APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing”

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” | www.APHLblog.org

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” | www.APHLblog.org

The Association of Public Health Laboratories (APHL) is very concerned about the decline in federal funding for public health functions such as detection, surveillance and response in the administration’s budget for fiscal year 2019. “It is extremely disheartening and disappointing to see such severe cuts to public health programs at CDC, HRSA, USAID and the Department of State at a time when the services they support are most in need,” said Scott Becker, executive director of APHL. “What is more, these cuts to public health funding come after a historic bipartisan agreement between Congress and the White House to increase federal spending overall for the next two years.”

CDC cuts include:

HRSA cuts include:

Global Health Programs:

  • $1.26 billion cut to Department of State Global Health Programs which includes funding provided to CDC for PEPFAR; and
  • $1.11 billion cut to USAID Global Health Programs.

While the majority of the president’s budget proposal is grim for public health, there were a few areas that are not as dark. APHL was pleased to see that the budget request designates $175 million to CDC to address the growing opioid crisis. Additionally, funding for the Global Disease Detection Program would increase by $51 million and funding for the Public Health Emergency Preparedness program would increase by $4.5 million.

As Scott Becker explained, “The director of the president’s Office of Management and Budget said, ‘the budget is a messaging document.’ In that case, the message to the American people seems to be, ‘Good luck if there is an outbreak or other public health emergency because federal early warning and response programs won’t be there to help you through.’”

APHL will continue work with Congress to assure that funding levels continue at the much-higher amounts provided in previous years. Adequate levels of federal support for state and local laboratory contributions are critical to the nation’s public health security.

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Q&A with Iowa lab’s safety officer, Drew Fayram: How the CDC/APHL biosafety and biosecurity program created a culture of safety

Q&A with Iowa lab’s safety officer, Drew Fayram: How the CDC/APHL biosafety and biosecurity program created a culture of safety | www.APHLblog.org

APHL recently checked in with Drew Fayram, the safety officer at the State Hygienic Laboratory at the University of Iowa, to get his perspective on the progress of the CDC/APHL biosafety and biosecurity program. Initiated in 2016 with support from the Domestic Ebola Supplement to the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement, the program aims to strengthen biosafety and biosecurity practices at public health and clinical laboratories nationwide. The Centers for Disease Control and Prevention (CDC) and APHL are collaborating as partners in this initiative.

Prior to becoming the safety officer, Drew served at the Iowa laboratory as an Emerging Infectious Disease Fellow and as the first manager of the Center for the Advancement of Laboratory Science.

Tell us about laboratory biosafety and biosecurity risk management prior to the CDC/APHL program.

Prior to the CDC/APHL program, there was great variation in biosafety and biosecurity staffing at public health laboratories. Many labs had someone who worked on biosafety part-time in addition to other roles, while a few larger labs had several biosafety specialists and added another to conduct outreach to clinical laboratories when funding became available through the CDC/APHL program.

At Iowa, we had a safety officer who had other extensive management duties. After she retired, we hired another individual to oversee safety, security and building operations. In 2015 when we received funding from the CDC/APHL program, I assumed all of the biosafety roles at the Hygienic Lab, along with outreach to clinical labs. A year later, our Safety and Security Officer retired and I took on all safety duties, including but not limited to biosafety.

How has the CDC/APHL biosafety and biosecurity program benefited you as a laboratory safety officer?

Q&A with Iowa lab’s safety officer, Drew Fayram: How the CDC/APHL biosafety and biosecurity program created a culture of safety | www.APHLblog.orgThe CDC/APHL program has benefited me professionally and personally. Historically, there was no formal entry point into the field of laboratory biosafety and biosecurity. As far as I know, no US colleges offer a major in biosafety. But now the field is becoming more standardized with common resources and language, which has made it easier to bring you up to speed on regulations and best practices. The CDC/APHL program has played a big role in this, along with other groups like the American Biological Safety Association International (ABSA).

For me, the CDC/APHL program has helped advance my skills and build professional connections through in-person training, online meetings and networking opportunities. Through the program, I have connected with staff from other public health labs, CDC, ABSA International, USAMRIID and the Eagleson Institute, as well as laboratory scientists from other countries. The connections with ABSA are particularly valuable, as people there have spent their careers helping scientists conduct laboratory science safely. Without the support of the CDC/APHL program, I would never have been able to meet so many people in such a short time and so early in my career, nor would I have received the quantity or quality of training made possible by the program.

