Waging War On Infectious Disease

November 1, 2005 by Natalie Salat

The visitors have come to Winnipeg all the way from Guangdong, China. They are not ordinary tourists, and this is no ordinary visit. These scientists are from the region where the SARS virus–severe acute respiratory syndrome–originated two and a half years ago, and they have made a transcontinental journey to tour a unique, world-class facility, the Canadian Science Centre for Human and Animal Health (CSCHAH).

The small group is here, in particular, to see the National Microbiology Laboratory (NML), which boasts Canada’s only Biosafety Level 4 laboratories–where scientists don space-age Hazmat suits to study deadly viruses such as SARS, Ebola and anthrax. In a Level 4 lab, of which there are only 15 in the world, researchers work with dangerous agents that spread easily through airborne or casual contact and can cause serious, often untreatable diseases.

Emerging and re-emerging diseases, bioterrorism and antibiotic resistance cannot be taken lightly in an age when the human population is growing rapidly–often in places where sanitation is poor–and global airplane travel can transplant diseases faster than you can say ‘immunodeficiency.’ This year, an outbreak of Marburg hemorrhagic virus–similar to Ebola–killed more than 320 people in Angola, prompting emergency response teams from the Canadian science centre and other international organizations to go there to help contain the disease’s spread.

Such times call for state-of-the-art science. “We have a very important role to play to make sure people have safe food, safe water,” says Dr. Frank Plummer, the renowned scientist who heads the NML and who recently received US $8.3 million from the Bill and Melinda Gates Foundation to study immunity to HIV. “Thirty years ago, infectious diseases were thought to have been conquered. (But) we are at war with these bugs, and the bugs are winning.”

Using an array of equipment, from electron microscopes and centrifuges to machines that can detect exactly which proteins are in a tissue sample, NML scientists work to identify, control and prevent disease. They test human and animal tissue, create vaccines, monitor the development of diseases across Canada, discover new scientific methods, train up-and-coming scientists, and work with government and international agencies to prepare emergency responses to threats such as bioterrorism and a flu pandemic.

There’s not another lab like it, says Dr. Peter Wright, deputy director of the National Centre for Foreign Animal Disease (NCFAD), based at the Winnipeg centre. “It is the only (Level 4) laboratory right now in the world where you have both human health and animal health in the same place. The vast majority of infectious diseases in humans do come from an animal origin.”

Having such a facility enabled researchers to be the first to inject the SARS virus into chickens and pigs to see if the virus would replicate, indicating whether these animals would be a source. (They weren’t.) NCFAD also had a hand in identifying the strain of avian flu that hit British Columbia in 2004, forcing the slaughter of 19 million birds.

The Level 4 lab space takes up a small portion of the science centre, whose area would cover five football fields. The complex is made up of interconnected blocks and was designed by local architects Smith Carter to give the feeling of a town hall. Construction began in 1992, and the building opened in 1999. Within its 30,000-square-metres you will find Biosafety Level 2, 3 and 4 labs. Biosafety Level 1 labs, such as you would find in high school, can deal with micro-organisms not known to cause disease in healthy humans. In Level 2 labs, such as in hospitals, employees wear some protective equipment and work with diseases that pose a moderate risk. High-containment labs, with biosafety levels 3 and 4, require special protective equipment and safety procedures because the pathogens are not only highly contagious, but deadly.

The facility’s Emergency Operations Centre was launched last February as a result of the SARS crisis, when communication between government and health officials was found to be grievously lacking. The EOC features massive TV screens, computers and sophisticated networking technology through which staff can co-ordinate with Ottawa and health and science centres across Canada, as well as keep track of international developments. NML staffers are on call 24-7 in case of emergency.

