Lab Culture Ep. 12: Bitten by the public health bug — How I found my lab niche

Lab Culture Ep. 12: Bitten by the public health bug -- How I found my lab niche | www.APHLblog.org

The people who work in public health laboratories make a difference in your community daily. In this third episode, members of the Emerging Leader Program cohort 10 sit down with their peers to hear how their public health laboratory careers have made an impact.

You can listen to our show via the player embedded below or on iTunes, Stitcher or wherever you get your podcasts. Please be sure to subscribe to Lab Culture so you never miss an episode.

ELP cohort 10 members featured in this episode:

Interviewees:

  • Degina Booker has been working in the public health lab for 40 years and is now the administrative services director for the Mississippi Public Health Lab.
  • Dr. Burton Wilcke, Jr., now retired, has worked in public health laboratories for over 35 years in Vermont, Michigan and California. Dr. Wilcke remains active in the public health laboratory community as a member of both the APHL Workforce Development Committee  and the Global Health Committee.
  • Dr. Musau WaKabongo, now retired, was the Public Health Laboratory Director at the Placer County Public Health Laboratory  and has worked in several public health laboratories in California for 13 years.
  • Dr. Maria Ishida has been working in public health for 11 years and is now the director of the New York State Food Laboratory.

Are you thinking about a career in a public health laboratory?

The post Lab Culture Ep. 12: Bitten by the public health bug — How I found my lab niche appeared first on APHL Lab Blog.

September 30, 2014: As Ebola Arrived, the Texas Public Health Lab was Ready

This post was originally written for From The Lab Bench on October 2, 2014.
________

By Michelle M. Forman, senior media specialist, APHL

The world is not as large as it often seems, and there are countless reminders that diseases are willing travelers. As US health officials saw Ebola ravage populations in West Africa, it became clear that we needed to prepare just in case this devastating disease arrived here. To much of the public health community in the US, the question of Ebola arriving wasn’t a matter “if” but rather “when.” And when it arrived, a coordinated response would be critical to rapid and thorough containment.

The first step was to ensure we were able to detect Ebola in suspect cases. In August, FDA issued an emergency use authorization (EUA) for an Ebola detection test developed by scientists at the Department of Defense (DoD) United States Army Research Institute of Infectious Disease (USAMRIID). Once the EUA was issued, CDC quickly began working with certain state and local public health laboratories, all members of the Laboratory Response Network (LRN), to determine which were best equipped to perform this testing.

September 29, 2014: As Ebola Arrived, the Texas Public Health Lab was Ready | www.APHLblog.org Select laboratories were approached by CDC to receive the test kit (Initial deployment of the test was limited to 12 LRN member laboratories but CDC continues to expand the number of qualified labs.); the Laboratory Services Section of the Texas Department State Health Services (the state public health lab) was an obvious choice given its stellar record in biothreat testing. Dr. Grace Kubin, director of the state public health lab, explained that they had the necessary instrumentation, four highly skilled biothreat staff well versed in handling select agents and a biothreat laboratory located in a separate building from the rest of the laboratory to ensure proper containment of threat agents. Once the Commissioner of the Texas Department of State Health Services, Dr. David Lakey, gave his approval, the laboratory immediately began preparing.

The first step was to inform all of the staff at the state laboratory. “I wanted them to hear it from me first, not the media,” said Dr. Kubin. She reviewed the extensive safety precautions that would be taken to ensure everyone’s safety. From there, she worked closely with her team to establish step-by-step guidelines for handling of an Ebola specimen from receipt to distribution of test results. Laboratory staff would work with state epidemiologists who would serve as the initial contact for suspect cases. Staff in the shipping office would be alerted when potential Ebola specimens were expected; just as with all biothreat specimens, they were not to open the package but instead contact biothreat lab staff to come pick it up.

None of this was atypical for this laboratory, though. Its biothreat team works routinely with far more dangerous select agents such as ricin and anthrax. This is what they do and they do it safely. Everything was already in place for their routine work; the possibility of Ebola meant tightening existing systems and keeping fear at bay.

September 29, 2014: As Ebola Arrived, the Texas Public Health Lab was Ready | www.APHLblog.orgAt the end of August they determined they were ready to test for Ebola.

