Biosecurity blunder hospitalises lab worker with typhoid in the Netherlands

A biosecurity blunder in the Netherlands caused a lab worker to be hospitalized with typhoid fever, MailOnline can reveal.

The accident occurred during the height of the Covid pandemic, but details have only now come to light.

Scientists claimed the incident showed how easily lab-acquired infections can occur, even in facilities with strict security measures.

The unknown lab technician was only noticed after he went to the victim with complaints of headache and fever of ‘unknown origin’.

Tests initially ruled out anything sinister, prompting doctors in Amsterdam to send them home.

But they were called back by the hospital 36 hours later after blood tests by doctors at the time in OLVG Amsterdam turned out to be positive for salmonella.

The bacteria were also found in faecal samples taken by the employee.

Samples of the bug have been sent to the Dutch government’s infectious disease lab for further analysis.

The results showed that the lab worker had salmonella typhi – a highly contagious bacteria that causes typhoid fever.

The doctors shared details of the incident in a medical journal and admitted they were baffled because the worker had “no history of traveling to an endemic country or contact with patients with typhoid fever.”

Hoping to solve the mystery of how they contracted typhus, medics contacted the lab technician’s employer.

It turned out that the worker had been experimenting with a salmonella sample in a BSL-2 lab two weeks before they got sick — about how long it takes to develop the telltale, cold-like symptoms of typhoid.

Biological Safety Levels (BSL) are ranked from one to four based on the agents or organisms lab workers are examining.

While BSL-1 applies to laboratories working with low-risk microbes that pose little risk of infection in healthy adults, for example some strains of E.coli, BSL-4 laboratories work with highly dangerous and exotic microbes, including Ebola .

Widely known BSL-4 laboratories include Porton Down in the UK and the Wuhan Institute of Virology, central to the Covid lab leak theory.

Safety protocols in BSL-2 laboratories include personal protective equipment (PPE), including face shields, self-closing, lockable doors, and performing procedures that could cause infection from aerosols or splashes in a biological “safety cabinet.”

Follow-up genetic testing of the bacteria revealed it was the same strain, indicating it was a “lab-acquired infection.”

Experts, including some from the Amsterdam University Medical Center (UMC), write in the report: ‘Despite continuous improvements in biosecurity, laboratory-acquired infections are incidental.

“This incident occurred despite good laboratory precautions.”

No violation of biosafety protocols was discovered, and experts are still confused as to how they caught it since the bacteria isn’t airborne.

Details of the lab-acquired infection in Amsterdam were published earlier this month in the journal Diagnostic Microbiology and Infectious Disease.

But the Amsterdam UMC medical center and research institute informs MailOnline that the incident took place in early 2021 around the spring.

It did not share the exact name or location of the laboratory in Amsterdam, or whether it happened at one of its own locations.

Dr. Gregory Koblentz, an expert in biological defenses at George Mason University, said the lab should be commended for pinpointing the source of the infection.

However, because they were unable to determine how the worker became infected, the incident “cannot be used to draw broader conclusions about the risk of lab-acquired infections,” he added.

Professor Mark Stevens, chair of microbial pathogenesis at the University of Edinburgh, meanwhile, said ‘the most likely explanation was that it was acquired in the laboratory’.

He told MailOnline: “This does not necessarily indicate a leak from the lab. It is not airborne and spills would have been collected in the cabinet.

“If the technician touched liquid or solid media on which the bacteria grew, and then accidentally touched their mouth or didn’t wash their hands properly, that could be enough.

Lab-acquired accidents are rare. Although risks are assessed and control measures are applied, the chance of human error cannot be ruled out.’

Professor Willem van Schaik, director of the Institute of Microbiology and Infection at the University of Birmingham, said: ‘These infections do occur, but thankfully they are very rare as laboratories have to follow strict biosecurity rules.

“I expect that the Dutch authorities will have made considerable efforts to review the procedures in this laboratory.”

He added: ‘For the organism Salmonella Typhi, this case in Amsterdam appears to be only the fourth reported laboratory-acquired case this century, three of which were reported in a South African laboratory with problematic biosafety procedures.

“In contrast, more than 10 million people are believed to be infected with salmonella typhi each year, with the consumption of water and food contaminated with the bacteria being the most common routes of infection.”

Experts said only that the worker handled salmonella cultures in a “biosafety cabinet” – a ventilated room that uses High Efficiency Particulate Air (HEPA) filters to purify the air entering the work area and leaving the environment.

The worker underwent 14 days of antibiotics in hospital before making a “full recovery,” experts said.

It’s not the first time lab workers have fallen ill after biosecurity blunders.

In 1972, a laboratory worker at the London School of Hygiene and Tropical Medicine contracted smallpox after poor biosecurity measures were applied in the laboratory.

They then infected three others and killed two.

Meanwhile, in 2014, inadequate lab safety led to possible exposure of 75 staff members to anthrax at the Centers for Disease Control and Prevention (CDC) Roybal campus in Atlanta.

Typhoid fever is usually spread by touching contaminated surfaces, with the insect found in feces and urine.

The fever is most common in parts of the world with poor sanitation and limited access to clean water. But it can be prevented by vaccination.

Without prompt treatment, the highly contagious infection can cause serious complications and be fatal.

Common symptoms of the infection include a persistent high temperature that gradually increases each day, headache, fatigue, constipation, and general aches and pains.

But normally it’s only travelers visiting countries like Bangladesh, India or Pakistan who choose to get the jab.

According to the World Health Organization, approximately 21 million cases and 222,000 typhoid-related deaths occur worldwide each year.

Typhoid fever is uncommon in the UK, with around 300 confirmed infections each year.

About 350 people are diagnosed with typhoid fever each year in the U.S., according to the CDC.