Has the program led to improvements in biosafety and biosecurity practice at the State Hygienic Laboratory in Iowa?

The trainings offered through the CDC/APHL program have better prepared me to serve as a resource for staff to help identify tools and best practices in biosafety and biosecurity. As a matter of fact, I was a few minutes late to this interview because someone stopped me in the hall to ask a question about a biosafety issue. I believe my efforts to serve in this role encourage staff to remain more alert to biosafety and biosecurity considerations. It’s becoming part of our culture. I also work closely with our Safety Committee, which brings together staff from all areas of the lab to proactively address safety issues at our facility before they cause anyone potential harm.

How has the CDC/APHL program changed biosafety and biosecurity practices at clinical labs in Iowa?

Our lab has offered workshops on rule-out of bioterrorism agents to clinical labs in our state for many years, and we have always emphasized biosafety practices at these workshops. The CDC/APHL program has allowed us to offer additional workshops specifically focused on biosafety and biosecurity to train clinical labs on how to conduct a biosafety risk assessment to make sure that they are taking appropriate steps to mitigate risks associated with infectious agents. The assessment is theirs, not mine. I share an assessment template, but advise them to adjust it to meet their needs. The staff then conduct the assessment at their facility themselves.

For some staff, the assessment is a new experience. Many are familiar with quality risk assessment, but not biosafety risk assessment. But regardless of past experience, staff have successfully identified potential, actionable risks, such as biosafety cabinets that require replacement or procedures that should be performed inside a biosafety cabinet.

As a result of the assessments, I’ve started to see a change in attitude at clinical laboratories. Before, staff accepted risks because they recognized the importance of fast test results for ensuring the best patient outcome possible. They may have thought, “That extra step is going to slow me down, and our patients aren’t going to get their treatment as quickly.” Now through the CDC/APHL program, risk assessment is becoming a part of daily operations, and labs are finding ways to mitigate risk while still getting test results quickly.

What’s more, our relationship with these laboratories continues beyond the risk assessment. I usually get around one phone call and several emails each week from clinical laboratories asking biosafety-related questions. Many clinical labs now have staff who, as part of their regular duties, are paying additional attention to biosafety issues and engaging in conversations about best practices. I believe the consideration of biosafety issues in every day practice is an even more valuable outcome of the CDC/APHL program than putting a checkmark in a box on a risk assessment form.

If Congress does not reauthorize funding for the CDC/APHL biosafety and biosecurity program in 2018, how would this affect public health labs and their clinical laboratory partners?

If the program is not continued, we risk losing our investment in highly trained laboratory biosafety officers in public health labs. There is a tight market for this skill set. If federal funding does not continue to support these positions, many biosafety officers could be scooped up by universities and research centers, leaving the public health system without their expertise.

Q&A with Iowa lab’s safety officer, Drew Fayram: How the CDC/APHL biosafety and biosecurity program created a culture of safety | www.APHLblog.org

Likewise, clinical labs could lose training resources provided by biosafety officers, such as training on packaging and shipping infectious substances. Each clinical lab should have a minimum of two staff trained for this purpose, and frequent turnover at these labs means that new staff often must start from the beginning.

Unfortunately, we’re already experiencing some challenges. The number of packaging and shipping trainings offered by APHL contractor Dr. Pat Payne has been reduced, and we are on the waiting list to get her back. She is a true expert on this highly complex topic who keeps up on the latest IATA and DOT requirements, and other developments affecting shipping of hazardous agents. The reduction in trainings results from cuts to the cooperative agreement that supports APHL training.

In Iowa, our lab has made a commitment to continue the biosafety program regardless of federal funding. If need be, we may offer fewer workshops, develop fewer resources and contract for fewer third-party developed courses, but we will continue to serve as a resource for clinical labs in our state. However, I expect that many – if not most – public health labs may not have the capacity to make this kind of commitment.

What would you say to legislators who discounted the value of the CDC/APHL biosafety and biosecurity program?

I would say that the duty of the public health system is to protect the health of the public. This includes their constituents. The CDC/APHL biosafety/biosecurity program was initiated to address issues identified during the US response to domestic Ebola cases in 2014 and other biosafety mishaps that occurred in the United States around that same time. You’ll remember that several US health professionals contracted Ebola Virus Disease. They and their families, along with those who provided care for these patients, lived with the associated stigma. Some people were hesitant to be around them out of fear for their own safety. Some, like Nina Pham, the Vietnamese nurse who contracted Ebola from a patient, continue to battle ongoing health problems as well.

