University of Texas Medical Branch

Photo Credit: Melanie Westfall | Daily Texan Staff

There are deadly diseases on campus. They are not carried by birds, squirrels or freshmen — they live in a few of the hundreds of labs. Scientists at UT take the strictest precautions to ensure these pathogens do not reach students. 

These precautions are organized into levels labs must comply with: biosafety level (BSL) 1, 2, 3 and 4. BSL-1 and BSL-2 labs store viruses, bacteria or fungi that are well-understood, treatable and not particularly contagious. BSL-1 labs deal with pathogens that do not usually cause a noticeable illness in humans. For example, they may carry the canine hepatitis virus or a non-threatening strain of E. coli. BSL-2 labs carry mildly infectious viruses or bacteria, such as the
salmonella bacteria. 

The highest biosafety level at UT is BSL-3. BSL-3-level defenses are used for pathogens that could be deadly if inhaled. However, specimens stored in BSL-3 labs have a vaccine or an effective treatment plan. Scientists can study the bacteria responsible for the bubonic plague in a BSL-3 lab but not the Ebola virus. Other specimens scientists can study in BSL-3 labs include West Nile, SARS and rabies viruses.

BSL-3 labs on UT campus are located within a lower lab level. The labs are about the size of a large bedroom cabinet, with the specimens sitting on an arm-level shelf. Researchers reach their hands underneath a glass window, with gloves covering their hands and arms. The glass protects the worker’s face and body from the pathogens. Air runs toward the inside of the cabinets, and vents vacuum it up so that the researchers are never exposed to disease-filled air. Even with these precautions, the workers may choose to wear respirators — breathing equipment that resemble gas masks. Anything inside the BSL-3 area must be decontaminated with strong chemicals or high temperatures before it can be removed. Labs use BSL-4 precautions while working with diseases that easily transmit through the air and cause crippling or deadly illnesses that have no vaccines or viable treatment options. 

There are no BSL-4 labs on campus, but scientists at UT-Austin sometimes use data that scientists at the University of Texas Medical Branch at Galveston gather for further research. There are only 15 BSL-4 labs in the world, and the UTMB branch has two. According to the UTMB website, scientists there study pathogens that cause illnesses such as anthrax, hemorrhagic fevers and drug-resistant tuberculosis.

These biosafety regulations may seem thorough, but they are not A&M-proof. In April 2006, inspectors from the Center for Disease Control and Prevention found that a worker at a high-containment lab at A&M was exposed to and infected by contagious bacteria. According to further government investigation, the same lab was performing unauthorized experiments and taking infected animals out of the lab without permission. It’s easy to snicker at the Aggies, but, as the CDC official wrote, “No one knows whether the Texas A&M incidents are the tip of the iceberg or the iceberg.” 

This disaster at A&M led to a further investigation of Texas laboratories, and that inquiry  found 13 mostly mild “incidents” in the UT system. Some workers at the UT Health Sciences Center were exposed to anthrax, but investigators did not record any infections. Maintenance workers failed to wear proper protective equipment while fixing the air filter at a lab at UT-San Antonio, but they did not become ill. Four workers on the UT-Austin campus became sick after exposure to Shigella bacteria, which causes abdominal infections. While this infection is uncomfortable, antibiotics can clear it up and all of the workers made full recoveries. 

For a university system that stretches across the state and includes more than 100,000 students, 13 incidents over seven years may seem like a reasonable price of admission for the right to do research on infectious diseases. However, these mishaps caused UT-Austin to implement improved training programs, a new “Rapid Response Team” and an upgrade to research surveillance tools. 

Scientists need to manage diseases in the most effective way possible, whether during daily encounters or an emerging pandemic. This means that what stands between the UT-Austin community and BSL-3-level diseases are physical barriers and the good judgements of researchers. 

UT scientists maintain the highest standards of safety to uphold the reputation of the University, and, more importantly, the health of the students and faculty.

In a special meeting Thursday night, the UT System Board of Regents announced the System’s commitment to being prepared to utilize its resources for protecting citizens from public health threats, including Ebola.  

“The University of Texas System is fortunate to have some of the nation’s leading experts in the research and treatment of infectious diseases, and we have the largest national biocontainment laboratory in the world, located on an academic campus at the University of Texas Medical Branch in Galveston,” said Gene Powell, vice chairman and regent, in a statement at end of the meeting. “Our research expertise, world-class health care and state-of-the-art medical facilities across Texas positions us among the most experienced resources in the nation and the world.”

At the beginning of the meeting, Jim LeDuc, the director of the Galveston National Lab at UTMB, gave an overview of the Ebola virus and the particular subtype — Ebola Zaire — that is now infecting people.

Currently, three people have been diagnosed with the Ebola virus in the U.S.

Thomas Eric Duncan, who contracted the disease in Liberia, died from Ebola last week at Texas Health Presbyterian Hospital in Dallas. So far, two nurses involv:ed in his care have also contracted the virus and are presently receiving treatment. 

According to LeDuc, people become infected with Ebola by either coming in contact with wild animals stricken with the disease, eating contaminated bush animal meat or through direct contact with infected bodily fluids.