Just over a month later, on Sunday, September 28, Dr. Kubin started receiving emails concerning a possible Ebola case in Dallas; later that evening CDC approved the Texas state public health lab to begin testing. On Monday the specimens were shipped to the state lab and to CDC for simultaneous testing. Early Tuesday morning the specimen arrived at the lab where staff were waiting to receive it.

This was their first specimen.

Just as instructed, the shipping staff alerted the biothreat laboratory staff of the package’s arrival without opening it. Testing began right away.

By early afternoon the biothreat lab staff obtained a presumptive positive result for Ebola. CDC laboratory staff, working simultaneously and performing additional testing, confirmed that finding shortly after.

Lab staff devoted the rest of the day to distributing information to Commissioner Lakey, the hospital staff, CDC and other key parties. Though the patient was already in treatment and under isolation, staff knew other potential cases could surface as the contact investigation progressed so they were poised to receive specimens any time of the day or night. “They’re used to getting calls at three AM saying there is a specimen that needs immediate testing,” explained Dr. Kubin.

While I expected my conversation with Dr. Kubin to end with her telling me that her staff felt a sense of accomplishment or relief that they successfully performed this critical test, she didn’t. For her staff, aside from the convoy of news trucks in their parking lot, this was all in a day’s work.

The Texas state public health lab acted quickly and efficiently, just as expected. Had the specimen been sent to any of the other approved LRN laboratories, we trust they would’ve done the same. They are strong, dedicated members of the public health system in this country. Because we have such a system in place, health officials and experts remain confident that this single Ebola case will not spiral into an outbreak.

When news of Ebola in Texas disappears, you’ll know the public health system did its job.

September 29, 2014: As Ebola Arrived, the Texas Public Health Lab was Ready | www.APHLblog.org

 

From The Lorax to the Laboratory

by Vanessa Burrowes, APHL-CDC Emerging Infectious Disease Laboratory Fellow, North Carolina State Laboratory of Public Health

When I was a kid, I was pretty curious about everything around me. If I wasn’t asking a million questions to increasingly exasperated adults or devouring an adventure book series like The Boxcar Children, you could usually find me outside playing in the dirt getting scraped up and loving every minute of it. While those explorations certainly led me to science in an indirect way, it was Dr. Seuss who led me straight there.

From The Lorax to the Laboratory | www.aphlblog.org

On a dreary rainy day when I was four years old, my preschool teacher sat several of us down to watch a movie in the hopes of abating our restlessness. I sat there with my peers for my first viewing of the original version of Dr. Seuss’s The Lorax. I returned home that evening filled with a horrific fear of the future. I dreaded that, like the world of the Lorax, my world too would someday become grey, poisoned and hopeless, full of Humming Fish walking out of lakes and brown Bar-ba-loots gloomily dragging their feet away to escape such a heavily polluted place. The Once-ler’s profound advice that, “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not,” triggered a driving sense of responsibility within me at a very young age. From that day forward, I decided to dedicate my life to protecting the environment and the health of those living in it with the hope of preventing such a dreadful event from happening. Even at four years old, The Lorax definitely gave me perspective on the role I could play during my time on earth.

Many years later as I started thinking about possible careers, my parents tried to push me, their oldest child, into pursuing medical school. They were both immigrants from families with no prior science background and worked hard throughout their lives to become chemists. My mother wanted both of her daughters to pursue science careers and take advantage of the growing field of opportunities the U.S. had to offer female scientists, especially if there was the chance for us to become financially independent which seemed most tangible in medicine. I respected my mom’s feminist ideology and followed through by shadowing in the oncology unit at Aultman Hospital in Canton, Ohio for about three months during high school. Try as I might, I didn’t enjoy working under flickering fluorescent lights, racing back and forth between nurses to help aid dying patients, or viewing various body fluids being projected everywhere. Maybe I picked the wrong unit to begin exploring medical careers, but I knew from that experience that while I was still very interested in science, I ultimately wanted to find a much more controlled environment where I could do my best to help prevent people from getting to that terminal stage of disease in the first place.

