from the bench
Preventing History from Repeating:
The Evolution of Risk Assessments Since 1918
by Michael Pentella, PhD, MS, D(ABMM), chair, Biosafety and Biosecurity Committee (BBC); Russell W. Currier, DVM, past-president,
American Veterinary Medical History Society; and Sean Page, associate specialist, Public Health Preparedness and Response
For many Americans today, influenza
seems like an annoying disease that
can be easily prevented by obtaining a
flu shot, frequent handwashing and, if
infected, quarantining oneself until the
symptoms dissipate. However, in 1918,
influenza showed the world that the
flu can be deadly for populations if not
properly prepared for. With estimates
placed at 675,000 American deaths from
the outbreak, the 1918 influenza killed
more people globally than World War I.
100 years later, biorisk management
is now recognized as an important
component of the laboratory quality
management system, which should
include mitigation, evaluation and
continuous improvement.
The 100th anniversary of the 1918
influenza pandemic offers an
excellent opportunity for public health
laboratorians to reflect on the risk posed
to the scientists who were working
with specimens from patients infected
with this deadly agent. Using lessons
learned from the 1918 pandemic
and other major outbreaks through
the decades that followed, state and
territorial public health laboratories
have developed and integrated biosafety
practices into bench work, with the goal
of protecting laboratorians from known
and unknown pathogens. One tool
that has been exceptionally beneficial
in improving laboratory safety in the
past century is the risk assessment.
A Revolutionary Concept: Biosafety
As the deadly 1918 virus was spreading,
medical scientists were at a loss as to
how to identify the cause of the outbreak,
let alone how to create a vaccine or
therapeutic agent to combat it. At the
time, microbiology was essentially
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LAB MATTERS Summer 2017
One Tool, One System, One Brighter Future
In 2015, APHL established the Biosafety and
Biosecurity Committee in 2015 with the goal of:
• urging laboratories to enhance biosafety
practices via routine risk assessments and
standardized training
• identifying true risk and best practices
The committee has assembled a variety of
laboratory biorisk resources including risk
assessment documents, webinars, and a
biosafety and biosecurity website. It has
established a biosafety officer community of
practice and fields a yearly biosecurity survey
to assess the evolving needs of laboratorians.
• developing consensus standards and
guidelines
• improving laboratory reporting of
exposure events.
bacteriology, since viruses were not yet
commonly recognized in the laboratory. In
culturing sputum from infected patients,
bacteriologists identified the bacterium
Haemophilus influenza in many specimens
and erroneously concluded that it was
the causative agent. Eventually the work
of Dr. Richard Shope in 1930 uncovered
that “swine flu” was due to a virus, not
H. influenza. In 1933, Shope and a team
of researchers in the United Kingdom
established the pathogenicity of human
influenza virus using the ferret model.
In 1918, scientists did not have an
essential tool—the risk assessment—
to help protect them from a laboratory-
acquired infection while they performed
testing. High-risk behaviors such as
mouth-pipetting were normal practice,
and personal protective equipment
(PPE) was not always available given the
severity of the outbreak. 100 years later,
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