US laboratory scientists are exposed routinely to hazardous pathogens, and the risks associated with this work must not be ignored. The CDC/APHL program is crucial to ensuring the nation’s public health system responsibly and vigilantly safeguards the health of their laboratory staff and communities during future public health emergencies. We must continue to take steps to proactively mitigate risks to healthcare and public health laboratory professionals.

 

 

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Public health labs at center of 2017 mumps outbreaks: ‘This really could be a new normal for mumps’

Public health labs at center of 2017 mumps outbreaks: ‘This really could be a new normal for mumps’ | www.APHLblog.org

by Kim Krisberg

As of December 2, more than 4,900 cases of mumps had been reported to the Centers for Disease Control and Prevention in 2017. That’s less than the previous year’s case count of more than 6,000, but it’s still thousands more than any year in over a decade. Peter Shult, who works in one of the nation’s four Vaccine Preventable Disease Reference Centers, believes the last two years may be the new normal.

“This is happening in well-immunized populations,” said Shult, PhD, director of the Communicable Disease Division at the Wisconsin State Laboratory of Hygiene. “So (unlike measles outbreaks), it’s not an issue that people are unvaccinated — it’s probably more that we have a less-than-perfect vaccine. And with no new mumps vaccine coming down the pipeline anytime soon, this really could be a new normal for mumps.”

In early January, the Wisconsin Department of Health Services reported 62 confirmed mumps cases since November 2016, mostly clustered on college campuses. Many fellow Midwestern states — Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri and Kansas — reported mumps cases as well this year, some outbreaks numbering in the hundreds. In Wisconsin, 65% of those diagnosed with mumps had received two doses of vaccine, 6% had received one dose and 29% had an unknown immunization history. Wisconsin’s state public health lab conducts all the mumps testing for the state, but as a Vaccine Preventable Disease Reference Center, it also provides mumps testing for state public health labs that drew down such testing capacity as vaccine-preventable outbreaks became less common in the U.S.

Since summer 2016, according to Shult, the Wisconsin lab has received about 1,300 specimens for mumps testing — that’s a significantly higher number than in recent years, he added. Hundreds of those samples came in from other states, most notably from Alabama and Missouri, both of which experienced recent mumps outbreaks on university campuses. Of those 1,300 samples, about 220 tested positive for mumps, said Tim Davis, senior microbiologist in the Wisconsin lab.

Responding to a surge in mumps testing demands, especially during the typically busy flu season, means a “pretty substantial uptick” in the lab’s overall workload, said Shult, who also serves as the lab’s associate director. Fortunately, as one of the country’s four reference labs, the Wisconsin lab has built up the capacity to handle such surges. Lab technicians processed up to 20 mumps specimens a day, with a goal of delivering results the same day they’re received for both in-state and out-of-state samples. That speed is essential for the epidemiologists working to get ahead of a spreading outbreak and stop transmission. If a specimen comes back positive for mumps, it undergoes genotyping to determine if it’s linked to a larger outbreak.

Commercial labs in Wisconsin can do diagnostic testing for mumps, Shult said, but not as quickly and not as accurately as the state public health lab.

“It’s really the public health lab,” he said, “that’s on the front line.”

To the west in Washington state, the mumps case count from October 2016 to September 2017 was at 891 — that’s at least 700 more cases than any year since 2005. As of the end of August, the Washington State Department of Health Public Health Laboratories had received just more than 2,600 specimens for mumps testing, according to Ailyn Perez-Osorio, PhD, supervisor for molecular PFGE and virology. She said lab staff worked with epidemiologists to triage the daily flow of mumps specimens, using criteria such as date of illness onset and the risk of disease transmission to prioritize samples for testing. The lab also gathered results from commercial labs and shipped specimens for testing to the Minnesota Public Health Laboratory Division, which serves as a Vaccine Preventable Disease Reference Center.

One goal of the triage system, Perez-Osorio said, was making sure the lab’s rapid mumps testing capacity directly supported outbreak containment efforts, instead of only providing diagnostic results.

“We took a lot of consideration with our testing decisions to make sure we weren’t using up all of our resources,” Perez-Osorio said. “We had to preserve our capacity to prioritize testing for the public health response over diagnostic testing.”