As college approached, I was feeling a bit lost. While I definitely still felt a love of science, I also toyed with the idea of being a lawyer or a judge and even started looking into political science degree programs. This all stemmed from my short-lived, very “successful” role as a sharp-witted, intelligent prosecuting attorney (complete with a sweet drawn-on mustache) in a 5th grade play. I loved the thrill of the investigative work, probing through clues until arriving at some semblance of an answer. But was it a good career choice for me?

It wasn’t until later that I realized that I could have it all.

During the summer of 2007 I was selected as one of 30 students from around Ohio to attend the REAL (Regents Environmental Academy for Learning) Summer Science Program at Bowling Green State University. I gained an overview of basic concepts of biology, chemistry, pollution and toxicology, but my favorite workshop was on epidemiology, my first exposure to public health. We were given a fictional case study where 15 out of 20 kindergarten students had contracted an unknown bacterial illness after visiting a local zoo. To uncover the cause for the outbreak, we reviewed hospital files, patient records and poured through interview transcripts. By investigating all of these factors, we were able to pinpoint the strain and source of the ingested bacteria. The thrill of the detective work involved in solving this case, as well as insight into the interconnected dynamics of disease transmission, ignited my interest in pursuing public health as a career. It seemed to feed all of my interests: science, detective work and a strong desire to help improve our world.

I’m currently an APHL/CDC Emerging Infectious Diseases (EID) Laboratory fellow working at the North Carolina State Laboratory of Public Health (NCSLPH). This fellowship has given me several opportunities to communicate my findings from various projects and ideas with public health leaders and stakeholders from the North Carolina Department of Health and Human Services.

One of the coolest moments of my fellowship so far may have been when I was unexpectedly put in charge of leading a research and development (R&D) meeting with NCSLPH’s research collaborative company, bioMérieux, during a site visit to their headquarters in Durham, NC. As I was en route to their building, I learned that my boss couldn’t make it with me. After talking myself through an initial bout of nervousness, I realized that I was confident that I knew what parts of our procedures needed to be improved and was able to advise them on troubleshooting issues that had arisen during our experiments. Not only did the staff astutely listen and actively ask for my input, but they also took all of my advice into consideration. When I received the final version of the protocol, I noticed that many of my suggestions were incorporated. For the first time in my life, I felt that people were finally asking me for constructive input and respecting my contributions to a given project.

But, I have to be very honest. Without question, the ultimate moment of my EID fellowship so far was when I finally fulfilled a lifelong dream of wearing the full personal protective equipment (PPE) necessary to work in a BSL-3 suite. I donned the PAPR, Tyvek suit, booties… the works! All the movies, TV shows and news clips showing people wearing these suits make them look like the ultimate scientist superheroes (and smartest villains for the shameless Breaking Bad fan in me). Now I pretty much work full-time in this superhero scientist suit. As part of the project I mentioned before, I’m working with Brucella spp (highly pathogenic, #1 cause for laboratory acquired infections) to submit protein spectral data to bioMérieux to build their MALDI-TOF Vitek MS database for BSL3 pathogens. While the PPE does allow me to feel like a scuba diver exploring the unknown depths of the microbiological ocean, it still takes me a long time to physically get into the thing so the magic has worn off a bit. I look more like the Michelin tire mascot on most days, but I still feel like a scientific superhero inside! I hope I can make this my uniform to wear while riding into a future public health battle!

I like to think that the work I’m doing as an EID fellow has a significant impact on protecting the public (even though it doesn’t include that awesome mustache from my time as a prosecutor). I still have my whole career ahead of me and who knows what’s in store. I’m not worried about that right now; I’m too busy having the time of my life.

Biomonitoring and the Public Health Laboratory: Everything You Want to Know

Biomonitoring and the Public Health Laboratory: Everything You Want to Know | www.aphlblog.org

Simply stated, biomonitoring allows public health practitioners to understand whether environmental contaminants are being absorbed into people’s bodies. Given improvements in technology; the capabilities and expertise that now exist in public health laboratories; and the increasing public demand for more information about chemical exposures, biomonitoring is poised to become an integral component of public health practice.

APHL proudly recognizes all of the great work public health laboratories are doing to advance the practice of biomonitoring. We have made it a priority to share these biomonitoring achievements through a variety of channels.

