Thursday, April 14, 2005

We send Canada mad hamburgers, they save our asses.

At least, this story in CounterPunch sure makes it look that way.

OK, first, the part you've probably heard (and can read about, thanks to the Cincinnati Enquirer, here, or administer aurally, thanks to All Things Considered, here):

Flu test kits were sent out to labs all over the world by a company that makes flu test kits. Flu test kits come with samples of flu viruses of various sorts, which one uses for comparison when characterizing the influenza strains current flu sufferers present with.

What is less common (one assumes from the media attention) is for flu test kits to come with samples of flu strains that have killed millions of people.

This makes a certain amount of sense. You don't want your lab technicians, in a moment of distraction, to make a mistake that will lead to the release of a virus that could start a deadly flu pandemic.

The linked NPR story presents the inclusion of the H2N2 strain of the influenza A virus (which henceforth I'll refer to as "death-flu") in these test kits as an accident. The Cincinnati Enquirer story, however, says it wasn't. From the story:

[CDC director Julie] Gerberding said the inclusion of the virus in Meridian test kits sent to 3,747 labs does not appear to have been accidental.

"They made the decision to include that particular influenza isolate," she said. "We don't have any details as to how or why that decision was made. That will be something we'll be exploring as we move forward."

Expanding on that point later, Gerberding said, "I'm sure it wasn't an inadvertent use because it's impossible to believe they did not know they were dealing with H2N2 ... Our information right now is that Meridian created these proficiency test products knowing that the H2N2 viruses were in them."

If it wasn't an accident that the company included this death-flu, I hear you ask, what on Earth were they thinking?

Well, the test kits were made to meet the specifications of the College of American Pathologists. Quoting again from the Cincinnati Enquirer article (I'm adding the bold emphasis):

Dr. Jared Schwartz, secretary-treasurer of the pathologists organization, said the organization's arrangement with Meridian called for the provision of an influenza A strain with a biosafety level 2 rating from the CDC. The H2N2 virus carries that rating. The CDC said it will conduct an "expedited review" to raise it to a level 3.

"The vendor ... looked in their freezer and found an influenza virus they thought was appropriate," Schwartz said, "and even though they knew it was an H2N2, they felt it was a safe virus because they felt it had been attenuated (or diluted)."

Schwartz said the pathologists did not ask for an H2N2 virus in its flu test kits and will be more specific as to virus and pathogen subtypes in future orders. He said he expects to continue doing business with Meridian

So technically, Meridian delivered the product it was supposed to (a test kit including an influenza A strain with a biosafety level 2 rating). It didn't need to be a sample of death-flu, but that's what they had on hand. And, the CAP didn't say that it couldn't be death-flu ...

"When do we get to Canada in this story?" I hear you ask. Right about now.

So, nearly 4000 labs receive these test kits. They expect that the test kit includes an influenza A strain with a biosafety level 2 rating. But, they have no reason to think that it's death-flu. And they might have gone on thinking the test kit contained a relatively benign level 2 bug had it not been for the vigilance of a lab technician in Winnipeg, Manitoba on March 25. Note that these test kits had been out and about for about six months when the Canadian lab tech recognized the death-flu in the test kit. So, it would seem, American labs either don't do this kind of quality control check, or they just hadn't gotten around to it yet.

The CounterPunch article linked above discusses (OK, rants about) the implications of this whole situation for US funding priorities, especially in terms of regulatory agencies and the health care system more generally.

At a time like this, I happily recall that when I took the "Which Canadian province are you?" quiz, I was Manitoba.


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