When Sean Kaufman joined the faculty in Rollins School of Public Health in 2004, he came from the CDC, where he had helped respond to outbreaks of anthrax, SARS, and West Nile virus. But he experienced a pang of fear when Ruth Berkelman, director of RSPH’s Center for Public Health Preparedness and Research, told him the center had received an NIH grant to create a training program for biosafety level (BSL) 3 and 4 labs. She wanted Kaufman to design and implement the curriculum.

But Kaufman specialized in health and human behavior, and despite his extensive CDC experience he had never even been inside a BSL lab.

Such labs are numbered according to risk: BSL 3 labs focus on lethal inhalable infectious agents for which treatments exist. Workers in BSL 4 labs must wear positive-pressure suits with oxygen hoses connected to them to protect against organisms, such as Ebola and other viruses causing hemorrhagic fever, for which there is no effective treatment.

In the years since its inception, the Emory program Kaufman designed in collaboration with CDC and NIH has trained more than 2,000 people from across the world, including scientists and lab technicians, police, firefighters, and other emergency responders. Numerous BSL training programs have sprung up based on the Emory model, which started the trend and remains the gold standard.

BSL training has much in common with flight simulation that exposes pilots on the ground to dangers they will face in the sky. BSL training takes place either in the mock lab on the Emory campus or in real labs worldwide before they "go hot" (become active). Trainees experience problems like spills with all the adrenaline rush and urgency of real-life situations—but without the risk of serious illness or death. The weeklong training also is designed to "provoke" errors.

"You can learn about BSL emergencies from textbooks the same way you theoretically can learn to swim from a PowerPoint presentation, but the only real way to learn how to respond to BSL emergencies is by responding," says Kaufman. "Our program bridges the gap between knowing something in your head and being able to respond quickly, appropriately, and with minimal risk."

In a typical day, Kaufman trains participants, polishes the curriculum, or gives talks about BSL training. The hardest part of his job is being away from home and his two sons for sometimes up to a month. During the past six months, he has provided training in soon-to-be-active BSL labs in Jordan, Switzerland, India, Mexico, and Honduras, as well as at the University of Florida, George Mason University, and UCLA.

The best part of his job, says Kaufman, is "seeing the light bulb go on when participants learn to do something they previously thought impossible."