Just in case you missed these great resources and stories, they are here:

Free Webinars

Blog posts and Lab Matters Articles

Fact Sheets

Other resources

Tell us what you think: EH@aphl.org.

 

Enterovirus D68 Testing, Surveillance and Prevention: What We’re Telling Our Friends

By Laura Iwig, MPH, Senior Specialist, Infectious Disease Program, Stephanie Chester, MS, Influenza Program and Kelly Wroblewski, MPH, MT (ASCP), Infectious Disease Program, APHL

Fall brings the start of many things every year – school, of course, but also respiratory virus season. And this year as both kick-off we’re faced with an outbreak of a virus that is new to many, enterovirus D68 (EV-D68). Terrifying headlines have loaded up our Facebook newsfeeds, so we’re here to straighten things out a bit. When our friends and family ask us about EV-D68, this is what we tell them.

Enterovirus D68 Testing, Surveillance and Prevention: What We’re Telling Our Friends | www.aphlblog.org

First of all, there are many enteroviruses and D68 is just one type. What makes EV-D68 unique is that it is causing severe illness in some people, particularly children which is always cause for concern. Keep in mind that while there are severe cases being reported, there very likely are also less severe cases of EV-D68 with typical cold-like symptoms going unreported. The number of severe cases is not necessarily the full picture. Despite there being no vaccine or specific treatment for EV-D68, it typically resolves itself without any complications.

We know this all sounds kind of scary especially when news reports are focusing on the most severe cases. But it is important to understand that the clinical and public health communities are well-equipped to deal with enterovirus outbreaks and actually respond to similar outbreaks on a routine basis. We and our partners are prepared.

Clinical, commercial and public health laboratories are conducting testing to determine if severe cases and/or outbreaks are being caused by an enterovirus or closely related rhinovirus. (Not specifically D68 – we’ll get to that below.) Many of these labs utilize rapid molecular methods to detect a wide array of respiratory pathogens, including enteroviruses.

If testing confirms that you do have an enterovirus and if you have severe symptoms, CDC is conducting additional testing to determine which type of enterovirus you may have. For the public, the value in differentiating EV-D68 from other related viruses is to provide real-time information to your doctor to help recognize symptoms associated with severe cases, identify them and get them early supportive treatment. For example, if your child has an underlying condition such as asthma and comes down with a cold that starts to become severe, his doctor might want to be more proactive in supportive care if they have learned from public health officials that EV-D68 was detected in your community. Knowing that it is EV-D68 is in the community or even a specific school can impact public health infection control measures and raise awareness for patients and parents to be more proactive about intervention if their child does get sick.

There is also significant value to the scientific and public health communities in determining if enterovirus cases and outbreaks are caused by EV-D68. Historically, this particular type of enterovirus has been rarely reported so we are still learning how easily it transmits, who is at risk for severe illness and how widespread the virus may be. In fact, some scientists are wondering if EV-D68 is truly as rare as many think or if our testing capabilities have improved allowing us to detect more cases. Science is a never ending process of information gathering. While most actions won’t be any different from other respiratory outbreaks if even if epidemiological and laboratory surveillance activities detect EV-D68, these investigations may change how we deal with outbreaks like these in the future making us more prepared.

What can you do to protect yourself and your family?

  • Wash your hands frequently with soap and water! Alcohol based hand sanitizers do not work against enteroviruses.
  • Avoid close contact with those who are sick.
  • Clean and disinfect surfaces, especially those touched by those who are ill. The virus can be easily killed on surfaces.

For now, we are reassuring our friends and family that the clinical and public health communities are prepared and are responding to this outbreak. That gives us peace of mind and hopefully it will do the same for you.

