USAMRIID (United States Army Medical Research Institute of Infectious Diseases)

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USAMRIID (United States Army Medical Research Institute of Infectious Diseases)

█ BRIAN HOYLE

USAMRIID is an acronym for the United States Army Medical Research Institute of Infectious Diseases. The facility is operated by the Department of Defense and serves as the country's principal laboratory for research into the medical aspects of biological warfare. Specifically, the facility aims to develop vaccines for infectious diseases, other treatments such as drugs, and tests to detect and identify disease-causing microorganisms.

While developed for use in the laboratory, USAMRIID is mandated to explore the use of the treatments and tests in the real world of the battlefield. The research conducted at USAMRIID is defensive in nature. Infectious microbes are investigated only to develop means of protecting soldiers from the use of the microbes by opposition forces during a conflict.

The infectious disease research expertise at USAMRIID is also utilized to develop strategies and training programs to do with medical defense against infectious microorganisms. For example, the agency regularly updates and publishes a handbook that details the various medical defenses against biological warfare or terrorism. This handbook, now in its fourth edition, is available to the public.

While some of the research conducted at USAMRIID is classified, other research findings of the resident civilian and military scientists are used to benefit the larger public community. USAMRIID and its counterpart USAMRICD (U.S. Army Medical Research Institute of Chemical Diseases) trains more than 550 military medical personnel each year on biological and chemical defense measures. Furthermore, over 40,000 military and civilian medical professionals have attended an annual course on the Medical Management of Biological Casualties from 1999 to 2002.

History of the USAMRIID. The Office of the Surgeon General of the Army established USAMRIID on January 27, 1969. The facility replaced the U.S. Army Medical Unit (USAMU), which had been operating at the Fort Detrick, Maryland location since 1956. The USAMU had a mandate to conduct research into the offensive use of biological and chemical weapons. This research was stopped by U.S. President Richard Nixon in 1969. In 1971 and 1972, the stockpiled biological weapons were destroyed.

The defensive research that USAMU had been conducting, such as vaccine development, was continued by USAMRIID. In 1971, the facility was reassigned to the U.S. Army Medical Research and Development Command. Also in 1971, the centerpiece laboratory was completed. Construction of the high laboratory, which was designed to house and study highly infectious and dangerous microorganisms, cost $14 million.

Biocontainment capability. Laboratories have a rating system with respect to the types of microbes that can safety be studied. There are four levels possible. A typical university research lab with no specialized safety features (i.e., fume hood, biological safety cabinet, filtering of exhausted air) is a Biosafety Level 1. Progression to a higher level requires more stringent safety and biological controls. A Biosafety Level 4 laboratory is the only laboratory that can safely handle microbes such as the Ebola virus, Bacillus anthracis (the cause of anthrax), the Marburg virus, and hantavirus.

USAMRIID has a 10,000 square foot Biosafety Level 4 facility and 50,000 square feet of Biosafety Level 3. It is the largest high-level containment facility in the United States and is one of only three such units. The others are at the Centers for Disease Control and Prevention in Atlanta, Georgia, and San Antonio, Texas. A fourth level 4 laboratory is planned for the Rocky Mountain Lab in Hamilton, Montana.

Entry to the Level 4 area requires passage through several checkpoints and the keying in of a security code that is issued only after the person has been successfully vaccinated against the microorganism under study. All work in the level 4 lab is conducted in a pressurized and ventilated suit. Air for breathing is passed into the suit through a hose and is filtered so as to be free of microorganisms.

The USAMRIID facility also contains a Biosafety Level 4 patent ward. The ward can house people who have been infected during a disease outbreak or researchers who have been accidentally exposed to an infectious microbe. This ward was used in 1982 to care for two researchers from the Centers for Disease Control and Prevention who were exposed to rat blood contaminated with the virus that causes Lassa fever. The two researchers, along with three others thought to have been exposed to the virus remained in the containment ward until they were determined to be free of infection.

Equipment is also available that allows the Biosafety Level 4 conditions to be mimicked in the field. Thus, an infected person can be isolated at the site of an outbreak and transported back to Fort Detrick for medical treatment and study of the infection.

Research and other activities. The research staff at USAMRIID numbers over 500 people and includes physicians, microbiologists, molecular biologists, virologists, pathologists, and veterinarians. Among the support staff who assist the researchers are laboratory technicians who have volunteered to be test subjects during clinical trials of vaccines and drugs.

As of late 2002, USAMRIID scientists have the ability to rapidly identify approximately 85 infectious microorganisms. Work is underway to develop protection against 40 of the microbes. Vaccines are in various stages of development for 10 of the microbes including the highly infectious anthrax bacterium, and the Ebola and Marburg viruses.

Researchers and support staff can also respond to disease outbreaks. On short notice, teams can journey to the site of the infection to begin an investigation. This response is often conducted in conjunction with personnel from the Centers for Disease Control and Prevention. USAMRIID teams can also respond to combat. A portable laboratory to treat biological warfare casualties can be quickly set up near a battlefield.

One well-known USAMRIID response occurred in 1989, when an outbreak of an Ebola virus occurred at a primate holding facility in nearby Reston, Virginia. Some personnel even became infected with the virus, which was later determined to be a different variety from that which causes hemorrhagic Ebola fever in humans. The response of the USAMRIID personnel was subsequently detailed in bestselling books and inspired popular movies.

The facility has played an important role in several military campaigns. For example, it served as the medical support staging area for vaccines, drugs, and medical equipment during Operation Desert Storm and Desert Shield beginning in October 1990. During these campaigns, the threat of biological warfare, including the use of anthrax and Clostridium botulinum spores, was real. USAMRIID's expertise in treating these infections was invaluable to the troops who were sent to Saudi Arabia and Kuwait.

USAMRIID and domestic terrorism. In the aftermath of the September 11, 2001 terrorist attacks on targets in the United States, several letters containing anthrax spores were sent to various locations in the eastern United States via the United States Postal Service. The culprits have not been apprehended as of late 2002. Sequencing of the genetic material from the spores determined that the source of the anthrax was a strain of the microbe that had been developed in the USAMRIID labs in the 1980s. Whether the bacteria actually used in the incidents came from USAMRIID or from another lab that acquired the bacteria from USAMRIID has not been established.

Between September 11 and the following May, USAMRIID received 31,000 samples, an average of almost 4,000 per month, and performed over 260,000 tests. During normal times four to six samples are analyzed each month. Before September 11, the Special Pathogens Sample Test Laboratory had a staff of six. Since the crisis, a tenfold increase in staff members work around the clock.

█ FURTHER READING:

BOOKS:

USAMRIID USAMRIID's Medical Management of Biological Casualties Handbook, Fourth Edition. Fort Detrick, MD: U.S. Army Medical Research Institute of Infectious Diseases, 2001.

ELECTRONIC:

USAMRIID. "Welcome to USAMRIID." The U.S. Army Medical Research Institute of Infectious Diseases. Fort Detrick, MD. July 25, 2002. <http://www.usamriid.army.mil/>(25 November 2002).