U.S. Army Medical Research Institute of Infectious Diseases

Definition

The US Army Medical Research Institute of Infectious Diseases (USAMRIID) is a branch of the Army Medical Research and Material Command.

Mission

The USAMRIID, located in Ft. Detrick, Maryland, was established in 1969 by a general order of the Office of the Surgeon General of the Army. The primary mission of the institute is to conduct medical research to develop vaccines, drugs, and specific diagnostic testing protocols to protect US military personnel throughout the world from biological threats and endemic diseases. The institute serves as the main research laboratory for the Biological Defense Research Program. It is the only Department of Defense (DOD) lab that can safely study infectious disease agents that require maximum containment strategies at biosafety levels (BSL) 3 and 4.

Although the foremost mission of the institute is to support members of the Armed Forces, the institute also works closely with civilian agencies such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), particularly in epidemiological research and response but also in countering bioterrorism.

Primary Research Areas and Accomplishments

Following its inception, USAMRIID developed and supplied a number of vaccines that have been crucial in controlling disease outbreaks in both military and civilian populations. For example, outbreaks of Rift Valley fever, a viral disease affecting both domestic livestock and humans, occur in areas of eastern and southern Africa, Madagascar, and parts of the Middle East. This mosquito-borne virus (prevalent during years of heavy rainfall) causes, in humans, fever, liver abnormalities, encephalitis, and ocular disease. A vaccine developed at the institute was used in treating high-risk patients in the Rift Valley fever epidemics in Egypt in 1977 and in Senegal and Mauritania in 1988. Ribavirin, an antiviral drug, may be used to treat future outbreaks.

The disease tularemia, caused by the bacterium Francisella tularensis, occurs naturally in rodent and lagomorph populations. Because F. tularensis can be inhaled, the use of aerosol applications of the bacterium as a biological weapon remains a threat. The institute worked on a tularemia vaccine that has been used in limited cases, but it has not been approved by the US Food and Drug Administration (FDA) for widespread use as of 2025.

USAMRIID has conducted decades of valuable research on the Ebola virus. The pathogen that causes Ebola hemorrhagic fever is a serious disease occurring in humans and in nonhuman primates. Initially recognized in 1976 in the Democratic Republic of the Congo (formerly Zaire), Ebola virus is one of two members of Filoviridae, a family of ribonucleic acid (RNA) viruses. The virus has been responsible for several epidemics, mainly centered in sub-Saharan African nations. Institute staff members have assisted the WHO and the CDC with Ebola outbreaks in Africa and have studied antiviral compounds that may eventually be used in a vaccine.

Following the terrorist attacks of September 11, 2001, in the United States, USAMRIID assisted several federal agencies in testing thousands of samples suspected of containing the bacterium that causes anthrax. Anthrax, an acute infectious disease caused by the bacterium Bacillus anthracis, can be transmitted to humans through the handling of infected mammalian carcasses or by the inhalation of spores. Because anthrax can infect humans by means of inhalation, the bacterium has been used as a biological weapon. From September 2001 through May 2002, institute personnel tested primarily nonmedical samples thought to be contaminated with anthrax. The lab also advised federal and state officials on area decontamination strategies. The anthrax antibiotic treatment protocol was developed at the institute’s animal research facility.

In response to the global outbreak of severe acute respiratory syndrome (SARS) in 2003, the institute worked with the CDC to identify antiviral drugs that might be used to control the coronavirus that causes the disease. Around 300,000 compounds were tested by the institute’s viral therapeutic branch, with at least one moving to clinical trials.

Despite USAMRIID's key role in infectious disease research, the institute has also faced criticism and other challenges. In 2008, Bruce E. Ivins, a microbiologist employed by the institute, died in an apparent suicide, and it emerged that he was considered by the FBI to have been behind the 2001 anthrax letter attacks. Though the allegations remained controversial, they drew considerable attention to the risk of biodefense researchers turning to terrorism. In early 2009, research at the Fort Detrick facility was temporarily suspended due to the discovery that certain pathogens were being stored but not listed in the inventory of hazardous materials onsite. Then, in August 2019, the laboratory was shut down indefinitely by the CDC over other safety concerns. According to inspectors, the facility was lacking key decontamination systems, although there were no reported injuries or infections to employees and no sign of an immediate public health threat. The institute resumed research in a limited capacity in November 2019, and by April 2020 it had returned to full operation.

