(Note: cette page n'existe qu'en anglais - Nota: deze pagina bestaat enkel in het Engels)
- Short introduction
- Route of exposure
- Survival (or persistence) outside the host
- Infectious dose
- Susceptibility to disinfectants
- Lists of pathogenic micro-organisms
- Annexes (opens in a new page)
When considering working with pathogenic micro-organisms, it is important to understand a few basic principles about the properties of these micro-organisms and their viability outside the host. To perform a specific risk assessment, the characteristics of the handled organisms and the characteristics of the activity should be considered, in order to apply the suitable containment level, work practices and biosafety equipments aiming at protecting public health and the environment.
Activities involving manipulation of pathogenic micro-organisms (genetically modified or not) are conducted in facilities such as laboratories, animal facilities, greenhouses and production plants. Depending on the type of activity, the human and environmental exposure to the manipulated micro-organism can differ.
Three main types of activities handling pathogenic micro-organisms can be distinguished:
- Routine laboratory activities: clinical biology principally performed in human and animal diagnosis laboratories and laboratories for quality control of environment (water,…), food/feed or drugs;
- Fundamental and applied research performed by universities, governmental institutions, private companies;
- Production essentially carried out in pharmaceutical and biotechnology companies.
For all activities, the handled organism can be involved in contamination of the workers and may cause Laboratory Acquired Infections (LAIs). LAIs are also of public health concern as an infected worker may present a risk of transmission to his colleagues, relatives, family members or other citizens. More information on LAIs can be found on the Belgian Biosafety Server.
If an incident occurs inside a facility, emergency responses should be applied in order to protect workers, public health and the environment. Many factors determine the relevance of emergency responses, and they should preferably be part of a risk assessment. This risk assessment should include but is not limited to specific data about the organism such as the route of exposure, the survival or persistence of the pathogenic micro-organism outside the host, the infectious dose, and the susceptibility to disinfectants.
The route of exposure indicates how a pathogenic micro-organism can infect human:
- Inhalation of infectious aerosols;
- Contact with intact skin or through skin lesions;
- Percutaneous inoculation (needle and syringe, cuts or abrasions from contaminated items and animal bites);
- Contact between mucous membranes and contaminated material (hands or surfaces);
- Ingestion (aspiration through a pipette, smoking or eating).
A great variability exists regarding the persistence of a micro-organism outside its host. Some pathogenic micro-organisms do not persist outside their host, for others persistence outside the host is unknown. Kramer et al. (2006) concluded from a literature review that “the most common nosocomial pathogens (related to a hospital-acquired infection and often manipulated in diagnostic labs) may well survive or persist on surfaces for months and can represent a continuous source of transmission if no regular preventive surface disinfection is performed”. Low temperatures, approx. 4°C or 6°C, are associated with longer persistence for most bacteria, fungi and viruses. The effect of humidity on individual pathogens is highly variable. Depending on the pathogen, high humidity either increases or decreases survival or even has no discernible effect. Some micro-organisms persist longer on steel, others on plastic, and for some the type of material does not influence their survival. Longer survival times have been described with higher concentrations or titres and/or in the presence of protein, serum, sputum, or without dust.
The infectious dose is the number of micro-organisms required to cause an infection in the host. Infectious doses may vary as healthy individuals may have other immunity responses than immunocompromised and can sometimes vary from one to hundreds of thousands of units. The host response to infection is highly variable, and is dependent on the interrelationship of many host, agent, and environmental factors. For many pathogenic organisms, infectious doses are not known.
This document does not aim at providing a total picture of available chemical inactivation methods, but some indications are given to help workers in the choice of a decontamination procedure. Factors that affect the efficacy of surface disinfection include:
- The prior cleaning of the object;
- The organic and inorganic load;
- The type of organism (e.g. lipid enveloped viruses, gram-negative bacteria, spores…) and the degree of microbial contamination;
- The concentration and the exposure time to the product;
- The physical properties of the object or surface that is contaminated;
- The presence of biofilms (biofilms adversely affect the activity of a chemical disinfectant);
- The temperature and pH of the disinfection process because these can alter the activity range;
- The relative humidity.
Usually a commercially available disinfectant comes with applicable instructions to be followed (e.g., dilution, shelf life, storage, material compatibility, safe use, and disposal).
The aim of this document is to provide a practical tool to help users to perform a proper implementation of emergency procedures. The present table aims at giving some properties of pathogenic micro-organisms that are known as major causative agents of LAIs and of some pathogenic micro-organisms of risk group 3 that are often manipulated in Belgian laboratories. It is important to keep in mind that this table will be subjected to regular updates in response to new scientific knowledge.
Avian Influenza viruses,Hepatitis A Virus, Hepatitis B Virus, Hepatitis C virus, Human Immunodeficiency viruses, Puumala Hantavirus.