The lab’s mumps screening is “highly complex,” she said, requiring RNA extraction and real-time polymerase chain reaction (RT-PCR) testing. Testing specimens in batches of about 30, it takes about five hours to get a result. Perez-Osorio said while additional staff were trained in mumps testing, the outbreak was simply too big to handle all the specimens without triaging the need and depending on outside help.

“People often stayed late, the majority were having to work extra hours — it was very taxing because of how long the outbreak went on for,” she said.

As of September, Perez-Osorio said mumps testing in the Washington lab had slowed to every other day, instead of every day, and the outbreak was tapering down. Thankfully, she said, the bulk of the outbreak didn’t happen during the summer when the same staff responsible for mumps testing is busy responding to peak rabies testing season.

On the issue of mumps spreading among vaccinated populations, Perez-Osorio said “it leaves a lot of questions.” On the flip side, she said her main concern is with pockets of anti-vaccine sentiment.

“It’s definitely hard to see people going in that direction because vaccines have brought so much safety to our communities,” she said. “It seems people have forgotten how horrible mumps and measles were back in the day.”

Emerging research is pointing to waning mumps immunity as a contributor to recent outbreaks. For example, a study published earlier this year in Frontiers in Physiology that studied mumps outbreaks in Scotland found that “waning immunity is the main factor in a repeated pattern of outbreaks.” In another study published in September in the New England Journal of Medicine, researchers studied the impact of a third dose of the measles-mumps-rubella vaccine in stemming an outbreak on an Iowa college campus. They found the third dose did improve mumps control and that waning immunity likely contributed to the outbreak’s spread. In late October, CDC’s Advisory Committee on Immunization Practices recommended a third dose of mumps vaccine as part of public health’s outbreak response.

Shult, at the Wisconsin State Laboratory of Hygiene, said just a handful of years ago, he wouldn’t have argued that all public health labs needed the complex testing capacity to deal with mumps outbreaks. As vaccine-preventable disease outbreaks became less common in the U.S., it just wasn’t practical for every state public health lab to sustain state-of-the-art testing technologies for the diseases. And, in fact, current funding levels wouldn’t even support all 50 states in building and maintaining that kind of lab capacity, which makes the country’s four Vaccine Preventable Disease Reference Centers all the more important.

Today, however, Shult said it’s “reasonable” to expect annual mumps outbreaks into the foreseeable future. And if that’s the case, he said it might be time to consider strengthening mumps testing across state public health labs.

“Moving forward, we should be asking ourselves if this is a capability that more states need or maybe we need to expand this part of the reference lab,” he said. “One could argue that states will be inundating reference labs (with mumps testing) in the future, and so we have to at least ask those questions.”

For more on recent mumps outbreaks, visit www.cdc.gov/mumps/outbreaks.html.

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Lab Culture Ep. 7: APHL’s International Team Meeting

Lab Culture Ep. 7: APHL’s International Team Meeting | www.APHLblog.org

The APHL International Team Meeting allows for US-based APHL leadership and global health program staff and consultants working in-country to discuss organizational operations and key programmatic successes and challenges. In most cases, this is the only time during the year that these individuals have an opportunity to meet face-to-face. Participants from Zambia, Zimbabwe, Kenya, Tanzania, Mozambique, Guinea, Sierra Leone and APHL’s US headquarters were all in attendance.

In November, Scott Becker, APHL’s executive director, traveled to Johannesburg, South Africa for the second APHL International Team Meeting. While he was there, he sat down with five members of the APHL international team to discuss their work and what led them to pursue a career in laboratory science.

Interviews include:

  • Levi Vere, Laboratory Quality Monitoring Manager, APHL Zimbabwe
  • Shanette Nixon, Global Health Consultant, APHL
  • Esther Vitto, Laboratory Program Support, APHL Sierra Leone
  • Mohamed Fofanah, Associate Specialist, Administration and Finance, APHL Sierra Leone
  • Rufus Nyaga, LIS Technical Consultant and Project Manager, APHL Kenya
Scott Becker and Levi Vere Scott Becker and Shanette Nixon Scott Becker, Esther Vitto and Mohamed Fofanah Scott Becker and Rufus Nyaga

Links:

APHL’s Global Health Program

Mudslides in Sierra Leone

Zimbawe After Mugabe

 

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APHL responds to “banned words,” remains focused on CDC’s budget

APHL responds to “banned words,” remains focused on CDC’s budget | www.APHLblog.org

By Scott J. Becker, executive director, APHL

Recent news concerning limits on language permissible in CDC budgetary communications has drawn considerable attention in the media. As a longstanding partner of CDC, APHL shares its commitment to science-based work to protect the public’s health and improve its health status. We are heartened by CDC Director Fitzgerald’s statement that CDC remains committed to evidence-based work described using all appropriate language, and we are confident that CDC will continue to serve all communities, including those most vulnerable and diverse.

