The National Institute of Infectious Diseases has finally been authorized to handle the most hazardous pathogens in its laboratory in Musashimurayama in western Tokyo as the health ministry, under an agreement with the city in early August, upgraded the facility to biosafety-level-4 (BSL-4) — the highest level of biosafety. The nation needs such a facility if it’s going to cope with serious infectious diseases. The NIID should do its utmost to ensure that no accidents occur at the lab because a BSL-4 facility handles pathogens that cause infectious diseases with high fatality rates and for which no effective treatment exists.
The institute built the Musashi- murayama facility as a BSL-4 lab in 1981. But facing strong opposition from nearby residents who feared that hazardous pathogens could leak into the environment, the facility has been forced to operate as a BSL-3 lab. The Ebola outbreak last year in West Africa, in which more than 10,000 people died, helped the Health, Labor and Welfare Ministry and the city sign the agreement. It will likely take several months before the facility will actually begin operating as a BSL-4 lab. New protocols must be established and workers must be trained for work requiring a higher level of security.
New types of infectious diseases have emerged since the latter half of the 20th century, such as AIDS, Ebola, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Eight pathogens that cause highly lethal diseases, including Ebola, Lassa fever, Marburg disease and smallpox, must be handled by a BSL-4 facility. A revision of the Infectious Diseases Control Law aimed at preventing bioterrorism bans possession, importation and transfer of most of these pathogens.
To prevent the escape of pathogens into the environment, the air pressure inside a BSL-4 lab is kept lower than that outside. Workers must work in pairs at all times and wear highly protective gear. Pathogens are studied inside a “chamber,” or sealed box. Exhaust from such a lab must go through a double filter.
During the Ebola outbreak, several people suspected of being infected entered Japan. A BSL-3 facility can verify whether a person is infected with Ebola. At the Musashimurayama lab, nine people suspected of being carriers were examined and all were found to be free of the virus. If any had been found to be infected, it would have become necessary to determine the exact type of virus affecting the patient and determine the best treatment. These things can be done only at a BSL-4 lab. Development of medicines and vaccines for highly hazardous infectious diseases will also require the use of a facility with this status.
As of March, 41 BSL-4 facilities were in operation in 19 countries, including the United States, Canada, Britain, Germany, China and South Africa. Japan is the only Group of Eight country without one. Under the agreement with the Musashimurayama Municipal Government, the health ministry will for the time being restrict the use of the lab to diagnosing and treating patients. The ministry also said it has no current plans to import samples of highly dangerous pathogens like Ebola to Japan for research purposes at the facility.
In operating the facility, gaining local residents’ understanding is indispensable. Some people in the neighborhood reportedly feel that the agreement between the ministry and the city came with too little advance warning. So far, no BSL-4 facilities in other countries have reported a pathogen leaking into the environment. Even so, such an event is possible. The health ministry must give priority to ensuring safety and transparency of the facility’s operations. It should not hide any relevant information.
Nagasaki University has a plan to build a larger and more sophisticated BSL-4 lab by around 2020 at a cost of around ¥10 billion. It aims to carry out basic research that will lead to development of therapies, vaccines and drugs as well as training of experts. In view of the necessity to fight high-risk infectious diseases and cope with bioterrorism, BSL-4 facilities have an important role. The government, universities and research institutes should hold discussions with local residents over such facilities in good faith. They should seriously listen to their concerns and respond appropriately, as well as enlighten them on the need for such facilities to gain their support.