Bacillus anthracis, Brucella spp., Campylobacter jejuni, Chlamydia psittaci, Clostridium difficile, Coxiella burnetii, E. coli enterohemarragic, Francisella tularensis, Haemophilus influenza, Legionella pneumophila, Mycobacterium tuberculosis, Neisseria meningitidis, Salmonella typhi, Shigella spp., Staphylococcus aureus.
Additionally, we also listed some parasites that are manipulated in laboratories.
Cryptosporydium spp., Echinococcus spp., Leishmania spp., Naegleria fowleri, Toxoplasma gondii
Baldo A., Leunda A., Do Thi C.D., Breyer D., Pauwels K., Welby S., Van Vaerenbergh B., Herman P. Biosafety risk assessment and management of laboratory derived influenza A (H5N1) viruses transmissible in ferrets. Applied biosafety, article in press.
Barwick R.S., Mohammed H.O., White M.E., Bryant R.B. Factors associated with the likelihood of Giardia spp. and Cryptosporidium spp. In soil from dairy farms. J Dairy Sci. 2003; 86: 784-791.
Bean B., Moore B.M., Sterner B.,PetersonL.R., Gerding D.N.,Balfour H.H. Jr. Survival of influenza viruses on environmental surfaces. J Infect Dis. 1982; 146: 47-51.
Carey C.M., Lee H., Trevors J.T. Biology, persistence and detection of Cryptosporidium parvum and Cryptosporidium hominis oocyst. Water Res. 2004; 38, 818-862.
Carr L. E., Rigakos C., Carpenter G., Berney G., Joseph S.W. An assessment of livehaul poultry transport container decontamination. Dairy Food Environ Sanit. 1999; 19 :753–759.
Castro-Hermida J.A., Pors I., Méndez-Hermida F., Ares-Marzás E., Charlier C. Evaluation of two commercial disinfectants on the viability and infectivity of Cryptosporidium parvum oocysts. Vet J. 2006; 171: 340-345.
Centers for Disease Control and Prevention. Naegleria fowleri: Primary Amebic Meningoencephalitis (PAM). Available at: http://www.cdc.gov/parasites/naegleria/general.html (03 October 2012).
Center for Food Security & Public Health, Institute for International Cooperation in Animal Biologics, World Organisation for Animal Health (OIE). Tularemia, Rabbit Fever, Deer Fly Fever, Meat-Cutter’s Disease Ohara Disease, Francis Disease. 2009, Available at: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.180.5248 (03 October 2012).
Day J.B., Nguyen H., SharmaS.K., Al-Khaldi S.F., Hao Y.Y. Effect of dehydrated storage on the survival of Francisella tularensis in infant formula. Food Microbiol. 2009; 26: 932-935.
Dennis D. T., Inglesby T.V., Henderson D.A., Bartlett J.G., Ascher M.S., Eitzen E., Fine A.D., Friedlander A.M., Hauer J., Layton M., Lillibridge S.R., McDade J.E., Osterholm M.T., O'Toole T., Parker G., Perl T.M., Russell P.K., Tonat K. Tularemia as a biological weapon: medical and public health management. JAMA. 2001; 285: 2763-2773.
Dickx V., Van Droogenbroeck C.,Van Vaerenbergh B., Herman P., Braeckman L., Vanrompay D. Chlamydia psittaci, causative agent of avian chlamydiosis and human Psittacosis: Risk assessment and biosafety recommendations. Applied Biosafety. 2012; 17: 85-88.
Doerrbecker J., Friesland M., Ciesek S., Erichsen T.J., Mateu-Gelabert P., Steinmann J., Steinmann J., Pietschmann T., Steinmann E. Inactivation and survival of hepatitis C virus on inanimate surfaces. J Infect Dis. 2011; 204 :1830-1838.
Druce J.D., Jardine D., Locarnini S.A., Birch C.J. Susceptibility of HIV to inactivation by disinfectants and ultraviolet light.J Hosp Infect. 1995; 30: 167-180.
Dubey J.P. Re-examination of resistance of Toxoplasma gondii thachyzoïtes and Bradyzoïtes to pepsin and trypsin digestion. Parasasitology. 1998; 116: 43-50.
Dubey J.P. Toxoplasmosis – a waterborne zoonosis. Vet parasitol. 2004; 126: 52-72.
DuPont H.L., Chappell C.L., Sterling C.R., Okhuyzen P.C., Rose J.B., Jakubowski W. The infectivity of Cryptosporidium parvum in healthy volunteers. N Engl J Med. 1995; 332: 855-859.
Eckert J., Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev. 2004; 17: 107-135.
Eitzen E., Pavlin J., Cieslak T., Christopher G., Culpepper R. (Eds). Medical management of biological casualties (3rd Ed). 1998. Fort Detrick, Frederick, MD: U.S. Government Printing Office.
