbidity and Mortality Weekly Report
(MMWR) for recommendations for vaccination against S. typhi.
Transfer of Agent: Contact the Department of Commerce for a
permit to export this agent.
Agent: Shigella spp.
Shigellosis is a demonstrated hazard to laboratory
personnel, with dozens of cases reported in the United States and Great Britain alone.(90)(91)(92)(93) While
outbreaks have occurred in captive nonhuman primates, humans are the only significant
reservoir of infection. However, experimentally infected guinea pigs, other rodents, and
nonhuman primates are also proven sources of infection. Laboratory
Hazards: The agent may be present in feces and, rarely, in the blood of infected
humans or animals. Ingestion and parenteral inoculation of the agent are the primary
laboratory hazards. The oral 25%-50% infectious dose of S. flexneri for humans is
approximately 200 organisms.(94) The
importance of aerosol exposure is not known.
Recommended Precautions: Biosafety Level 2 practices,
containment equipment, and facilities are recommended for all activities utilizing known
or potentially infectious clinical materials or cultures. Animal Biosafety Level 2
facilities and practices are recommended for activities with experimentally or naturally
infected animals. Vaccines are currently not available for use in humans.
Transfer of Agent: Contact the Department of Commerce for a
permit to export this agent.
Agent:
Treponema pallidum
Syphilis is a documented hazard to laboratory personnel
who handle or collect clinical material from cutaneous lesions. Pike lists 20 cases of
laboratory-associated infection.(95) Humans
are the only known natural reservoir of the agent. Syphilis has been transmitted to
laboratory personnel working with a concentrated suspension of T. pallidum
obtained from an experimental rabbit orchitis.(96)
Hematogenous transfer of syphilis has occurred from the transfusion of a unit of fresh
blood obtained from a patient with secondary syphilis. T. pallidum is present in
the circulation during primary and secondary syphilis. The minimum number (LD50)
of T. pallidum organisms needed to infect by subcutaneous injection is 23.(97) The concentration of T. pallidum in
patients' blood during early syphilis, however, has not been determined. No cases of laboratory animal-associated infections are reported; however,
rabbit-adapted strains of T. pallidum (Nichols and possibly others) retain their
virulence for humans.
Laboratory Hazards: The agent may be present in materials
collected from primary and secondary cutaneous and mucosal lesions and in blood.
Accidental parenteral inoculation, contact of mucous membranes or broken skin with
infectious clinical materials, and possibly infectious aerosols, are the primary hazards
to laboratory personnel.
Recommended Precautions: Biosafety Level 2 practices,
containment equipment, and facilities are recommended for all activities involving the use
or manipulation of blood or lesion materials from humans or infected rabbits. Gloves
should be worn when there is a likelihood of direct skin contact with lesion materials.
Periodic serological monitoring should be considered in personnel regularly working with
infectious materials. Vaccines are not currently available for use in humans.
Transfer of Agent: For a permit to import this agent,
contact CDC.
Agent: Vibrionic
enteritis (Vibrio cholerae, V. para-haemolyticus)
Vibrionic enteritis due to Vibrio cholerae or Vibrio
parahaemolyticus is a documented but rare cause of laboratory-associated illness.(98) Naturally and experimentally infected
animals are a potential source of infection. Laboratory
Hazards: Pathogenic vibrios may occur in feces. Ingestion of V. cholerae and
ingestion or parenteral inoculation of other vibrios constitute the primary laboratory
hazard. The human oral infecting dose of V. cholerae in healthy non-achlorhydric
individuals is approximately 106 organisms.(99)
The importance of aerosol exposure is not known. The risk of infection following oral
exposure may be increased in achlorhydric individuals.
Recommended Precautions: Biosafety Level 2 practices,
containment equipment, and facilities are recommended for activities with cultures or
potentially infectious clinical materials. Animal Biosafety Level 2 practices, containment
equipment, and facilities are recommended for activities with naturally or experimentally
infected animals. Although cholera vaccines exist, their routine use by laboratory staff
has not been recommended. The reader is advised to consult the current recommendations of
the Advisory Committee on Immunization Practices (ACIP) published in the CDC Morbidity and
Mortality Weekly Report (MMWR) for recommendations for vaccination against V. cholerae.
There are currently no human vaccines against V. parahaemolyticus.
Transfer of Agent: Contact the Department of Commerce for a
permit to export this agent.
Agent: Yersinia
pestis
Plague is a proven but rare laboratory hazard; cases
haae been reported in the United States.(100)(101) Work with Y. pestis requires special
security considerations due to its potential use for purposes of biological terrorism. Laboratory Hazards: The agent may be present in bubo fluid, blood,
sputum, cerebrospinal fluid (CSF), feces, and urine from humans, depending on the clinical
form and stage of the disease. Primary hazards to laboratory personnel include direct
contact with cultures and infectious materials from humans or rodents, infectious aerosols
or droplets generated during the manipulation of cultures, and infected tissues. In the
necropsy of rodents, primary hazards to laboratory personnel include accidental
autoinoculation, ingestion, and bites by infected fleas collected from rodents.
Recommended Precautions: Biosafety Level 2 practices,
containment equipment, and facilities are recommended for all activities involving the
handling of potentially infectious clinical materials and cultures. Special care should be
taken to avoid the generation of aerosols from infectious materials, and during the
necropsy of naturally or experimentally infected rodents. Gloves should be worn when
handling field-collected or infected laboratory rodents, and when there is the likelihood
of direct skin contact with infectious materials. Necropsy of rodents is ideally conducted
in a biological safety cabinet. Additional primary containment and personnel precautions,
such as those described for Biosafety Level 3, are recommended for activities with high
potential for droplet or aerosol production, for work with antibiotic-resistant strains,
and for activities involving production quantities or concentrations of infectious
materials.
Note: Vaccination for Y. pestis is
available and should be considered for personnel working with infectious materials or
infected rodents. The reader is advised to consult the current recommendations of the
Advisory Committee on Immunization Practices (ACIP) published in the CDC Morbidity and
Mortality Weekly Report (MMWR) for information on vaccination against Y. pestis.
Transfer of Agent: For a permit to import this agent,
contact CDC. Contact the Department of Commerce for a permit to export this agent.
Laboratory registration with CDC is required before sending or receiving this select
agent.
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