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A Brief History of Biocontainment
Theodore J Cieslak1, Mark G Kortepeter1
1Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198 USA.
Current Treatment Options in Infectious Diseases
|April 1, 2020
Summary
Clinical biocontainment, or high-level containment care (HLCC), emerged in 1969. These specialized units and transport systems are vital for managing highly hazardous infectious diseases and improving healthcare infection control.
Area of Science:
- Infectious Diseases and Public Health
- Biocontainment and Healthcare Infrastructure
Background:
- The concept of clinical biocontainment, or high-level containment care (HLCC), originated with the U.S. Army's Medical Research Institute of Infectious Diseases (USAMRIID) in 1969.
- The first modern biocontainment unit, "the Slammer," operated for 41 years, admitting 21 patients exposed to hazardous infectious diseases without any secondary transmissions.
- Despite questions of underutilization, HLCC units were established in civilian academic medical centers, proving crucial during the 2014-2015 West African Ebola Virus Disease (EVD) outbreak.
Purpose of the Study:
- To review the historical development and utility of clinical biocontainment units (HLCC).
- To emphasize the importance of HLCC units and associated transport systems in responding to emerging infectious disease threats.
- To highlight the potential for HLCC operational lessons to enhance broader healthcare infection control practices.
Main Methods:
- Historical review of the establishment and operation of the first military HLCC unit.
- Analysis of the role of civilian HLCC units during the West African Ebola Virus Disease (EVD) outbreak.
- Expert opinion on the future role and impact of HLCC facilities and transport systems.
Main Results:
- The initial military HLCC unit successfully contained hazardous pathogens without transmission to staff or other patients.
- Civilian HLCC units demonstrated their critical value during a major EVD outbreak.
- HLCC facilities and transport systems are considered essential for future responses to high-consequence pathogens.
Conclusions:
- Clinical biocontainment units and specialized transport systems are indispensable for managing highly hazardous infectious diseases.
- The successful operation of HLCC units provides valuable insights for improving infection control across the healthcare system.
- Continued investment and development in HLCC infrastructure are necessary for global health security.
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