Viral infections in workers in hospital and research laboratory settings: a comparative review of infection modes and respective biosafety aspects

Abstract

The currently accepted and practiced risk analysis of accidental viral infections based on the conventional dynamics of infection of the etiological agents is insufficient to cope with accidental viral infections in laboratories and to a lesser extent in hospitals, where unconventional modes of infection are less frequently present but still have relevant clinical and potential epidemiological consequences. Unconventional modes of infection, atypical clinical development, or extremely severe cases are frequently present together with high viral loads and high virulence of the agents manipulated in laboratories. In hospitals by contrast, the only possible association of atypical cases is with the individual resistance of the worker. Current standard precaution practices are insufficient to prevent most of the unconventional infections in hospitals analyzed in this study; it is recommended that special attention be given to flaviviruses in these settings.

Encephalitic Arboviruses: Emergence, Clinical Presentation, and Neuropathogenesis

“…Natural or laboratory-acquired infections have been documented in humans with all epizootic and many enzootic VEEV strains [44]. After a 2 to 4 day incubation period, all patients develop an incapacitating illness with high fever, headache, pharyngitis, malaise, and myalgia.…”

Aerosol Transmission of Infectious Disease

“…Although biologically plausible, aerosol transmission may be an opportunistic route for some pathogens, such as in the context of laboratory settings. 7 Roy and Milton 8 characterized an opportunistic transmission route as involving a novel source or unorthodox transmission pattern, but transmission through opportunistic routes need not be rare.…”

Animals in Healthcare Facilities: Recommendations to Minimize Potential Risks

“…Examples include Streptobacillus moniliformis (rat bite fever) resulting from the bite or scratch of laboratory rodents; 19 herpes B virus encephalitis, transmitted by the bite of non-human primates; 20 skin and soft tissue infection due to Pasteurella multocida from cat bites and scratches and dog bites; 21 and infection due to lymphocytic choriomeningitis virus, associated with exposures to laboratory rodents. 22 …”