Fayer R. Review: Cryptosporidium: a water-borne zoonotic parasite. Vet parasitol. 2004; 126: 37-56.
Fayer R., Graczyk T.K., Cranfield M.R., Trout J.M. Gaseous desinfection of Cryptosporidium oocysts. Appl Environ Microbiol. 1996; 62: 3908-3909.
Fayer R., Morgan U., Upton S.J. Epidemiology of Cryptosporidium: transmission, detection and identification. Int J Parasitol. 2000; 30: 1305-1322.
Fennelly K.P., Davidow A.L., Miller S.L., Connell N., Ellner J.J. Airborne Infection with Bacillus anthracis—from mills to mail. Emerg Infect Dis. 2004; 10: 996-1002.
Fitzpatrick K.A., Kersh G.J., Massung R.F. Practical method for extraction of PCR-quality DNA from environmental soil samples. Appl Environ Microbiol. 2012; 76: 4571-4573.
Food and Agriculture Organization of the United Nations, World Organisation for Animal Health, World Health Organization. Brucellosis in humans and animals. Available at: http://www.who.int/csr/resources/publications/Brucellosis.pdf (03 October 2012).
Gadre R.V., Ranade D.R., Godbole S.H. A note on survival of Salmonellas during anaerobic digestion of cattle dung. J Appl Bacteriol. 1986; 60: 93-96.
Hanosset R., Mignon B., Losson B. Données récentes sur une zoonose d’actualité : l’échinococcose alvéolaire due à Echinococcus multilocularis. Ann Méd vét. 2004; 148, 153-167.
Hanson P.J., Gor D., Jeffries D.J., Collins J.V. Chemical inactivation of HIV on surfaces. BMJ (clinical research ed.). 1989; 298: 862-864.
Herwaldt B. Laboratory-acquired parasitic infections from accidental exposures. Clin Microbiol Rev. 2001; 14: 659-688.
Joachim A., Eckert E., Petry E., Bialek R., Daugschies A. Comparison of viability assays for Cryptosporidium parvum oocysts after desinfection. Vet parasitol. 2003; 111: 47-57.
Johnson B. OSHA infectious dose white paper. Applied Biosafety. 2003; 8: 160-165.
Kaatz G. W., Gitlin S. D., Schaberg D.R., Wilson K.H., Kauffman C.A., Seo S.M., Fekety R. Acquisition of Clostridium difficile from the hospital environment. Am J Epidemiol. 1988; 127: 1289-1294.
Kallio E.R., Klingström J., Gustafsson E., Manni T., Vaheri A., Henttonen H., Vapalahti O., Lundkvist A. Prolonged survival of Puumala hantavirus outside the host: evidence for indirect transmission via the environment. J Gen Virol. 2006; 87: 2127-2134.
Kern P, Ammon A, Kron M, Sinn G, Sander S, Petersen LR, Gaus W, Kern P. Risk factors for alveolar echinococcosis in humans. Emerg infect dis. 2004; 10: 2088-2093.
Kersh G.J., Wolfe T.M., Fitzpatrick K.A., Candee A.J., Oliver L.D., Patterson N.E., Self J.S., Priestley R.A., Loftis A.D., Massung R.F. Presence of Coxiella burnetii DNA in the environment of the United States, 2006 to 2008. Appl Environ Microbiol. 2010; 76: 4469-4475.
Kimblin N., Peters N., Debrabant A., Secundino N., Egen J., Lawyer P., Fay M.P., Kamhawi S., Sacks D. Quantification of the infectious dose of Leishmania major transmitted to the skin by single sand flies. Proc Natl Acad Sci USA. 2008; 105: 10125-10130.
Kramer A., Schwebke I., Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis. 2006; 6: 130.
Leitch G.J., He Q. Cryptosporidiosis – an overview. J biomed Res, 2012; 25: 1-16.
Mbithi J.N., Springthorpe V.S., Sattar S.A. Chemical disinfection of hepatitis A virus on environmental surfaces. Appl. Environ. Microbiol. 1990; 56: 3601-3604.
National Association of State Public Health Veterinarians (NASPHV). Compendium of measures to control Chlamydophila psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis). 2017. Available at: http://nasphv.org/documentsCompendiaPsittacosis.html (on 07 September 2017).
Okhuysen P.C., Chappell C.L., Crabb J.H., Sterling C.R., DuPont H.L. Virulence of three distinct Cryptosporidium parvum isolates for Healthy adults. J Infect Dis. 1999; 180: 1275-1281.
Oyston P.C., Davies C. Q fever: the neglected biothreat agent. J Med Microbiol. 2011; 60: 9–21.
Pike RM. Laboratory-associated infections. Summary and analysis of 3921 cases. Health Laboratory Science. 1976; 13:105-114.