Our primary focus is on ensuring that CDC receives funding that will enable APHL members – local, state and territorial public health laboratories – to do the vital work necessary to detect and respond to public health threats. We feel strongly that, while the words CDC uses in their budget submission are extremely important, the funding levels are at least equally deserving of our attention.

We look forward to working with the Administration and Congress to ensure the best scientific evidence is used in all public health decision making and that all public health professionals are able to use language that appropriately conveys the public health policies and programs that allow for improvement for the health of our nation.

You can also read Scott Becker’s letter to the editor of The Washington Post on this matter.

 

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Scaling-up viral load testing in Ghana is critical to stopping HIV

Scaling-up viral load testing in Ghana is critical to stopping HIV | www.APHLblog.org

By Robyn Sagal, specialist, Global Health, APHL; Samantha Dittrich, manager, Global Health Security, APHL

When HIV first struck Ghana in 1986, it didn’t adhere to global trends. There was a high prevalence of HIV in females, not males. The spread began in rural areas, not urban centers. Regions with more polygamy had lower rates of HIV, not higher. Over 30 years later, Ghana has made significant headway in slowing new infections, but there continues to be an upward trend that’s deeply concerning.

The top HIV/AIDS experts around the world see substantial evidence that antiretroviral therapy (ART) can be highly successful in suppressing the virus in infected people and decreasing the likelihood of transmission. In fact, evidence shows that when the virus is suppressed to the point of being undetectable, the infected individual has low or no risk of transmitting the virus to others. Given these facts, one key to slowing and eventually halting the transmission of HIV is close monitoring of every infected person’s viral load (testing for the amount of HIV in the blood). Regular and consistent viral load testing can determine whether ART is a success or failure. If ART is successful, viral load testing will indicate viral suppression; if not, as when treatment is inconsistent or the virus has become drug resistant, it will show either no change or an increase in viral load. Viral load testing is critical to determining next steps for individual treatment as well as determining whether the epidemic is progressing or regressing.

In keeping with global HIV response efforts, Ghana is shifting their attention to scaling-up viral load testing per the World Health Organization’s (WHO) “treat all” recommendation. That is, not only should infected and high-risk individuals receive ART, they should also have access to regular viral load testing. Additionally, the country has adopted the UNAIDS 90/90/90 global targets aimed at ensuring that 90% of the people receiving treatment are virally suppressed, with the goal of ending HIV/AIDS by 2030. Scaling-up viral load testing requires increasing laboratory capacity, an undertaking to which Ghana and APHL are committed.

In order to develop the Ghana Laboratory Viral Load Testing Extension plan, APHL has worked closely with CDC-Ghana, the Ghanaian Ministry of Health (MOH), Ghana Health Service (GHS), the National AIDS Control Programme (NACP) and many other partners and stakeholders. This plan outlines a strategy to increase and monitor laboratory capacity for viral load testing. It includes an ambitious, targeted approach that balances achieving global goals of ART treatment monitoring with the limited resources available in the country. The plan accelerates the scale-up of viral load testing by defining national testing targets and a timeframe for achieving them, improving stakeholder collaboration and pooling available resources for better distribution.

In addition, APHL has collaborated with the Centre for Remote Sensing and Geographic Information Services (CERSGIS) to map all 245 ART centers in Ghana. This huge undertaking generated geo-referenced maps for each site, including the latitude and longitude of the ART centers along with other related attributes such as differentiated models of care sites, regional viral load centers, sector viral load centers, functional viral load centers, testing staff capacity, ART equipment at the centers and much more. Visualizing these data at various administrative levels provides national decision makers with a more nuanced understanding of program coverage and priorities for scale-up. By mapping rather than graphing or charting the data, users are better able to recognize important patterns.

As the global health community works to end AIDS by 2030, laboratory testing will continue to be essential for diagnosis, treatment and prevention. APHL’s viral load scale-up activities in Ghana will help those already afflicted by HIV/AIDS to receive effective treatment and  will ultimately decrease the number of new infections in the country.

