When asked how many BSL-4 labs exist in the United States, Kurilla confirmed there was no standard way to count them. Some buildings have two rooms with BSL-4 classification, but is it one lab or two? Kurilla said the NIH has not decided.
"There's a 'glove box', for example, at Georgia State University that specifically contains a herpes virus B – a monkey virus that's fatal to humans – and that's the only work they do -- but they call that a BSL-4 lab," Kurilla said, wondering whether a BSL-4 lab should be defined as a facility or a room or a box in a room.
The GAO counted 15 BSL-4 labs in October 2007. Although two such labs existed before 1990, three were constructed between 1990 and 2000, and 10 were constructed from 2001 to 2007.
"A major proliferation of high-containment BSL-3 and BSL-4 labs is taking place in the United States, according to the literature, federal agency officials, and experts," the GAO report says. "Though several agencies have a need to know, no one agency knows the number and location of these labs in the United States. Consequently, no agency is responsible for determining the risks associated with the proliferation of these labs."
In its most recent look at BSL-4 labs, which was published in 2010, the GAO determined that there were no standard perimeter security protocols from lab to lab.
Still, Garrett described being inside the CDC's Atlanta BSL-4 lab -- which recently had "serious" airflow problems that could have exposed passersby to airborne pathogens -- as being so secure that it's like being "inside of a bubble inside of a bubble inside of a bubble." She was able to enter the lab because it was undergoing a complete cleaning, and said she doesn't expect to be allowed inside again because of strict security.
But Are The Labs Safe?
Almost 400 incidents involving the potential release of infectious "agents" occurred between 2003 and 2009, according to a 2011 National Research Council report. More than half were simply called "loss of containment" incidents, but there were also several incidents involving needle pricks, animal bites or scratches and equipment failure.
But Dr. Donald Henderson, an epidemiologist at the University of Pittsburgh, says labs are becoming stricter about safety. Henderson was part of a panel of experts that evaluated the safety of a BSL-4 lab in Fort Detrick, Md.
Henderson examined the lab, called the U.S. Army Medical Research Institute of Infectious Diseases, for every possible scenario -- even sewage system failures.
"It's elaborate, I must say," Henderson said of the lab's security protocols, of which there are many overlapping mechanisms. "There are all sorts of provisions with regard to security in terms of guarding any facility so that they're there to assure no one can break into the laboratory, and to have, 24-hours-a-day, some sort of security guard activity protecting it."
The lab also had experts on call to treat any employee who could potentially become ill from one of the diseases, Henderson said. But no lab technician has actually come down with a disease he or she was working on since the 1980s, when a researcher got smallpox, he said.
"That was just before major changes were made across labs with regard to smallpox in particular and, to a great extent, to many other agents that would be particularly dangerous agents," he said. "I think it became more stringent and more stringent … The whole field of what is best to do is evolving."