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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Fatal infection in lab worker remains a mystery

No specific infection control breach has been identified in the death earlier this year of a 25-year-old research laboratory associate at the VA Medical Center in San Francisco. Richard Din was working on a project to develop a vaccine against Neisseria meningitides serogroup B, the very pathogen that was found in his blood upon autopsy

Soon after he came home from work one day last spring, Din complained of headache, fever and chills. He developed a rash and lost consciousness in the car on the way to the hospital. He died about 17 hours after his first symptoms appeared.

“There’s no evidence that he did anything outside of laboratory routine practice,” says Harry Lampiris, MD, chief of infectious disease at the San Francisco VA Medical Center. “At the end of the day, it’s a mystery. He had only been working in the lab for about six months. We tried hard to get to the question of whether he did something to increase his risk. He didn’t disclose anything to friends, coworkers didn’t observe anything.”

The medical center undertook a review of “all the potential microbiologically transmissible agents that we work with in all our research laboratories,” he says.

The hospital also beefed up its lab safety and training. Lab workers should be aware of the signs and symptoms of early infection with an organism such as N. meningitides and should seek antibiotic prophylaxis if there’s an exposure, he says.

Clinical laboratories operate under the standard of “universal precautions. Any specimen could be high risk,” Lampiris says.

Reporting of exposures, incidents such as spills, and near-misses is important to maintaining a culture of safety, he says. “Laboratory safety is everyone’s responsibility. If there’s any kind of breach, lab employees feel they can report it to the [principle investigator] with no risk of recrimination,” Lampiris says.

Michele Marill