In early 2020, USAMRIID also became involved in research on SARS-CoV-2, the virus responsible for the coronavirus 2019 (COVID-19) pandemic. That March, the institute's director noted that it would be one of several facilities receiving samples of the virus in order to cultivate samples for tests of vaccines and treatments. Research on COVID-19 at USAMRIID continued throughout the early 2020s, focusing on improving speed, accessibility, and portability of tests, as well as identifying and monitoring variants of the virus.

Education and Future Research

The continuing threat of bioterrorism has led to the critical need for both military and civilian healthcare professionals to recognize and deal with a biological attack. To address this need, USAMRIID developed a training series, Medical Management of Biological Casualties, covering the essential topics of managing the care of the victims of a biological attack. The training course includes classroom, laboratory, and field exercises designed to prepare healthcare providers with the necessary skills of personal protection and of treatment and decontamination within a biological-attack environment.

The continuing research efforts and goals of the institute include vaccine development for deadly pathogens such as anthrax, plague, botulinum neurotoxins, staphylococcal enterotoxins, hantaviruses, Ebola virus, Venezuelan equine encephalitis, and novel coronaviruses. In August 2023, USAMRIID committed to analyzing the genomic sequence of mosquitoes after the detection of the first non-travel-related malaria case in Maryland in more than forty years.

Impact

The USAMRIID provides valuable research and development to assist healthcare providers both in the armed forces and in civilian realms in the United States and around the world. Many critical vaccines and treatment protocols for a number of diseases were developed at institute laboratories, and the agency’s ongoing research continues to assist in future international healthcare efforts. In 2023, in addition to the institute’s focus on genome sequencing to detect COVID-19 variants, researchers were also preparing their labs and research setup, ensuring a small head start if another pandemic occurs.

Bibliography

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Borden Institute, Office of the Surgeon General, U.S. Army. Textbooks of Military Medicine. Washington, D.C.: Author.

Centers for Disease Control and Prevention. “Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Exposure Management and Antimicrobial Therapy.” Morbidity and Mortality Weekly Report, vol. 50, no. 42, 2001, pp. 909-919. www.cdc.gov/mmwr/PDF/wk/mm5042.pdf. Accessed 4 Feb. 2025.

Committee on Advances in Technology and the Prevention of Their Application to Next Generation Biowarfare Threats. National Research Council. Globalization, Biosecurity, and the Future of the Life Sciences. Washington, DC: National Academies Press, 2006.

Friedlander, A. M., and S. F. Little. “Advances in the Development of Next-Generation Anthrax Vaccines.” Vaccine, vol. 27, 2009, doi.org/10.1016/j.vaccine.2009.08.102. Accessed 4 Feb. 2025.

Grady, Denise. "Deadly Germ Research Is Shut Down at Army Lab Over Safety Concerns." The New York Times, 5 Aug. 2019, www.nytimes.com/2019/08/05/health/germs-fort-detrick-biohazard.html. Accessed 4 Feb. 2025.

Kime, Patricia. "CDC Lifts Shutdown Order on Army Biolabs at Fort Detrick." Military.com, 1 Apr. 2020, www.military.com/daily-news/2020/04/01/cdc-lifts-shutdown-order-army-biolabs-fort-detrick.html. Accessed 4 Feb. 2025.

Kortepeter, M. G., et al. “Managing Potential Laboratory Exposure to Ebola Virus by Using a Patient Biocontainment Care Unit.” Emerging Infectious Diseases, vol. 14, no. 6, 2008, pp. 881-887. doi.org/10.3201/eid1406.071489. Accessed 4 Feb. 2025.

Mongilio, Heather. "US Army Medical Research and Development Command Laboratory Studying New Coronavirus." Stars and Stripes, 4 Mar. 2020, www.stripes.com/news/us/us-army-medical-research-and-development-command-laboratory-studying-new-coronavirus-1.621178/u-s-army-medical-research-institute-of-infectious-diseases-1.621179. Accessed 4 Feb. 2025.

Murray, C. K., and L. L. Horvath. “An Approach to Prevention of Infectious Diseases During Military Deployments.” Clinical Infectious Diseases, vol. 44, no. 3, 2007, pp. 424-430. doi.org/10.1086/510680. Accessed 4 Feb. 2025.

"US Army Infectious Disease Experts to Analyze Mosquitos After Confirmed Malaria Case." U.S. Army, 25 Aug., 2023, www.army.mil/article/269395/us‗army‗infectious‗disease‗experts‗to‗analyze‗mosquitos‗after‗confirmed‗malaria‗case. Accessed 4 Feb. 2025.