credits bmbl December 7 '06.doc - Central Michigan University

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Agent Summary Statements – Fungal Agents SPECIAL ISSUES Transfer of Agent Importation of this agent may require CDC and/or USDA importation permits. Domestic transport of this agent may require a permit from USDA/APHIS/VS. A DoC permit may be required for the export of this agent to another country. See Appendix C for additional information. Agent: Coccidioides immitis and Coccidioides posadasii Coccidioides spp. is endemic to lower sonoran deserts of the western hemisphere including northern Mexico, southern Arizona, central and southern California, and west Texas. The original species (C. immitis) has been divided into C. immitis and C. posadasii. 12 These species are dimorphic fungal pathogens existing in nature and in laboratory cultures at room temperature as filamentous molds with asexual spores (single-cell arthroconidia three to five microns in size) that are the infectious particles that convert to spherules under the appropriate culture conditions in vitro at 37°C and in vivo in warm-blooded animals. Occupational Infections Laboratory-associated coccidioidomycosis is a documented hazard of working with sporulating cultures of Coccidioides spp. 13-15 Occupational exposure has also been associated in endemic regions with archeology 16 and high dust exposure. 17 Attack rates for laboratory and occupational exposure are higher than for ambient exposure when large numbers of spores are inhaled. Smith reported that 28 of 31 (90%) laboratoryassociated infections in his institution resulted in clinical disease, whereas more than half of infections acquired in nature were asymptomatic. 18 Risk of respiratory infection from exposure to infected tissue or aerosols of infected secretions is very low. Accidental percutaneous inoculation has typically resulted in local granuloma formation. 19 Natural Modes of Infection Single spores can produce ambient infections by the respiratory route. Peak exposures occur during arid seasons. Coccidioides spp. grow in infected tissue as larger multicellular spherules, up to 70 microns in diameter and pose little or no risk of infection from direct exposure. The majority of ambient infections is subclinical and results in life-long protection from subsequent exposures. The incubation period is one to three weeks and manifests as a community-acquired pneumonia with immunologically mediated fatigue, skin rashes, and joint pain. One of the synonyms for coccidioidomycosis is desert rheumatism. A small proportion of infections is complicated by hematogenous dissemination from the lungs to other organs, most frequently skin, the skeleton, and the meninges. Disseminated infection is much more likely in persons with cellular immunodeficiencies (AIDS, organ transplant recipient, lymphoma). 186
Agent Summary Statements – Fungal Agents LABORATORY SAFETY Because of their size, the arthroconidia are conducive to ready dispersal in air and retention in the deep pulmonary spaces. The much larger size of the spherule considerably reduces the effectiveness of this form of the fungus as an airborne pathogen. Spherules of the fungus may be present in clinical specimens and animal tissues, and infectious arthroconidia in mold cultures and soil or other samples from natural sites. Inhalation of arthroconidia from environmental samples or cultures of the mold form is a serious laboratory hazard. Personnel should be aware that infected animal or human clinical specimens or tissues stored or shipped in such a manner as to promote germination of arthroconidia pose a theoretical laboratory hazard. Containment Recommendations BSL-2 practices, containment equipment, and facilities are recommended for handling and processing clinical specimens, identifying isolates, and processing animal tissues. ABSL-2 practices, containment equipment, and facilities are recommended for experimental animal studies when the route of challenge is parenteral. BSL-3 practices, containment equipment, and facilities are recommended for propagating and manipulating sporulating cultures already identified as Coccidioides spp. and for processing soil or other environmental materials known to contain infectious arthroconidia. Experimental animal studies should be done at BSL-3 when challenge is via the intranasal or pulmonary route. SPECIAL ISSUES Select Agent Some Coccidioides spp.are Select Agents requiring registration with CDC and/or USDA for possession, use, storage and/or transfer. See Appendix F for additional information. Transfer of Agent Importation of this agent may require CDC and/or USDA importation permits. Domestic transport of this agent may require a permit from USDA/APHIS/VS. A DoC permit may be required for the export of this agent to another country. See Appendix C for additional information. Agent: Cryptococcus neoformans Cryptococcus neoformans is a monomorphic fungal pathogen existing in nature, in laboratory cultures at room temperature and in vivo as a budding yeast. The sexual stage is grouped with the Basidiomycetes and is characterized by sparse hyphal formation with basidiospores. Both basidiospores and asexual yeasts are infectious. Occupational Infections 187
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Biosafety in Microbiological and Bi
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SECTION VIII-H: Prion Diseases 299
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Forward Biosafety in Microbiologica
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Editors: L. Casey Chosewood, MD Dir
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Guest Editors: Matthew J. Arduino,
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Charles B. Millard, PhD Lieutenant
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Robert Bull Karen B. Byers Jane Cap
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Thomas L. Miller Douglas M. Moore M
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Robert Yarchoan Uri Yokel Lisa Youn
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Introduction laboratories chose not
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Introduction RISK CRITERIA FOR ESTA
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Introduction BMBL includes an impor
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Section II Biological Risk Assessme
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Biological Risk Assessment informat
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Biological Risk Assessment The NIH
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Biological Risk Assessment effectiv
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Biological Risk Assessment Third, m
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Biological Risk Assessment 14. Oxma
