Research Occupational Health Program (ROHP)
\nBoston University
\n617-358-7647<\/p>\n
Chlamydiae are small obligate intracellular parasites and were once considered to be viruses. However, they contain DNA, RNA and ribosomes and make their own proteins and nucleic acids and are now considered to be true bacteria. They possess an inner and outer membrane similar gram-negative bacteria and a lipopolysaccharide but do not have a peptidoglycan layer.<\/p>\n
Strains of C. trachomatis<\/em> can cause urogenital infections, trachoma, pneumonia and lymphogranuloma venereum (LGV), infant pneumonia, pelvic inflammatory diseases (PID), Reiter’s syndrome (oligoarthritis) and neonatal conjunctivitis.<\/p>\n If untreated, chlamydial infections can progress to serious reproductive and other health problems with both short-term and long-term consequences such as pelvic inflammatory disease (PID), chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). In laboratory accident settings, infections are usually manifested as conjunctivitis, however severe cases of pneumonia have occurred through exposure to aerosols. There have been six reported \u00a0\u00a0\u00a0\u00a0\u00a0 cases of infection with C. trachomatis<\/em> up to 1987.<\/p>\n Risk Group\/BSL Modes of Transmission <\/strong>Host Range\/Reservoir Symptoms Some laboratory workers exposed to C. trachomatis<\/em> via aerosolized mode have developed conditions including mediastinal and supraclavicular lymphadenitis, pneumonitis,<\/p>\n Conjunctivitis and keratitis will usually present as eye pain, photophobia, eye discharge, and impact to vision.<\/p>\n Meningitis occurs in association with one of the other diseases.<\/p>\n Incubation Period Viability Survival Outside Host Lab coat, gloves and eye protection must be work when direct skin contact with infected materials or animals is unavoidable. Additional PPE and practices may be recommended based on rick assessment.<\/p>\n All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC).<\/p>\n Biosafety Level 3 practices, equipment, and facility design are recommended for work with high concentration cultures, screening BSL-2 practices, containment equipment, and facilities are recommended for personnel working with clinical specimens and cultures. BSL-3 practices, containment equipment and facilities are recommended for activities involving work with culture specimens or clinical isolates known to contain or potentially be infected with LGV serovars. Laboratory work with LGV serovars can be conducted in a BSL-2 facility as long as BSL-3 practices are followed when handling potentially infectious materials including but not limited to use of primary containment such as BSC\u2019s.<\/span><\/p>\n ABSL-2 practices, containment equipment, and facilities are recommended for activities with experimentally infected animals.<\/span><\/p>\n No vaccine available<\/p>\n Person to person transmission is possible through direct contact with discharges from infected persons, or materials soiled therewith. Standard precautions are recommended for both conjunctivitis and pneumonia. Health care providers should immediately report to local board of health (BPHC) where the diagnosis was made.<\/p>\n Diagnosis is made based on syndromic presentation and laboratory confirmation. Diagnosis of suspected site can be made by PCR based methods or culture on clinical tissue. EIA and serologies are also available.<\/p>\n Perform one of the following actions:<\/p>\n Antibiotics can be given for prophylaxis with the agents listed below.<\/p>\n Sensitive to doxycycline, tetracycline, erythromycin, and azithromycin. They are usually prescribed orally. Chlamydial conjunctivitis can be treated topically with tetracycline, erythromycin, and fluoroquinolones. In most cases, the infection resolves within one to two weeks.<\/p>\n Mayo Clinic; http:\/\/www.mayoclinic.com\/health\/chlamydia\/DS00173\/DSECTION=prevention<\/a><\/p>\nPathogenicity<\/h3>\n
Biosafety Information<\/h3>\n
\n<\/strong>Risk Group 2
\nBiosafety Level 2 Practices
\nBiosafety level 2 (enhanced or BSL-3 based on a full risk)<\/p>\n
\n<\/strong>Direct contact with discharges from infected persons, or materials soiled there with;<\/p>\n\n\n
\n <\/td>\n Transmission<\/td>\n<\/tr>\n \n Skin Exposure (Needlestick, bite, or scratch):<\/td>\n Yes<\/td>\n<\/tr>\n \n Mucous Membrane Splash to Eye(s), Nose or Mouth:<\/td>\n Yes, Direct skin contact with mucous membranes<\/td>\n<\/tr>\n \n Inhalation:<\/td>\n Inhalation of droplet aerosols. Most reports of laboratory-acquired infections with C. trachomatis attribute the infection to inhalation of large quantities of aerosolized organisms during purification or sonification procedures.<\/td>\n<\/tr>\n \n Ingestion:<\/td>\n No<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n
\n<\/strong>Humans<\/p>\n
\n<\/strong>C. trachomatis<\/em> can cause a spectrum of clinical manifestations including genital tract infections, inclusion conjunctivitis, trachoma, pneumonia in infants, and LGV.<\/span><\/p>\n
\n<\/strong>The incubation period for the infection is 6 to 19 days for adult conjunctivitis; 5 to 12 days for trachoma.<\/p>\n
\n<\/strong>Susceptible to 1% sodium hypochlorite, 70% ethanol, 2% glutaraldehyde, formaldehyde.<\/p>\n
\n<\/strong>Carcass and organs – 1 to 7 days; glass – 30 min; water (50\u00b0C) – 30 min<\/p>\nInformation for Lab Workers<\/h2>\n
Laboratory PPE<\/h3>\n
Containment<\/h3>\n
In Case of Exposure\/Disease<\/h3>\n
\n
\n
\n<\/strong>You will be referred to or transported to the appropriate health care location by the emergency response team.<\/li>\n<\/ul>\n<\/li>\nVaccination<\/h3>\n
Information for First Responders\/Medical Personnel<\/h2>\n
<\/strong>Public Health Issues<\/h3>\n
Diagnosis\/Surveillance<\/h3>\n
First Aid\/Post Exposure Prophylaxis<\/h3>\n
\n\n
\n Skin Exposure (Needlestick or scratch):<\/td>\n Immediately go to the sink and thoroughly wash the wound with soap and water for 15 minutes. Decontaminate any exposed skin surfaces with an antiseptic scrub solution.<\/td>\n<\/tr>\n \n Mucous Membrane Splash to Eye(s), Nose or Mouth:<\/td>\n Exposure should be irrigated vigorously.<\/td>\n<\/tr>\n \n Splash Affecting Garments:<\/td>\n Remove garments that may have become soiled or contaminated and place them in a double red plastic bag.<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n Treatment<\/h3>\n
References<\/h3>\n