Laboratory-Acquired Parasitic Infections from Accidental Exposures

Abstract

SUMMARY Parasitic diseases are receiving increasing attention in developed countries in part because of their importance in travelers, immigrants, and immunocompromised persons. The main purpose of this review is to educate laboratorians, the primary readership, and health care workers, the secondary readership, about the potential hazards of handling specimens that contain viable parasites and about the diseases that can result. This is accomplished partly through discussion of the occupationally acquired cases of parasitic infections that have been reported, focusing for each case on the type of accident that resulted in infection, the length of the incubation period, the clinical manifestations that developed, and the means by which infection was detected. The article focuses on the cases of infection with the protozoa that cause leishmaniasis, malaria, toxoplasmosis, Chagas' disease (American trypanosomiasis), and African trypanosomiasis. Data about 164 such cases are discussed, as are data about cases caused by intestinal protozoa and by helminths. Of the 105 case-patients infected with blood and tissue protozoa who either recalled an accident or for whom the likely route of transmission could be presumed, 47 (44.8%) had percutaneous exposure via a contaminated needle or other sharp object. Some accidents were directly linked to poor laboratory practices (e.g., recapping a needle or working barehanded). To decrease the likelihood of accidental exposures, persons who could be exposed to pathogenic parasites must be thoroughly instructed in safety precautions before they begin to work and through ongoing training programs. Protocols should be provided for handling specimens that could contain viable organisms, using protective clothing and equipment, dealing with spills of infectious organisms, and responding to accidents. Special care should be exercised when using needles and other sharp objects.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…In these cases, safety deficiencies are evident in the transportation of contaminated materials, among other factors (93) . Risk factors include ignorance, inattention, lack or misuse of personal protective equipment, inadequate facilities and equipment, poor lighting, lack of training, non-compliance with standard precautionary measures, and non-adoption of routine technical protocols (93) (110) .…”

“…The process of monitoring and control must include the development of continuing education actions in health and supervision, to check the proper use of personal protective equipment and, if applied, the communication of work accidents within the demarcated processes for the health surveillance of workers (39) (93) (110) .…”

Occupationally Acquired P. Falciparum Malaria

“…The first occupational P. falciparum malaria case in HCW was reported in 1924, and thereafter cases of occupational P. falciparum, P. vivax, P. ovale infection have been documented [9]. An extensive review of the occupational P. falciparum malaria in HCWs identified 22 cases, 59.1% of which occurred in females [6].…”

The laboratory diagnosis of Strongyloides stercoralis

“…This simplifies specimen transportation, particularly where collection occurs some distance from the testing laboratory, and there is no risk of laboratoryacquired strongyloidiasis 21 . DNA extraction and amplification can be performed within 1 day, however, laboratories may batch specimens according to demand.…”