MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. -- When the Ebola epidemic hit in 2014, the Army kept a keen eye on service members who returned from supporting that mission downrange. Fevers or aches meant that they were quarantined for safety while their blood samples were carefully drawn, packaged, and sent to Madigan Army Medical Center's Biosafety Level 3 laboratory.
"We tested eight or nine folks I think during the timeframe, and they were all negative, but had they been positive we would've known about it, we could've put them in containment, treated them or transported them for appropriate treatment," said Eric Lee, Madigan's biosafety officer.
Lee is part of a small team of microbiology experts who are trained to work in the BSL3 lab, located outside of the hospital, to potentially handle more dangerous or "select" agents such as Ebola, anthrax, the plague, MERS, and other infectious organisms (bacteria, viruses and parasites) that are difficult to treat and exceptionally contagious.
A BSL3 lab is only one step down from the highest containment level labs, given BSL4 designations; only five such labs exist in the United States. As it is, Madigan's BSL 3 lab offers both a higher level of protection and a higher level of security than the main microbiology lab at Madigan, said Lt. Col. Kurt Jerke, the chief of microbiology. The lab works closely with the Centers for Disease Control and Prevention to inform them when they might work with any potential select agents.
"There are certain bacteria and viruses that are among the most pathogenic, that (we) have the least amount of treatment for ... So any of the organisms that we detect in our laboratory that meet any of those criteria in the main lab, then immediately our techs stop working on them, box them up safely, we transport them out here and we test them out here to see if it's a select agent," said Lee.
The layers of safety makes this an extremely high reliability process, he said.
"We want to have zero defects," Lee said. "This is a zero defects process, and if we do have a problem along the way, we have extra layers of safety to catch it."
Working with select agents requires extremely specialized training, which is why Madigan brought trainer Vickie Jones from the University of Texas Medical Branch International Training Biocontainment Center to the lab in January to work with Army microbiology staff from Madigan, Korea, and Texas.
This was the first time that such specialized training was offered onsite at Madigan.
"We look at the safety of the person who is working, we look at the safety of the environment -- so the environment is not just the room that we're in, but it's also the community that we're a part of as well as the land and the people -- and then we look at the safety of our products because of course we want quality assurance," said Jones, an environmental health and safety consultant.
While the training focused on extra tips about how to properly don and doff personal protective equipment (such as gowns, eye protection, and respiratory protection), the staff also learned rules of how air moves in labs.
What it really honed in on, though, was decontamination procedures -- these can make or break keeping an agent properly contained.
"With very good, very strong decon practices, it's really helpful in preventing cross-contamination," said Jones.
The training helped to ensure that Madigan's BSL3 lab is always ready.
"We're lucky enough we don't have live agent here on a regular basis, but we have to treat every sample as if it is live so learning this will definitely help us in the long run," said Lee, noting that the lab has never detected a select agent (such as Ebola), but the ability to do so is crucial.
"We are open 24 hours, so if our techs get something, we just don't stop. We get the military guys in here, and they work on through and get us an answer," he said.
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