Labs fail to identify anthrax in unannounced tests

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(New Mexico) State Labs Flunk Tests on Spotting Anthrax

By E. J. Mundell (From Haz--Mat-WMD Tuesday May 22)

ORLANDO (Reuters Health) - In a recent test, every medical laboratory
that received a patient specimen containing the deadly anthrax bacterium
failed to spot the organism or refer it to another lab, scientists
report. The finding is worrisome, because "if Bacillus anthracis is used
covertly in a bioterrorism attack, it will probably be first isolated in
a clinical laboratory," according to Dr. Linda Nims and colleagues at
the New Mexico State Laboratory in Albuquerque. Nims presented the
findings here Monday at the annual meeting of the American Society for
Microbiology. Speaking with Reuters Health, Nims explained that as a
former clinical microbiologist, she suspected that most of her
colleagues would dismiss an unexpected culture finding such as B.
anthracis as an innocuous contaminant. "You feel like, 'well, it was on
the skin but it's not causing the patient's infection," she said. The
common response would be to abandon any further investigation of the
bacillus. "I wanted to see if the laboratories in my city still did the
same thing," Nims said. So, unannounced, she and her colleagues
submitted four specimens-not from real patients-to four large New Mexico
laboratories. Each contained a weakened form of B. anthracis. The
result, Nims said, was "exactly what I thought-people just thought it
was a contaminant. Three out of four laboratories turned it out as a
contaminant or just 'Bacillus species.' One referred it to us--9 days
after they first looked at the specimen." These types of mistakes and
delays could have enormous public health consequences in the event of a
real anthrax outbreak, the researchers warn.

Laboratories could "take a prolonged period of time to identify the
organism or not identify it at all, which could result in increased
illness and death in the population."

To address the problem locally, the New Mexico State Laboratory has
presented training sessions in spotting and reporting B. anthracis for
personnel at the four labs that flunked the test. The measure seems to
have worked. In a second round of tests, all four labs correctly
referred the bacillus to the state lab when it came across their desks,
with three of the four doing so within a day. Nims believes this type of
initiative may be needed nationwide, given the ongoing threat of
bioterrorism. "I think that all laboratories have to be aware of it and
probably ask their state health lab for help in training on it," she
said.