OTGV #38 - EHI-SARS
Broadcast Date: 29/09/03
Singapore was rocked by a SARS scare this month as a researcher was found to have the SARS coronavirus in his body.
The researcher is a post-doctoral student who worked at both the National University of Singapore and the Environment Health Institute laboratories.
The Health Ministry convened a review panel of overseas and local expert to audit the bio-safety practices of the labs working with the SARS virus.
Chong Ching Liang looks at what was uncovered in this week's On The Grapevine.
========================
The Environment Health Institute or EHI laboratories are rated at bio-safety level 3 or BSL-3.
This means that it can handle highly infectious diseases.
Yet a visiting researcher from the NUS caught something there and ended being the latest addition to Singapore's health statistics.
Hi, welcome to On the Grapevine with me Chong Ching Liang.
It is a huge bullet dodged.
Singapore could have the misfortune of accidentally starting another SARS outbreak through EHI's contaminated virus samples.
Acting Health Minister Khaw Boon Wan considers Singapore lucky that only one person is infected and that he didn't infect anyone else.
"And in this instance, I think luckily it is a minor trip. It is like a small earthquake. Richter scale 2.0. It alerts us to the possible fault lines. Important thing is to learn from this and tighten up procedures so that in future we can one prevent possibility of a real serious earthquake of Richter scale 7.1 or if bad luck something happen, we know how to respond to that. On hindsight looking at this development of the incident I would consider ourselves lucky."
And the incident revealed the fault-lines well.
The first fault lay with the researcher and his supervisor says the Head of the review panel, Dr Antony Della Porta of the World Health Organisation.
"He was working with someone who supervised him and I think the situation was that they rushed and they didn't put the appropriate protective equipment on."
But it extends further.
When the SARS outbreak happened, the EHI was recruited to join in the fight against SARS.
This generated certain complications says the Institute's head, Dr Ooi Eng Eong.
"On hindsight of course we could have put in better system in place. We anticipated the volume of the work would be low and the bulk of the work will be on dengue. We never anticipated to have to deal with SARS. And so on hindsight, yeah we could have done certain things better. And so we are going to take the opportunity and from here on to take stock of our situation, review our procedures, do our protocols, put in system in place and prevent this from ever happening again."
Dr Della Porta says Singapore and its public sector labs have varying standards making safety practices confusing to visiting researchers.
He says the fault-line extends from the individual to the laboratory, and to the lack of appropriate governing public policies on bio-safety.
"It's obvious that the lab put in enormous efforts and put in fantastic efforts during the SARS outbreak but it led to some inconsistencies where the lab was not really prepared to handle organisms at that level. And so to some extent, this incident occurred because of that. But it also occurs because Singapore doesn't have a set of legislative standards for biological safety, and that was one of our strongest recommendations, that that be introduced."
Dr Della Porta explained how the SARS bug may have contaminated the other virus samples.
"We can come up with many hypotheses. Obviously they are working in the same biologically safety cabinet. In theory they have decontaminated between handling the different viruses. If for example a plate or something to contaminated, say some weeks or months before hand, and you were to use that to grow the next stocks, that stock will have a low level of contamination. The next time you use that stocks, it will actually grow up more viruses."
He also took pains to explain that it wasn't the entire EHI laboratory being infectious.
One reason why the latest patient got infected was that he failed to wear the appropriate safety attire while he handled the SARS-contaminated West Nile virus.
In theory even if the researcher didn't catch the SARS bug, he could also come down with the West Nile virus.
Dr Della Porta says there may be new infection if appropriate actions aren't taken.
"I don't think it happen just at the one time. And that's why we are not sure which stocks could have the virus in and which of them might not so we suggest that the prudent and safe to do was to get rid of all stocks and start fresh."
Dr Ooi says his Institute accepts the review panel's call.
"First thing that we are going to do now is to go back and destroy all the virus. We are going to clean the BSL-3 lab and resume work in the BSL-2 lab. Fortunately, a lot of the important projects like the diagnostic test all that have been completed. We know at what level of the virus it can pick up and we know the anti-body tests how well it can perform. So a lot of the critical information on the diagnosis and patient information is already there. So in that sense I don't think it will affect the way we respond to outbreaks. Hopefully we will never see one more."
Analyst with GK Goh Research, Mr Song Seng Wun says this incident isn't likely to impede Singapore's aspiration to be a biomedical hub.
"The point to bear in mind really is that the biomedical clusters here are endowed mainly by the big MNCs from all over the world and some of the biggest names like for instance Schering-Plough who has an integrated society up in Tuas, runs their own labs for instance. They are an international company I would argue, I would even suggest that the standards that they maintain in the Singapore labs will be no different from what they maintained elsewhere as well. So I don't think this latest incident in the government-run labs will have any implications as far as these companies are concerned."
Mr Khaw Boon Wan has assured that existing gaps in bio-safety measures will be plugged.
The research on SARS may have encountered a small hiccup but it will continue.
Until the EHI has upgraded its safety practices, the research center won't be able to continue to grow the SARS virus.
But the Singapore General Hospital's laboratory still can.
No expert thinks Singapore is less capable to deal with the next SARS outbreak.
The fight goes on.
This is Chong Ching Liang for Newsradio 938.
===================================
Related Links:
Newsradio 938 (now 938Live)
http://www.938live.sg/
National University of Singapore
http://nus.edu.sg
Ministry for the Environment's Environment Health Institute web-page
http://app.nea.gov.sg/cms/htdocs/category_sub.asp?cid=130
World Health Organisation
http://who.int/
GK Goh and Associates
http://www.gkgoh.com.sg/
Singapore was rocked by a SARS scare this month as a researcher was found to have the SARS coronavirus in his body.