Public Health Agency of Canada. Pathogen Safety Data Sheets and Risk Assessment. Available at: http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/index-eng.php (03 October 2012).
Quinn P.J. An investigation of the activity of selected disinfectants against Brucella abortus. Ir Vet J. 1984; 38: 86-94.
Robertson J.L., Cambpell A.T., Smith H.V. Survival of Cryptosporidium parvum oocysts under various environmental pressures. Appl Environ Microbiol. 1992; 58: 3494-3500.
Rogers J.V., Choi Y.W. Inactivation of Francisella tularensis Schu S4 in a biological safety cabinet using hydrogen peroxide fumigation. Applied Biosafety. 2008; 13: 15-20.
Rogers M.E., Ilg T., Nikolaev A.V., Ferguson M.A., Bates P.A. Transmission of cutaneous leishmaniasis by sand flies is enhanced by regurgitation of fPPG. Nature. 2004; 430: 463–467.
Rutala W.A., Weber D.J., the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities. Center for Disease Control and Prevention (CDC). 2008. Available at : http://www.cdc.gov/hicpac/pdf/Disinfection_Sterilization/Pages1_2Disinfe... (03 October 2012).
Sarkar P., Gerba C.P. Inactivation of Naegleria fowleri by chlorine and ultraviolet light. Journal - American Water Works Association. 2012, 104, 51-52.
Scott G.H., Williams J.C. Susceptibility of Coxiella burnetii to chemical disinfectants. Ann N Y Acad Sci. 1990; 590: 291-296.
Sewell D.L. Laboratory safety practices associated with potential agents of biocrime and bioterrorism. J Clin Microbiol, 2003; 41(7): 2801-2809.
Shimakoshi Y., Sano K., Nakano T., Nakamura T., Ohshiba S., Katsu K., Nakai M. A micro-suspension-test for evaluation of disinfectants against human immunodeficiency virus. Kansenshogaku Zasshi. 1995; 69: 532-538.
Singh K. Laboratory-acquired infections. Clin Infect Dis. 2009; 49: 142-147.
Thomas Y.,Vogel G.,Wunderli W.,Suter P, Witschi M.,Koch D.,Tapparel C., Kaiser L. Survival of influenza virus on Banknotes.Appl Environ Microbiol. 2008; 74:3002-3007.
US Environmental Protection Agency Office of Pesticide Programs. List H: EPA’s registered products effective against Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistant Enterococcus faecalis or faecium (VRE). Available at: https://www.epa.gov/pesticide-registration/list-h-epas-registered-produc... (on 31 May 2017).
Van Bueren J., Larkin D.P., Simpson R.A. Inactivation of human immunodeficiency virus type 1 by alcohols. J Hosp Infect. 1994; 28: 137-148.
Veit P., Bilger B., Schad V., Schäfer J., Frank W., Lucius R. Influence of environmental factors on the infectivity of Echinococcus multilocularis eggs. Parasitology. 1995 ; 110, 79-86.
Vohra P., Poxton I.R. Efficacy of decontaminants and disinfectants against Clostridium difficile. J Med Microbiol. 2011; 60: 1218-1224.
Wainwright K.E., Miller M.A., Barr B.C., Gardner I.A., Melli A.C., Essert T., Packham A.E., Truong T., Lagunas-Solar M., Conrad P.A. Chemical inactivation of Toxoplasma gondii oocysts in water. J Parasitol. 2007; 93: 925-931.
Walther B.A., Ewald P.W. Pathogen survival in the external environment and the evolution of virulence. Biol Rev. 2004; 79: 849-869.
Wang X., Jobe M., Tyler K.M., Steverding D. Efficacy of common laboratory disinfectants and heat on killing trypanosomatid parasites.Parasit Vectors. 2008; 1: 35.
Weir S.C., Pokorny N.J., Carreno R.A., Trevors J.T., Lee H. Efficacy of common laboratory disinfectants of the infectivity of Cryptosporidium parvum oocysts in cell culture. Appl Environ Microbiol. 2002; 68: 2576-79.
Williams A.P., Avery L.M., Killham K., Jones D.L. Persistence of Escherichia coli O157 on farm surfaces under different environmental conditions. J Appl Microbiol. 2005; 98:1075–1083.
World Health Organization. Legionellosis. Available at: http://www.who.int/mediacentre/factsheets/fs285/en/ (on 05 October 2012).
World Organization for animal Health. OIE Terrestrial manual 2008, chapter 2.1.4., Echinococcosis / Hydatosis, 175-189. Available at: http://www.oie.int/doc/ged/D7710.pdf (31 May 2017).
Yoo J.-H.Antimicrobial efficacies of alkaline disinfectant solution and commercial disinfectants against Brucella ovis. Korean J Vet Serv. 2009; 32: 347-351.