 

MERS-CoV: Why We Are Not Panicking

By Tyler Wolford, Specialist, Laboratory Response NetworkPublic Health Preparedness and Response Program; and Stephanie Chester, Senior Specialist, Influenza Program, Infectious Disease Program, APHL

MERS-CoV: Why We Are Not Panicking | www.aphlblog.orgBy now you have probably heard that CDC has confirmed two cases of Middle East Respiratory Syndrome (MERS-CoV) infection in the US. Both were imported from Saudi Arabia; travelers became sick on their journey and sought care here in the US. This is the kind of stuff that typically gets us, infectious disease and preparedness folks, amped up, reaching for coffee and telling our loved ones we might be working late. We know that MERS-CoV is a serious infection – as of mid-May 2014, there have been 536 laboratory-confirmed cases and 145 deaths of MERS-CoV. However, the laboratory community is accustomed to responding to these situations—and that’s good news for public health. We have written, tested and rewritten preparedness plans, policies and procedures for dealing with novel and/or unexpected events and pathogens. We have dealt with white powders (more times than we can count), influenza A(H3N2)v, re-emerging vaccine preventable diseases and many other threats. In addition, we were given a lengthy (roughly two-year) heads-up with MERS-CoV. And while we know not to expect this luxury every time (we’re looking at you, 2009 H1N1 pandemic), the lead time meant that CDC, public health laboratories, health departments and clinicians were alerted and prepared well before the first US two cases occurred. Efforts by CDC and the public health labs ensured that, when the first cases arrived, they could be rapidly identified so proper precautions and epidemiologic investigations could begin. What are the reasons for our relative calmness despite the arrival of MERS-CoV on our shores? We were – and still are – prepared as the case count mounted on the other side of the Atlantic. Here are the specifics:

  • Planning. MERS-CoV was first reported in 2012 in Saudi Arabia. Once transmission became sustained in the Middle East, public health officials knew it was likely that a case would arrive in the US: we just didn’t know when. We had time to plan our response.
  • An approved test. CDC rapidly developed a real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test which was granted emergency use authorization (EUA) by the FDA on June 5, 2013, and deployed the same month to 44 state public health laboratories and one local public health laboratory.
  • Infrastructure. The Laboratory Response Network (LRN) provided critical infrastructure for rapid distribution of the MERS-CoV test to public health laboratories across the US.
  • Training. Once laboratories received the test, they trained their staff and completed proficiency testing to demonstrate that they were trained and ready to perform testing should the need arise.
  • Experience. With health departments and physicians on alert, over 150 patients with MERS associated symptoms have been tested using the CDC assay. All were found to be negative.  This testing provided valuable opportunities for laboratories to familiarize themselves with the test.
  • Communication. CDC, APHL and other partner organizations have maintained timely communications with states, and others partners to keep everyone abreast of the current situation.
  • Dedication. Our public health labs are full of amazing scientists who are willing to spend countless hours, seven days a week to ensure rapid test results.

So if we aren’t panicking now that we have MERS-CoV cases in the US, what are we doing? We’re sprinting to keep pace with MERS-CoV and so far we have performed well, managing every step in the process with precision.

  • Indiana promptly notified CDC of a presumptive positive MERS-CoV infection and CDC rapidly confirmed this result.
  • CDC and Indiana started epidemiologic investigations and tested samples from close contacts of the infected patient.
  • APHL and CDC began communications immediately after the first case was confirmed.
  • APHL, in collaboration with CDC, held a laboratory alert call on May 6, 2014, to provide state and local public health labs with a situational update and to review laboratory testing guidance.
  • Currently CDC is distributing new proficiency testing panels so labs can refresh their competency on the CDC MERS-CoV test.

MERS-CoV is a serious threat that deserves the highest level of preparedness and attention.  Fortunately for the American public, we in the public health system are poised to handle MERS-CoV and other health threats whenever, wherever and however they enter our country. This is why we aren’t panicking, but it’s also why public health requires steady support.  Pathogens have no regard for budgets, funding cycles or economic trends. They won’t wait, and neither can we.

Testing for MERS-CoV: The Indiana Lab’s Story

By Lixia Liu, Deputy Director, Indiana State Department of Health Laboratories

Stephanie Dearth is a cheerful young supervisor with blond hair and black-framed eye glasses.  This was her third week as the supervisor of the virology laboratory at the Indiana State Department of Health Laboratories (ISDHL). When she arrived at work on Wednesday, April 30, she felt lighter as she had submitted her portion of a grant application the day before. She thought she might be able to catch up on her many tasks that had been put on hold. She took a sip of her coffee and walked to the laboratory.