Winnipeg’s flagship of science had a bit of a rocky start. The initial cost estimate for the complex was $150 million, notes Stefan Wagener, scientific director for biosafety and environment as well as chief administrative officer, who joined the CSCHAH in 2001. “By the end, it was $180 million. Treasury Board was not pleased.” But, like the Field of Dreams–“if you build it, they will come”–the centre has grown from 150 staff to 400 since it began operating in 1998. “Treasury Board knows now that (the science centre is) way overfilled.” In fact, adds Wagener, “we’re seriously looking into increasing capacity in a number of areas–lab space, office space.” The planned extensions will be physically connected to the original structure.

It wasn’t just Treasury Board that had to be won over. In the early 1990s, when local residents learned that a government building would replace the defunct asphalt plant that had been on the site, they were initially gung-ho, says senior communications officer Elaine Krawchenko. “Then they heard it was going to be a Level 4 building.”

It took a change of management, the establishment of a community liaison committee and months of work to turn around opposition to the ‘virology lab,’ as locals call it. The Level 4 lab didn’t start being used until 2000, when all committee concerns had been answered.

Two government agencies currently share the science centre–the Canadian Food Inspection Agency (CFIA) and the Public Health Agency of Canada.

The foreign animal disease centre is part of the food inspection agency, and plays a key role in identifying and reporting foreign animal diseases such as mad cow disease, foot and mouth disease and avian influenza, the pandemic threat du jour.

NCFAD gets tissue samples from animals with suspected disease, and its 55 staff use an arsenal of tools to make a diagnosis. The pressure to be accurate is high. “There’s no such thing in the world as a perfect (diagnostic) test. If you go out there with a false positive, and they shut our borders down for three weeks before they figure it out, you’ve just lost $100 million in trade,” says Wright.

To do its work, NCFAD has 15 large animal cubicles, one of which is in the Level 4 lab. Each cubicle can hold two calves, or four to six pigs, or 20 to 30 chickens. When the centre runs its foreign animal disease training course, to which veterinarians from across Canada are invited, “we’re just chock-a-block full.” By nature and necessity, the centre is an ominous site for the live animals that come here–it will be their last stop. “There’s no way of getting around it,” says Wright.

On the human health side, the National Microbiology Lab forms part of the Public Health Agency–whose objective is to keep people alive and healthy. The PHA has two “pillars”–one at the Winnipeg centre, the other in Ottawa; chief public health officer Dr. David Naylor divides his time between the two.

The NML program’s mandate encompasses research, training, surveillance and leadership, sums up senior medical adviser Dr. Amin Kabani, who oversees special projects such as the EOC. “We do basic research, and that research is world-class.” Recent examples include the development of vaccines against the hemorrhagic fever viruses Ebola, Lassa and Marburg. So far, these vaccines worked well in non-human primates; now, they need to be tested on humans.

“The second part we do is training,” continues Kabani. “We have 60 to 75 graduate students and a huge number of co-op students. These are the young people who populate tomorrow’s institutions.” Next is surveillance. “We have to play an active part in laboratory surveillance (across Canada). What organisms are getting picked up? What are they resistant to?”

The NML also has partnerships with government departments, universities and international agencies, including the Department of National Defence, the University of Manitoba, the United States Centres for Disease Control and Prevention, the U.S. Bioterrorism Response Network and the World Organization for Animal Health. “We are leaders in some aspects,” says Kabani, “but we are part of a lot of networks.”

Who walks through the doors of the Winnipeg facility on a daily basis? Employees range from microbiologists and veterinarians to biosafety officers and radiation testers to electricians, carpenters and cafeteria staff. “It really does take a village to run this facility,” observes Krawchenko.

Any staff member that will be at the facility for more than 10 days must go through a rigorous security clearance process. A vast number of people also sign in to the facility–11,000 individuals in 2004. These visitors, like the scientists from Guangdong, can’t just saunter through the facility unaccompanied. “We have to babysit them,” says the good-humoured Wagener, who is overseeing the development of a comprehensive biorisk management program.

Asked how the science centre maintains a safe and secure environment, Wagener jokes, “I can tell you, but then I’d have to kill you.”

