Labs fail to identify anthrax in unannounced tests

[Incognito Innominatus]

(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.