A National Resource
The U.S. Army Medical Research Institute of Infectious Diseases was established in 1969 by General Order No. 6, dated January 27, 1969, Office of the Surgeon General of the Army. The orders renamed the former U.S. Army Medical Unit, which had been established at Fort Detrick in 1956. The unit was assigned in 1971 to the U.S. Army Medical Research and Development Command, a field operating agency of the Surgeon General of the Army.
The current principal laboratory facility for USAMRIID was completed in 1971 in two phases. Phase I construction cost $7.6 million; Phase II, $6.33 million. Colonel Dan Crozier commanded the USAMU during its transition to USAMRIID.
USAMRIID's research facility has more than 10,000 square feet of Biosafety Level 4 (BL4) and 50,000 square feet of Biosafety Level 3 (BL3) laboratory space. It is the largest containment laboratory in the U.S. There has never been a release of any dangerous organism outside the laboratory environment. In addition, a special BL4 patient containment ward is available for medical care of patients, who may have been accidentally exposed to infectious agents within the laboratory, or who may have acquired a highly hazardous disease in an endemic area.
The Institute also houses a 16-bed research ward, where clinical trials of vaccines and drugs are conducted in accordance with rigorous regulations of the U.S. Food and Drug Administration (FDA). The goal is approval of a medical product for human use.
The Institute's military and civilian staff of approximately 500 includes physicians, veterinarians, microbiologists, pathologists, chemists, molecular biologists, physiologists, and pharmacologists. It also includes technical and administrative staff to support research. The staff includes approximately 70 Medical Research Volunteer Subjects (MRVS), who are highly trained laboratory technicians who have requested the opportunity to participate in clinical trials of vaccines and drugs. The clinical trials are the first phase of human testing in the lengthy research and development process, which is thoroughly monitored and leads to approval of a vaccine or drug, which becomes a medical countermeasure to protect U.S. military personnel.
The Institute deploys teams on short notice to train and equip personnel who establish diagnostic laboratories in theaters of combat operations. Other teams specialize in rapid response to investigate disease outbreaks anywhere in the world and can evacuate patients in BL4 isolation.
A world scientific resource, USAMRIID is a reference laboratory for the World Health Organization in Geneva, Switzerland, and collaborates with it and the CDC in Atlanta, Georgia, in helping diagnose and treat unusual diseases whenever they occur.
Colonel Joseph Metzger assumed command in 1973, succeeding Brigadier General Kenneth Dirks, whose leadership spanned only a few months in 1972. Colonel Metzger was followed in 1977 by Colonel Richard F. Barquist, who was responsible for expanding research programs in Rift Valley fever, Argentine hemorrhagic fever, and other unusual diseases and hemorrhagic fevers that may affect rapid deployment forces.
Another major area in which the Institute continues on the leading edge is in laboratory animal science. USAMRIID is fully accredited by the Association for the Assessment and Accreditation of Laboratory Animal Care International (AAALAC), a nonprofit organization that evaluates research laboratory animal care and use programs and facilities. AAALAC accreditation is regarded as the standard for excellence in animal care and use.
One of the most concise papers written on the modern history of USAMRIID was written by Colonel David L. Huxsoll, commander of the Institute from 1983-1986. It was a letter to the editor of the Frederick News-Post, prepared in response to unjust criticism of the Institute and its ability to work safely with high hazard microorganisms. Huxsoll wrote:
[USAMRIID collaborates] with major universities through-out the U.S. [and] with international organizations ... research is performed in strict and full compliance with the guidelines and regulations of ... National Institutes of Health; U.S. Public Health Service; U.S. Centers for Disease Control; Food and Drug Administration; Nuclear Regulatory Commission; and Occupational Safety and Health Administration. These oversight functions are particularly relevant to the development process for products destined to be used in humans ... USAMRIID always meets, and in most instances, exceeds research safety requirements set by these agencies.
Research is unclassified ... Indeed, USAMRIID has a tradition of being open to the press ... hosted visits from numerous domestic and foreign television crews ... encouraged interviews with scientists and administrators concerning ongoing research and past achievements.
The Institute is host and sponsor to a variety of national and international scientific conferences and symposia. We are also open to the community; classes from surrounding high schools and colleges regularly tour the facilities...