Walking through the facility with Krawchenko, some of those measures are obvious, including security checkpoints where guards actually pay attention to photo ID and search bags. Special access cards and fish-eye cameras are also part of the routine. “You get used to it,” says Krawchenko. Although the management won’t divulge how much is spent on security, the facility is guarded round the clock. All shipments that come into the facility–live animals, virus samples, mail, laundry supplies, etc.–come in through one shipping and receiving area so they can be tracked.

Special safety measures are paramount at the high-containment (Level 3 and 4) labs. Like the science centre’s logo, a box within a box, the labs were built so they would be completely contained within the structure. They also have submarine doors to keep them airtight. “We are always trying to contain the organisms as much as possible,” explains Wagener. “We (also) have engineering tools available to us that allow us to keep the bugs in a box while at the same time working with them.” One of those is a biological safety cabinet, which directs airflows away from the researcher. “But, I can’t put a sheep or a cow in a biosafety cabinet, so we have airtight rooms. When you enter the Level 4, that room is under a constant high vacuum. If there’s ever anything released, it gets sucked out (through filters).”

Wagener says the Level 4 facility is one of the safest, cleanest areas in the centre. “We double- and triple-treat all our waste. We take care of all the flows–the people, the materials, the air, the water.” The air that leaves the Level 4 lab is cleaner than when it enters the building, thanks to HEPA filtration. One solid waste renderer and three 5,000-litre liquid waste cookers sterilize the already pre-treated waste that comes out of the labs.

Limiting access to Level 4 is another way to keep a tight control over the deadly agents. Only 18 scientists are permitted to work there. “You talk to Frank Plummer and the scientific directors–we do not have access to Level 4. We don’t need to,” explains Wagener. “If Frank wants to actively work in Level 4, then he has to go through six months of training.”

Part of that training is simply how to prepare for working in the lab, how to communicate with your lab “buddy” over the radio, and how to come back out unaccompanied by deadly micro-organisms. All Level 4 staffers are provided with clothing and pressurized biosafety suits that are for use in the lab only; those who wear glasses must keep a pair just for lab use. After a day’s work, scientists first take a chemical shower in their Hazmat suit, and then a regular shower before getting back into civvies. This whole process takes approximately 35-40 minutes.

When training courses are on, and there are a couple dozen more people using the Level 4 lab, things can get pretty busy. In a way, that’s a plus. “You can’t just have a Level 4 laboratory sitting idle and expect to come in tomorrow and just start it up,” explains Wright. “You have to have your program running continually.” That way, the scientists know if there are any problems with the suits, equipment or airflows.

There’s no danger of the work drying up at the NML. “This place is like a magnet,” says Wagener, “especially for those that are in the process of designing and building new facilities.” He chooses his words carefully when expressing concern about the rising number of high-containment labs around the world. “Billions are being spent on level 3 and 4 labs. We are already questioning why we need so many new labs. Where are all the people coming from that are supposed to work in those? Who is training them?”

Part of Wagener’s biorisk management remit involves having an outreach program, where NML staff share their knowledge with other scientists who are going to be working with deadly, contagious diseases. And this is with good reason. “During the height of the SARS outbreak…three (international) labs almost caused another outbreak because people working with the virus got sick.” The NML also has a mobile high-containment lab (Level 3) that staff can use anywhere, from Canada to Angola to Vietnam.

In some cases, NML scientists get poached to work in other parts of the world–Asia, Europe, the U.S. “There certainly is a significant demand for our people. Fortunately, the majority like it here. With the outreach program, people aren’t only coming to us (like those from Guangdong), but we have our people go (on assignment) to places.”

In a world that is becoming ever smaller by virtue of population growth and plane travel, the people who spend their days at the Canadian Science Centre for Human and Animal Health in Winnipeg are trying to stay one step ahead in the fight against infectious disease–and helping other countries do the same.

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