The lab mishaps at the Centers for Disease Control and Prevention are having "broad impacts," compromising care for patients with diseases like tuberculosis and chikungunya and potentially slowing work overseas on Ebola and MERS, according to a CDC official.
Multiple improprieties -- including transporting dangerous materials in Ziploc bags and sending a live sample of bird flu to a low-security lab -- prompted CDC Director Dr. Thomas Frieden last week to instruct his highest-security labs to stop transferring out biological materials.
The transfer moratorium means laboratories around the world can no longer depend on the CDC to help them diagnose unusual diseases such as drug-resistant tuberculosis, Middle East respiratory syndrome, Rocky Mountain spotted fever and typhus, said Michael Shaw, deputy director of the CDC's office of infectious diseases.
"The CDC is one of the only places that can diagnose these diseases," Shaw said.
Hardest hit, health experts say, may be TB patients.
Because of the transfer moratorium, some patients have been unable to find out what type of TB they have. That means their doctors don't know which antibiotic to prescribe, according to Kelly Wroblewski, director of infectious disease programs at the Association of Public Health Laboratories.
"The moratorium was the absolute right thing to do; you've got to triple-check all your procedures," said Scott Becker, executive director of the association. "But if this goes on for another week, we're going to have even more problems."
The CDC is one of only three public health labs in the United States that can do quick testing on drug-resistant tuberculosis specimens to see which antibiotic might work the best. The other two, in California and New York, might be able to handle some of the overflow, Wroblewski said.
The CDC will also be turning away about 100 samples per week that need to be checked for chikungunya, a mosquito-borne disease that's risen to record levels in Puerto Rico, the U.S. Virgin Islands and other parts of the Caribbean, according to Shaw.
Doctors in the area have been sending specimens to the CDC to help diagnose the disease, which often has the same symptoms as dengue fever or malaria. Without answers, doctors on the ground will have difficulty knowing how to treat their patients and whether they need to isolate them from other people, Shaw said.
The CDC has also stopped a mosquito surveillance program in Gulf Coast states aimed at detecting whether infected bugs are bringing the disease to the continental U.S.
State labs in the United States also rely on materials from the CDC to test substances such as white powders that are suspicious for bioterrorism. The labs have enough materials to last a while but at some point will run out.
Internationally, labs that are working on the Ebola crisis in Africa and on Middle East respiratory syndrome might see their work slowed down because of the CDC lab situation.
Those international labs depend on materials from the CDC to do their work. Shaw said they also currently have enough but might run out soon.
The 22 CDC labs under the moratorium are in Atlanta; Anchorage; San Juan, Puerto Rico; and Fort Collins, Colorado. The moratorium will be removed lab by lab as each one can prove that it can operate safely again, and some of the CDC labs might be able to transport materials in a few days, but others might not not be fully operational for months, Shaw said.
"We shouldn't and we won't be doing this work unless we can do it in a safe way," he added. "As soon as each lab can document that policies and procedures and validated protocols are in place, they can resume transporting materials."