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BU delayed reporting possibly lethal exposure

Boston University officials waited nearly two weeks to notify public health authorities that they had serious concerns that researchers might have been exposed to a potentially lethal bacterium while conducting experiments, a delay that could have violated laws requiring prompt reporting of suspected infectious disease cases.

The university yesterday confirmed that on Oct. 28, test results showed that researchers who had thought they were working with a harmless variety of the bacteria tularemia instead had been working with material that appeared to be contaminated and that might have caused illnesses in three researchers. In May, two scientists had fallen ill with flu-like symptoms, and in September, a third became ill, raising suspicions that they had developed tularemia.

On Nov. 4, Dr. Peter A. Rice, the senior scientist involved in the research, was ordered by the university's Institutional Biosafety Committee to immediately cease all his work on developing a vaccine against the bacterium because of concerns about the safety of workers, BU said.

But the suspected cases of tularemia were not reported to the state Department of Public Health until Nov. 9 and to the Boston Public Health Commission until Nov. 10. The city's director of communicable disease control, Dr. Anita Barry, said last night that BU "should have notified us as soon as someone suspected a case of tularemia."

Tularemia is a reportable disease in Massachusetts, and state law requires "cases or suspect cases" of such diseases to be reported to public health authorities "immediately, but in no case more than 24 hours" after being identified.

Barry said the Oct. 28 test results, coming after three workers had become sick, should have triggered a report to health authorities.

The acting provost of BU's medical campus, Dr. Thomas J. Moore, said yesterday that he could not explain the delay in reporting.

"I have been unable to come up with reasons why time went by from the 28th to the 9th," Moore said. He said that when laboratory scientists received the Oct. 28 test results, "they must have assumed something was amiss."

Further, Moore said he believed that Rice first became seriously concerned when the third researcher fell ill in September.

"The light first went on for Peter about something being amiss when the third person got sick," Moore said. "I guess maybe in retrospect somebody could [ask] why didn't Peter alert someone then."

BU officials said yesterday that they had decided to remove Rice from his position as chief of infectious diseases. Moore said Rice had failed to show adequate leadership, which contributed to safety lapses in the lab. Among those lapses was that workers violated rules requiring tularemia to be handled in an enclosed chamber that filters infectious agents out of the air, according to Moore. Rice will remain on the BU faculty, but no decision has been made on whether he will be allowed to continue with tularemia research, Moore said.

In an interview, Dr. Aram V. Chobanian, interim president of BU and formerly dean of the medical school, said that he supported the demotion of Rice and that the move was prompted in part by Rice's failure to deal with the suspected tularemia cases in a "timely manner." Chobanian said he had been told that Rice had not alerted colleagues of his concerns about tularemia exposure soon enough.

A spokeswoman for BU Medical Center said the university would not make Rice available for an interview. Rice did not return telephone messages left Tuesday and yesterday at his office or respond to e-mails.

The tularemia exposures are being investigated by public health agencies, but also by the FBI, BU and city officials said yesterday.

Under federal law, the FBI becomes involved whenever there is a release of biological agents that could be used in acts of bioterrorism.

The dangerous form of tularemia is on the list of select agents that would trigger an FBI investigation. But the disease detective who is leading the US Centers for Disease Control and Prevention probe said yesterday that nothing has emerged to suggest that the cases were the result of deliberate contamination.

The researchers who got sick, apparently from inhaling tularemia, believed they were working with a weakened strain that was engineered specifically for vaccine research and posed no threat to the workers.

So neither they nor colleagues initially linked their flu-like symptoms to potential exposure. All three recovered after being treated with antibiotics.

But after the possible contamination was found, tests performed in November by the CDC showed that researchers unwittingly had been using tularemia that was a mixture of the harmless strain and a highly virulent form, which in nature is spread by insects and animals such as rabbits and rodents.

It remains a mystery how material believed to be incapable of causing illness became contaminated with a dangerous pathogen.

"But there's no credible evidence I know of to suggest it was an intentional event," said Dr. Paul Mead, the medical epidemiologist directing CDC's investigation.

Stephen Smith can be reached at

How events unfolded after the exposures

These are key events in the exposure of three Boston University scientists to tularemia.

May 22, 2004: First researcher becomes ill with fever, cough, and headache.

May 24: Second researcher becomes ill with similar symptoms and is hospitalized overnight.

Sept. 20: Third researcher becomes ill with symptoms similar to the two earlier cases and is hospitalized several days.

Oct. 28: Concerned about the workers' illnesses, BU scientists perform DNA analyses of two samples of tularemia used by researchers. The samples are believed to contain identical strains of a weakened, harmless form of the bacteria, but on Oct. 28, results show the samples have different DNA profiles, suggesting that one of them could be contaminated and represent a threat to researchers; the university's occupational health division is notified.

Nov. 4: BU notifies Dr. Peter A. Rice to stop his tularemia vaccine research.

Nov. 9: The state Department of Public Health is notified by Boston University of possible cases of tularemia exposure; blood samples of three researchers who fell ill are sent to state public health lab for analysis.

Nov. 10: The Boston Public Health Commission is notified.

Nov. 12: Blood tests for all three researchers are positive for tularemia.

Nov. 23: US Centers for Disease Control and Prevention reports that samples of tularemia from the BU lab contain both the harmless variety of tularemia and a highly infectious strain capable of causing illness.

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