Nebraska Biocontainment Unit on call

Health officials say lab can fill national role if needed to treat outbreaks of disease, viruses

Omaha, Neb. ? If fears about a U.S. outbreak of avian flu ever come to fruition, the Nebraska Biocontainment Unit could be at the forefront of treatment.

The 10-bed unit, part of the Nebraska Medical Center in Omaha, is the largest quarantine and treatment facility in the country.

“If we ever had a situation, they certainly would be equipped to handle it,” said Von Roebuck, a spokesman for the Centers for Disease Control and Prevention.

So far, though, there’s been no need.

Dr. Philip Smith, medical director for the unit, said the ward hadn’t been activated since it opened in March 2005, but it came close.

A few months ago, he said, there were discussions with the state health department about using it for a patient with drug-resistant tuberculosis.

On Saturday, the unit was part of an emergency-preparedness drill in the greater Omaha area. Staff members quarantined and treated two “patients” with smallpox, one of 11 deadly infectious diseases the unit was designed to handle.

The two “patients” were driven separately to the unit while isolated in small containment pods, then were transferred to the unit for care.

Smallpox is “one of the worst ones we’d deal with,” Smith said.

“If this would happen, this would be a world event,” said Dr. Adi Pour, county health director. “It would be absolute chaos.”

A two-bed biocontainment unit at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Md., has been activated 20 times in the last 34 years. Those cases involved exposure to Lassa fever and ebola, Machupo and Junin viruses, but none resulted in a patient contracting a disease, according to spokeswoman Caree Vander-Linden.

The CDC’s unit at Emory University Hospital in Atlanta has been activated twice since it opened in 2002. Hospital spokesman Lancy Skelly could not pinpoint which diseases triggered the containment, but he said they were not related to bioterrorism.

Smith said he thought the first thing the Nebraska unit likely would see is a natural infection such as smallpox, monkeypox or avian influenza.

Referring to bird flu, nurse coordinator Patricia Lenaghan said “that would probably be the first thing we’d have.”

Most human cases of the disease have been linked to close contact with sick birds or their droppings carrying the H5N1 strain, but experts fear the virus could mutate into a form that spreads easily from person to person.

If a human case is diagnosed – theoretically anywhere in the U.S. or the world – the patient could be taken to the Nebraska Biocontainment Unit.

Chris Newlon, administrator for the biopreparedness section of Nebraska’s Health and Human Services System, said the unit is “extremely important.”

“It greatly enhances our ability to deal with a very serious situation in a short period of time and provide top-quality care,” she said.

About the lab

The Nebraska Biocontainment Unit opened in March 2005 as a collaboration between the Nebraska health department, Nebraska Medical Center and the University of Nebraska Medical Center.

¢ Construction costs: The unit cost about $1 million to construct, with space donated by the Nebraska Medical Center.

¢ Operating costs: The ward has not been activated yet, so the cost of a fully operational unit is unknown. Medical Director Philip Smith says the expense likely would be similar to operating an intensive-care unit.

¢ Staffing: Existing medical center staff volunteer for extra duty in the ward. Twenty registered nurses, five medical technicians and nine respiratory therapists have been trained to work there. When the unit is closed, they perform their normal duties.

¢ Activation: The unit can be activated by the state’s chief medical officer and the unit medical director for quarantine and treatment of 11 deadly infectious diseases: smallpox, anthrax, tularemia, plague, botulism, ebola virus and other viral hemorrhagic fevers, SARS, monkeypox, avian influenza and drug-resistant strains of staphylococcus aureus and tuberculosis.

Source: Nebraska Medical Center