The Institute has been a major influence in the development of vaccines and drugs. USAMRIID has made significant contributions to solving world health problems through its epidemiological, ecological, and environmental studies, improvements in rapid diagnosis, and its pioneering studies on interferon and synthetic substances that can increase the potential of the body's immune system...
Huxsoll listed some of USAMRIID's contributions to public health:
- Clinical trials on an antiviral drug and a vaccine to fight lethal, endemic diseases in Argentina, Korea, and the People's Republic of China;
- USAMRIID conducted large-scale field trials near Buenos Aires, with the Argentine Ministry of Health using the USAMRIID-developed vaccine for Argentine hemorrhagic fever. The vaccine was shown to be more than 95 percent effective in preventing the disease. More than 6,500 agricultural workers took part in the study.
- In 1971 when an outbreak of Venezuelan equine encephalitis threatened humans and animals in Brownsville, Texas, and the Rio Grande region, the VEE vaccine developed at USAMRIID was used to quell the disease.
- When Rift Valley fever broke out in Egypt in 1977, the USAMRIID-developed vaccine was used to protect people at high risk, including soldiers of the United Nations Peace Keeping Force.
- The USAMRIID-developed tularemia vaccine was sent to Italy by request of the Italian Government to protect humans from an epidemic.
- Vaccines developed at USAMRIID are provided to "at-risk" researchers throughout the U.S., Asia, Europe, Africa, Australia, and North and South America.
- In 1989, USAMRIID rushed vaccine to San Francisco in a matter of a few hours to save a baby from infant botulism.
- In 1990, a university hospital in Sweden requested USAMRIID expertise in diagnosis and treatment for a patient, who had recently returned from Africa and was thought to have Ebola hemorrhagic fever. The patient was in shock, near death, and could not be moved. A team of one physician and two nurses flew within 24 hours of the request, accompanied by the portable patient isolation equipment. The USAMRIID team trained the hospital staff in high containment (BL4) patient care. The patient survived.
USAMRIID has hosted and sponsored a variety of national and international scientific conferences and symposia on topics including: toxins, botulism, hemorrhagic fever viruses, and plague. Its scientists author more than 100 articles each year in peer-reviewed scientific journals. They also are invited speakers and session organizers at numerous scientific meetings in the U.S. and abroad.
In 1982, USAMRIID's maximum containment treatment facility was called on to provide care for two researchers from the CDC in Atlanta. The men were exposed to partially thawed rat blood, which was contaminated with Lassa fever virus. Lassa fever is an African hemorrhagic disease, which USAMRIID has been studying for more than a decade. The men were quarantined for more than 15 days. The patients were released and pronounced free of any signs of the disease. During the same time period three other patients were isolated in the ward after having been exposed to Lassa fever. They, too, were released after quarantine, free of the suspected disease.
In 1989, USAMRIID's expertise was called on by the Virginia Department of Health and Hygiene when a commercial laboratory animal holding facility in Reston, Virginia, experienced an outbreak of an Ebola virus in its primate population. The potentially devastating outbreak was quickly handled by USAMRIID personnel, preventing what health officials feared could have had a terrible effect on humans. Author Richard Preston chronicled in The Hot Zone the rapid and effective response by USAMRIID scientists and soldiers. This in turn sparked at least one major movie (Outbreak), which based its story on the basic scenario of the Ebola outbreak, but created a fictional disease and used characters based loosely on USAMRIID's Colonel Jerry Jaax and his spouse, Colonel Nancy Jaax, two highly respected veterinarians and researchers. The similarity in the script to these scientists ended with the fact they are married and assigned to an Army laboratory. Otherwise the situations were completely fictional.
In October 1990, USAMRIID became a staging area for shipping drugs, vaccines, diagnostics, and laboratory equipment and supplies for medical support of Operation Desert Shield. By the end of the Operation Desert Storm, six teams had been organized, trained, and equipped to join Theater Area Medical Laboratories for diagnosis of biological warfare and endemic disease threats. Special studies were begun to formulate medical doctrine on the use of anthrax vaccine in conjunction with antibiotics, immunization with botulinum toxoid, and immunoglobulin therapy for botulism. Protocols for the use of antiviral drugs to prevent or treat endemic infectious diseases were also prepared.
USAMRIID's science and technology base serves to address current threats to U.S. military personnel and is an essential element in the medical response to any future biological threats that may confront the men and women of the U.S. Armed Forces.