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New Lab Matters: Biomonitoring

New Lab Matters: Biomonitoring | www.APHLblog.org

In the 1970s, the National Health and Nutrition Examination Survey (NHANES) showed that gasoline lead was a major exposure for children and adults—a huge finding that would not have been known otherwise. Today NHANES provides a critical baseline for national background levels of exposure to other chemicals, but state efforts to test and document local, possibly elevated exposures to the new “alphabet soup” of PFOAs and PFOSs have been little funded and lagging. As our feature article shows, public health laboratories aim to change that through new technologies and the establishment of the new National Biomonitoring Network.

Here are just a few of this issue’s highlights:

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APHL says thank you

APHL says thank you | www.APHLblog.org

This year, APHL again joined Research!America and other public health partners to celebrate Public Health Thank You Day! Each year on the Monday before Thanksgiving, we take a moment to thank our staff, members, partners and others in the public health community for all the hard work they do to keep us safe and healthy.

A special thanks to all the unsung heroes in public health. I am especially grateful for those combating antibiotic resistance. It’s a difficult task, but we have the right people on it. Your talent and drive do not go unnoticed.

– Eric Ransom, APHL-CDC Antimicrobial Resistance Fellow

I am thankful for APHL members, associates, colleagues and partners who collaborate to promote, monitor and regulate public health.

– Tyler Wolford, senior specialist, Laboratory Response Network, Public Health Preparedness and Response

I am thankful for the school nutrition specialists who visit our school as part of the USDA Extension Program through the University of Maryland. They explain where food comes from and how to make healthy yet inexpensive choices in the foods we eat. Children stay engaged in what they learn by through simple recipes that are sent home each month. They even get my seven year old to try new snacks and vegetables as part of the “Two Bites” club.

– Shari Shea, director, Food Safety

Thank you, public health colleagues and partners, for your tireless dedication to the greater good. Whether you’re on the front lines or behind-the-scenes, the work you do is meaningful and appreciated! Many of you go above and beyond, especially when outbreaks emerge and disasters strike. Your passion, adaptability and commitment inspire me and I am grateful for the opportunity to work and learn with you.

– Robyn Sagal, specialist, Global Health

This year, I am thankful that the public health community reacted to Hurricanes Irma, Harvey and Maria quickly and collaboratively to ensure that the people affected have access to clean water, safe food and other essential resources.

– Sean Page, associate specialist, Public Health Preparedness and Response

It never gets old to say thank you to all of the unsung heroes who work in public health. These individuals ensure that our water is safe to drink; our food supply is safe and our communities are protected. From antibiotic resistance to Zika, public health scientists work tirelessly to protect communities. I salute all public health scientists and thank them for their hard work and dedication to public service.

– Chris Mangal, director, Public Health Preparedness and Response

This year, I am thankful for the collaborative nature of public health. Having just attended a multidisciplinary detection and response meeting, I really appreciate how intertwined different disciplines are from epidemiology to veterinary science, agriculture, clinical sector and laboratories. I am thankful when I see such respect being given from one sector to the other acknowledging that in order for public health to work the way it is supposed to we have to rely on each other.

– Stephanie Chester, manager, Influenza, Infectious Diseases

As we gear up for flu season, I’m thankful for all of the epidemiologists and laboratorians testing and sequencing influenza viruses. Thanks for keeping tabs on this ever-changing virus and keeping us prepared for the next pandemic.

– Elizabeth Toure, senior specialist, Global Health

I am thankful for hardworking colleagues dedicated to improving the health of all.

– Anne Gaynor, manager, HIV, Hepatitis, STD and TB Programs, Infectious Diseases

I’m thankful for all of the dedicated, passionate laboratory scientists who work in APHL’s member laboratories, tirelessly striving day in and day out to assure that our water is clean, our food is healthy, our babies grow up to be the best they can be, our families are safe from emerging infectious diseases and our world is a healthier place!

– Linette Granen, director, Membership & Marketing

I’m thankful that I can travel the world and know my vaccinations will protect me from deadly diseases!

– Madeline Rooney, specialist, Strategic Communications

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Biorisk management is fundamental to global health security

Biorisk management is fundamental to global health security | www.APHLblog.org

By Samantha Dittrich, manager, Global Health Security Agenda, APHL

Over the past 60 years, the number of new diseases per decade has increased nearly fourfold. Since 1980, the number of outbreaks per year has more than tripled. These alarming trends have serious implications for human and animal health as well as severe and lasting economic consequences in affected areas.