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Principles of Biosafety Safety equi
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Principles of Biosafety Often an in
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Principles of Biosafety Four standa
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Principles of Biosafety 4. Centers
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Laboratory Biosafety Level Criteria
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Section V Vertebrate Animal Biosafe
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Vertebrate Animal Biosafety Level C
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TABLE 1 SUMMARY OF RECOMMENDED BIOS
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Principles of Laboratory Biosecurit
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Occupational Health and Immunoproph
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Occupational Health and Immunoproph
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Agent Summary Statements - Viral Ag
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Agent Summary Statements - Arboviru
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• Section VIII-G: Toxin Agents Se
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Agent Summary Statements - Toxins i
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Agent Summary Statements - Toxins A
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• Section VIII-H: Prion Diseases
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Agent Summary Statement - Prion Dis
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Appendix A Proper maintenance of ca
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Appendix A declined. However, in ma
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Appendix A It is possible to exhaus
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Appendix A 4. The Class II, Type A2
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Appendix A prohibited. Furthermore,
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Appendix A plastic wrappers, pipett
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Appendix A touch-plate microburners
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Appendix A SECTION VI FACILITY AND
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Appendix A Development of Containme
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Appendix A C. Airflow Smoke Pattern
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Appendix A TABLES Table 1. Selectio
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Appendix A Table 3. Field Performan
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Appendix A FIGURES Figure 1. HEPA f
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Appendix A Figure 3. The Class II,
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Appendix A Figure 5B. The Class II,
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Appendix A Figure 8. The Class III
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Appendix A Figure 9B. The vertical
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Appendix A Figure 11. A typical lay
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Appendix A REFERENCES 1. Centers fo
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Appendix B Decontamination and Disi
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Appendix B surfaces are contaminate
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Appendix B TABLE 1 DESCENDING ORDER
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Appendix B dioxide gas exits the ge
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Appendix B d The effectiveness of a
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Appendix C Transportation of Infect
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Appendix C 1600 Clifton Road, N.E.,
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Appendix C disease in humans or in
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Appendix C Biological specimen, Cat
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Appendix D Agriculture Pathogen Bio
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Appendix D simultaneous opening of
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Appendix D 14. Pathological inciner
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Appendix D Wastes and other materia
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Appendix D Camelpox virus b a, b, c
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Appendix D SPECIAL ISSUES The impor
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Appendix D required by the USDA and
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Appendix D depression, anorexia, an
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Appendix D laboratory with enhancem
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Appendix D five day period of conta
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Appendix D slaughterhouses or indus
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Appendix D virus does not cause any
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Appendix D NDV is classified in the
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Appendix D movement permit is requi
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Appendix D Spring Viremia of Carp V
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Appendix D REFERENCES 1. Hess WR. A
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Appendix D 37. Alexander DJ. Newcas
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Appendix E Arthropod Containment Gu
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Appendix F Select Agents and Toxins
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Appendix G IPM issues and requireme
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Appendix H Working with Human, NHP
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Appendix I Guidelines for Work with
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decontaminated periodically, for ex
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0.25N, and/or sodium hypochlorite (
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k Irradiation causes a dose-depende
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7. Morin R, Kozlovac J. Biological
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Appendix J NIH Oversight of Researc
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Appendix K Resources for Informatio
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Appendix K E-mail: http://www2.gsu.
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Appendix K and http://www.who.int/c
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Appendix L HEPA High Efficiency Par
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