LeDuc said the mortality rate for the disease is 70 to 80 percent, and the number of people infected internationally has been doubling every two to three weeks.

“It’s most like to continue at this rate at least for the near future,” LeDuc said.

Scott Lea, a professor of infectious diseases at UTMB, also talked about how the medical branch has improved training for treating those with Ebola, protocols for lab testing of the virus and prepared a plan for the management of waste and infectious materials.

Lea said protocols appear much more stringent than those undertaken at the hospital in Dallas.

Editor's note: Corrected on December 7, 2011 at 2:42 a.m.

After growing concerns over the state’s ability to pay for health care services for its inmates, the University’s Board of Regents has taken a solid stance on providing health care for the state’s correctional facilities — pay the bills or find another provider.

The UT Board of Regents approved a new agreement Monday between the University of Texas Medical Branch and the Texas Department of Criminal Justice guaranteeing UTMB will be paid the remaining $45 million for the services it provides to inmates. If left unpaid, the agreement laid out measures to transition UTMB’s services out of the facilities or terminate them completely. UTMB’s total cost of services for the 2012 fiscal year is $430.5 million, including the $6.3 million left unpaid from the previous two year period, according to UTMB spokesman Raul Reyes. The state currently still owes UTMB $45 million, he said.

The agreement demands the Texas Department of Criminal Justice request $45 million from its 2013 fiscal budget for health care from the Legislative Budget Board to cover the money it still owes UTMB. Under the new agreement, UTMB will continue to provide health care services to the state for the remainder of the 2012 fiscal year, which ends in August, and will continue negotiations as to whether UTMB will provide care in 2013.

UT System spokesman Anthony de Bruyn said this was not the first time concerns about TDCJ’s ability to pay have been raised to the Board of Regents.

“The Board approved an extension of the contract last month and prior to that concerns have been raised,” de Bruyn said.

He said the Board was satisfied with the agreement both parties have come up with.

Reyes said that out of UTMB’s 11,000 employees, approximately 3,000 of them work in the state’s prison facilities. Both entities have been working together to provide health care to inmates since 1994.

“For years, we would get supplemental appropriations after we had provided care, and they were not always enough to cover the bill,” he said.

Reyes said UTMB always believed the new agreement with TDCJ would be approved.

“Throughout all this, everyone needs to know that patient care was never interrupted,” Reyes said. “We continued to provide care at one of the lowest costs throughout the nation, and we’re thankful that a solution has been worked out to make sure that the health care is continued.”

TDCJ spokesman Jason Clark said UTMB is the primary health care provider for 87 state facilities consisting of 120,000 inmates. Texas Tech University Health Science Center also provides health care for the state. He said biennial agreements are renegotiated based on legislative appropriations and renegotiated after each legislative session.

Clark said the request to the Legislative Budget Board for $45 million from state health care service’s budget for the fiscal year of 2013 has not been approved by the Legislative Budget Board.

Printed on Tuesday, December 6, 2011 as: Regents negotiate state inmate health care debts

Hospital visitors walk by the entrance to the Austin Women’s Hospital on Wednesday evening.

Photo Credit: Andrew Edmonson | Daily Texan Staff

Because of increasing operating costs and decreased state funding, the University of Texas Medical Branch at Galveston may cease operating the Austin Women’s Hospital located at University Medical Center Brackenridge, a UTMB spokesman said.

Legislative budget cuts reduced UTMB’s budget by $114 million over the next two years. Spokesman Raul Reyes said the health system is responding by reducing its budget by 6.1 percent for the 2012 fiscal year.

“We are being more prudent in the way that we manage our costs and are implementing measures to ensure financial success,” Reyes said in a statement. “It is projected that UTMB will sustain a $1.5 million loss on the Austin Women’s Hospital contract for fiscal year 2011. We have to mitigate those losses.”

Reyes said one cause for the projected loss is a lower-than-expected number of patients.

“We staff based on the assumption that there will be a certain level of patients coming in the door, and we don’t have that level,” Reyes said.

Central Health, formerly known as Travis County Healthcare, owns University Medical Center Brackenridge. In 1995, it leased the hospital to the Seton Healthcare Family, a Catholic health care system.

After Seton could no longer provide contraceptive and sterilization services because of the Catholic Church’s Ethical and Religious Directives, the health department took back the fifth floor of the Brackenridge building in 2002 to open a “hospital within a hospital” that could provide those services Seton could not, according to Catholic Health East, a Catholic health system.

According to the UT System, in 2003 the city of Austin and UTMB reached an agreement for UTMB to run the Austin Women’s Hospital on the fifth floor of University Medical Center Brackenridge.

If UTMB does decide to withdraw from the hospital, there are currently no plans for Seton to take over the fifth floor for its own uses, said Seton spokeswoman Adrienne Lallo.

Reyes said no decision regarding UTMB’s withdrawal has actually been made.

“We’re considering our options,” Reyes said. “We just want to make sure we do the financially responsible thing for UTMB and Texas taxpayers.”

Printed on Thursday, August 4, 2011 as: Austin hospital put on chopping block