Abstract
USAMRU-K Department of Emerging Infectious Diseases (DEID) is a program consisting of eight facilities (laboratories) that are centrally administered. It has instituted safety regulations in the past 5 years under specific safety standard operating procedures (SOPs) with a goal to minimize work-related risks, injuries, or illnesses to laboratory and clinical workers by ensuring that they have the recommended training, information, support, and equipment to work safely. The programs (Influenza [FLU], Acute Febrile Illness [AFI], Arthropod-borne Virus, Enterics, Malaria Drug Resistance, Malaria Diagnostic Center, and Entomology) respond to different health problems including emerging and re-emerging diseases, some of which could result from select agents such as Ebola virus, Marburg virus, West Nile virus, Africa Swine Fever virus, Bacillus anthracis, Yersinia pestis, and H1N1. The safety regulations are meant to enhance awareness through education and to minimize or prohibit possession, use, or transfer of dangerous microorganisms to safeguard the employees, environment, and communities from exposure. In Kenya the available government safety regulations cover only genetically modified organisms (GMO), and no data are available in most government laboratories concerning occupational health, biosafety, and biosecurity when working with such agents. In the laboratories at USAMRU-K, no data existed before these regulations were instituted. For the USAMRU-K to address these biorisk and occupational health gaps, a Safety Officer was designated and trained and embarked on vigorously training all employees and carrying out biannual audits and surprise audits in all the USAMRU-K laboratories to bring them to acceptable biosafety/biosecurity and occupational health standards. The laboratories were assessed in occupational health, safety training and management, chemical safety, biorisk management, housekeeping, shipping dangerous goods, and data management using a structured questionnaire. The audits revealed that employees are actively engaged in research and patient recruitment with a wide variety of biological agents and disease presentations. Moreover, analysis of the biosafety and biosecurity data revealed biosafety was more prevalent than biosecurity, that simple practices and techniques predominated, and that perceptions of risk varied across the facilities as they deal with different biological agents. These findings provided unique insight into the variety of microorganisms studied in various USAMRU-K laboratories and uncovered a consistent weakness occupational health because vaccination was sporadic and no follow-up was conducted to determine if protection was achieved. Booster vaccinations were not documented.
USAMRU-K improved in biorisk management and occupational health 2 years after implementation of the regulations. USAMRU-K is now considered a regional reference point of consultancy in safety regulations from which other institutions from Kenya (Ministry of Health, Agriculture, and Tourism) and other countries (Uganda, Tanzania, Southern Sudan, and Cameroon) are learning. Since research facilities are located in close proximity to communities in Kenya, these findings indicated a potentially significant risk; therefore, future actions are warranted to improve the safe and secure handling of biological agents in the country to prevent accidental escape or release to the community.