In order to address these human health threats, a One Health approach is needed. One Health recognizes that the health of people is connected to the health of animals and the environment, and calls for interdisciplinary collaboration and communication in healthcare and public health practice. With the Global Health Security Agenda (GHSA) in progress, the One Health approach is more important than ever before, and partners must come together to accelerate progress towards a world safe and secure from infectious disease threats.

Inside public health laboratories around the world, scientists handle dangerous pathogens while testing human, animal and environmental specimens for disease. But these pathogens aren’t just confined to laboratory vials and storage tubes: they travel. Often diseases originate in local communities where samples are collected at healthcare facilities that are not equipped to safely and securely handle them. Blood, stool and even animal carcasses may be stored at clinics or emergency operations centers for hours or even days before the samples are transported to laboratories, often on via methods that lack the security requirements for safe sample handling, storage and disposal.

  • Safe handling of pathogens in a laboratory or public health setting by scientists or clinicians is biosafety. Simply put, biosafety is keeping yourself (the public health laboratory professional) safe from laboratory mishaps.
  • Keeping dangerous pathogens secure and out of the hands of someone who may want to use them intentionally to harm others is biosecurity.

Biosafety and biosecurity are fundamental parts of the GHSA. Laboratory biorisk management means instituting a culture of rigorous assessment of the risks posed by infectious agents and toxins and deciding how to mitigate those risks. It involves a range of practices and procedures to ensure the biosecurity, biosafety and biocontainment of those infectious agents and toxins. Threats posed by deliberate release (aka, bioterrorism) and accidental release of infectious agents from a laboratory can happen anytime and anywhere. To mitigate the risks, it is critical that we are prepared to prevent, detect and respond to these threats.

Biorisk management is fundamental to global health security | www.APHLblog.org

As a partner in the GHSA, APHL collaborates with ministries of health worldwide to develop effective national laboratory systems. One of the ways we do that is by providing guidance to our global partners to reduce laboratory biosafety and biosecurity risk. All laboratories – whether they test human, animal or environmental specimens – should develop and maintain biorisk management systems tailored to their unique operations and risks. There is no one-size-fits-all biorisk management system.

Most recently, APHL drafted a Biorisk Management Framework as a tool for partners in Ghana. The Framework offers a comprehensive, systematic approach to laboratory biorisk management. It includes a list of essential elements Ghanaian laboratories can use to assess their operations and better integrate and enhance biosafety and biosecurity programs, whether it is a human, veterinary or environmental laboratory.

In the coming months, APHL will work with partners from public health laboratories, local hospitals, and the veterinary and research communities to discuss a comprehensive, standardized approach to the development of a national Biorisk Management Framework. The goal of this One Health effort is to reduce laboratory biosafety and biosecurity risk.

Preventing the next outbreak will require a One Health approach with close collaboration among the health, animal, agriculture, defense, security, development and other sectors. APHL will be there as a partner, advisor and sounding board for countries working to better manage laboratory biosafety and biosecurity risk.

 

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Lab Culture Ep. 6: What is the Biosafety Peer Network?

Ep. 6: What is the Biosafety Peer Network? | www.APHLblog.org

Lab Culture Ep. 6: What is the Biosafety Peer Network? | www.APHLblog.org

The Biosafety Peer Network (aka the Visiting Biosafety Official Program) links US local, state, and territorial public health laboratories with US-affiliated Pacific Island laboratories to facilitate mentoring and information sharing among biosafety officials and officers. The exchange is intended to foster a collaborative community, advance  biosafety and biosecurity in laboratories, and ultimately improve public health laboratory biosafety and biosecurity across the US. So what exactly does the Biosafety Peer Network do? Three members of this network — Rebecca Sciulli (Hawaii), Paul Fox (Hawaii) and Anne Marie Santos (Guam) sat down for a conversation about their work.

Photo: Paul Fox (left) and Rebecca Sciulli (center) giving Anne Marie Santos (right) a tour of the Hawaii Laboratories Division facility to showcase their biosafety practices, as part of the Peer Network program.

Links

Biosafety Peer Network Program Application

Laboratory Biosafety & Biosecurity Resources

Biosafety & Biosecurity Training

 

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