The researcher is a post-doctoral student who worked at both the National University of Singapore and the Environment Health Institute laboratories.
The Health Ministry convened a review panel of overseas and local expert to audit the bio-safety practices of the labs working with the SARS virus.
Chong Ching Liang looks at what was uncovered in this week's On The Grapevine.
========================
The Environment Health Institute or EHI laboratories are rated at bio-safety level 3 or BSL-3.
This means that it can handle highly infectious diseases.
Yet a visiting researcher from the NUS caught something there and ended being the latest addition to Singapore's health statistics.
Hi, welcome to On the Grapevine with me Chong Ching Liang.
It is a huge bullet dodged.
Singapore could have the misfortune of accidentally starting another SARS outbreak through EHI's contaminated virus samples.
Acting Health Minister Khaw Boon Wan considers Singapore lucky that only one person is infected and that he didn't infect anyone else.
"And in this instance, I think luckily it is a minor trip. It is like a small earthquake. Richter scale 2.0. It alerts us to the possible fault lines. Important thing is to learn from this and tighten up procedures so that in future we can one prevent possibility of a real serious earthquake of Richter scale 7.1 or if bad luck something happen, we know how to respond to that. On hindsight looking at this development of the incident I would consider ourselves lucky."
And the incident revealed the fault-lines well.
The first fault lay with the researcher and his supervisor says the Head of the review panel, Dr Antony Della Porta of the World Health Organisation.
"He was working with someone who supervised him and I think the situation was that they rushed and they didn't put the appropriate protective equipment on."
But it extends further.
When the SARS outbreak happened, the EHI was recruited to join in the fight against SARS.
This generated certain complications says the Institute's head, Dr Ooi Eng Eong.
"On hindsight of course we could have put in better system in place. We anticipated the volume of the work would be low and the bulk of the work will be on dengue. We never anticipated to have to deal with SARS. And so on hindsight, yeah we could have done certain things better. And so we are going to take the opportunity and from here on to take stock of our situation, review our procedures, do our protocols, put in system in place and prevent this from ever happening again."
Dr Della Porta says Singapore and its public sector labs have varying standards making safety practices confusing to visiting researchers.
He says the fault-line extends from the individual to the laboratory, and to the lack of appropriate governing public policies on bio-safety.
"It's obvious that the lab put in enormous efforts and put in fantastic efforts during the SARS outbreak but it led to some inconsistencies where the lab was not really prepared to handle organisms at that level. And so to some extent, this incident occurred because of that. But it also occurs because Singapore doesn't have a set of legislative standards for biological safety, and that was one of our strongest recommendations, that that be introduced."
Dr Della Porta explained how the SARS bug may have contaminated the other virus samples.
"We can come up with many hypotheses. Obviously they are working in the same biologically safety cabinet. In theory they have decontaminated between handling the different viruses. If for example a plate or something to contaminated, say some weeks or months before hand, and you were to use that to grow the next stocks, that stock will have a low level of contamination. The next time you use that stocks, it will actually grow up more viruses."
He also took pains to explain that it wasn't the entire EHI laboratory being infectious.
One reason why the latest patient got infected was that he failed to wear the appropriate safety attire while he handled the SARS-contaminated West Nile virus.
In theory even if the researcher didn't catch the SARS bug, he could also come down with the West Nile virus.
Dr Della Porta says there may be new infection if appropriate actions aren't taken.
"I don't think it happen just at the one time. And that's why we are not sure which stocks could have the virus in and which of them might not so we suggest that the prudent and safe to do was to get rid of all stocks and start fresh."
Dr Ooi says his Institute accepts the review panel's call.
"First thing that we are going to do now is to go back and destroy all the virus. We are going to clean the BSL-3 lab and resume work in the BSL-2 lab. Fortunately, a lot of the important projects like the diagnostic test all that have been completed. We know at what level of the virus it can pick up and we know the anti-body tests how well it can perform. So a lot of the critical information on the diagnosis and patient information is already there. So in that sense I don't think it will affect the way we respond to outbreaks. Hopefully we will never see one more."
Analyst with GK Goh Research, Mr Song Seng Wun says this incident isn't likely to impede Singapore's aspiration to be a biomedical hub.
"The point to bear in mind really is that the biomedical clusters here are endowed mainly by the big MNCs from all over the world and some of the biggest names like for instance Schering-Plough who has an integrated society up in Tuas, runs their own labs for instance. They are an international company I would argue, I would even suggest that the standards that they maintain in the Singapore labs will be no different from what they maintained elsewhere as well. So I don't think this latest incident in the government-run labs will have any implications as far as these companies are concerned."
Mr Khaw Boon Wan has assured that existing gaps in bio-safety measures will be plugged.
The research on SARS may have encountered a small hiccup but it will continue.
Until the EHI has upgraded its safety practices, the research center won't be able to continue to grow the SARS virus.
But the Singapore General Hospital's laboratory still can.
No expert thinks Singapore is less capable to deal with the next SARS outbreak.
The fight goes on.
This is Chong Ching Liang for Newsradio 938.
===================================
Related Links:
Newsradio 938 (now 938Live)
http://www.938live.sg/
National University of Singapore
http://nus.edu.sg
Ministry for the Environment's Environment Health Institute web-page
http://app.nea.gov.sg/cms/htdocs/category_sub.asp?cid=130
World Health Organisation
http://who.int/
GK Goh and Associates
http://www.gkgoh.com.sg/
posted by CHONG Ching-liang | 3:47 PM
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