NIH will share more info about outbreaks, high-profile diseases

Patrick Semansky/AP - In this photo taken Aug. 21, 2012, Dr. Tara Palmore, deputy hospital epidemiologist at the National Institutes of Health Clinical Center, left, and Dr. Julie Segre, a geneticist with the National Human Genome Research Institute, pose at the NIH Clinical Center in Bethesda, Md. Last year a deadly superbug spread through the nation's leading research hospital, killing six patients before it could be stopped.

After absorbing criticism for failing to immediately disclose a deadly superbug outbreak, officials at the National Institutes of Health have agreed to notify state and county officials of any potentially high-profile diseases or outbreaks, even those that do not pose an obvious public risk, county officials said this week.

The new agreement between NIH, Maryland and Montgomery County is scheduled to be finalized after the Thanksgiving holiday, an NIH spokeswoman said. The pact is designed to prevent the controversy spawned after an antibiotic-resistant strain of the bacterium Klebsiella pneumoniae spread throughout the 234-bed research facility in Bethesda.

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The germ arrived at the hospital in June 2011 with a New York woman who needed a lung transplant. It infected more patients by August 2011, eventually infecting a total of 18, 12 of whom died. Seven of the deaths were directly attributed to the superbug.

In December, as the situation worsened, NIH contacted Maryland’s state epidemiologist, seeking advice. But neither NIH nor the state shared any information with the county about the outbreak, which became public in August 2012, when NIH researchers published a scientific paper about it. At the time, Montgomery County Council President Roger Berliner (D-Potomac-Bethesda) complained that the county hadn’t been notified.

Carol Jordan, the county health department’s director of communicable diseases and epidemiology, said recent discussions about the new agreement have clarified all the parties’ public health responsibilities, including informing the public.

Under the pact, NIH will notify the county of rare or potentially high-profile diseases or outbreaks that might alarm the public, even if there is no public health risk, Jordan said.

“Nobody wanted a repeat of what happened during the Klebsiella outbreak over there,” she said.

Jordan said the outbreak “was probably not a risk to the public,” but added, “When a paper is published about it, it will certainly raise questions from the public. . . . And that kind of thing, the county needs to know about.”

NIH officials have said they did not alert the public earlier for several reasons. Experts at NIH and elsewhere said healthy people outside the hospital were at minimal risk. The infection was not among the infectious diseases required to be reported to the federal Centers for Disease Control and Prevention. And as a federal facility not licensed by Maryland, NIH is not required to report health-care-acquired infections or certain other diseases to the state.

When the outbreak erupted, the clinical center’s infection control staff scrambled, walling off infected patients, tearing out plumbing and swabbing equipment, walls, railings and patients to track and contain the bacterium. Despite these extreme efforts, the outbreak still ticked along for more than a year as the hardy superbug lingered on hard surfaces — and inside patients, among the sickest of the sick.

Residents who live and work near the sprawling NIH campus, as well as some employees exposed to the affected wards, grumbled that they had been put at risk because they hadn’t been told about the infection.

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