Stephanie put her things away and went to her desk inside the laboratory. Between responding to her emails, discussing training plans for the new hire in her area and preparing for an upcoming CLIA inspection, the day went by quickly. She finally sat down at her desk after many trips to the lab bench; the voicemail light was blinking on her phone.

Testing for MERS-CoV: The Indiana Lab’s Story | www.aphlblog.org

Stephanie listened to the message. It was from Community Hospital in Munster requesting MERS-CoV testing. Recognizing the urgency of the request, she returned the call immediately and then sent an email to alert the ISDH respiratory epidemiologist about the request. Within an hour, the epidemiologist authorized the MERS-CoV test request from Community Hospital and held a teleconference with the ISDH (laboratory and epidemiology), CDC and the hospital. The specimens were scheduled to be delivered to the laboratory for testing the next morning.

When she told me the news I had goose bumps. I realized this may be the first MERS-CoV case in the United States. The weight of the situation was also felt by Dr. Omar Perez, the director of clinical microbiology. Stephanie, Omar and I stayed after the teleconference and discussed the plan for the next day.  Although the MERS-CoV assay was in place, the last MERS-CoV run was performed more than a year ago when the assay was first validated. To be cautious, the team decided to use BSL-3 practice for the entire process. We also agreed that the most experienced senior microbiologist, Jamie Yeadon-Fagbohun, would be the best choice to run the test. Jamie, who was known for her high quality work, had over five years of experience at the ISDHL. She worked on the response to the H1N1 pandemic, the discovery of novel H3N2v and many other high-profile outbreak investigations. She had worked under pressure before, but nothing like this.

The next morning I updated Dr. Judith Lovchik, ISDH assistant commissioner of public health protection and laboratory services, on the testing plan and discussed the testing approaches.  Meanwhile on the clinical microbiology floor, Stephanie, Omar and Jamie were detailing the testing plan.  The same conclusion was reached by all: time was of the essence in this situation.

Immediately after the arrival of a nasopharyngeal swab and serum sample from the patient, Jamie took the specimens to the bioterrorism suite where she gowned-up, put on the respirator and began processing the specimens. She wiped all the surfaces that the specimens might come into contact with and took every precaution to prevent potential carryover. Around noon Jamie resurfaced from the BT suite, her face reddened by the pressurization in the lab and her respirator.

By 3:00 that afternoon, the test runs were completed. Despite the increased anticipation of the nation’s first possible MERS-CoV case, Jamie was not expecting positive results.  “There is no way this would happen in Indiana. After all, Indiana is only a fly-over state,” Jamie thought to herself. After carefully reviewing the test results, Stephanie and Omar came to my office. I knew the results just by the looks on their faces. They told me that the serum sample was positive for all three genetic markers detected by the screening and confirmatory tests. As much as I was prepared for a positive result, I was still shocked to hear it. I immediately called Dr. Lovchik and broke the news to her.  She was equally shocked.

The perceived pressure earlier in the day turned into real pressure that was building with every thought of the potential impact. The lab team – Jamie, Stephanie, Omar and I – met again to review the testing details such as how the samples were arranged in the run, where the controls were situated, etc. With all possible errors ruled out, the team was confident in the results and ready to share the news with the rest of the nation.

As planned, the nasopharyngeal swab and serum sample were shipped to the CDC lab on Thursday for final confirmation of the MERS-CoV results on Friday morning.

The ISDH, Community Hospital and various CDC teams reconvened to plan the response actions based on the public health lab’s test results. The response plan would be executed as soon as CDC’s confirmatory test results were made available, which was scheduled to occur around 1:30 pm on Friday.

First thing on Friday morning the lab team met to discuss the action plan for a potential surge in testing once CDC confirmed results from the first case. Each team member was assigned a task: ordering reagents and supplies, requesting laboratory information management system (LIMS) modifications for easier sample submission, identifying microbiologists from other areas for surge capacity, and others.

Testing for MERS-CoV: The Indiana Lab’s Story | www.aphlblog.org

By noon, planning slowed, and the lab team had time to comprehend what the ISDH lab’s MERS-CoV results meant. But would the results be confirmed by CDC? The wait felt like eternity. I read every email that came across my computer screen. An email from CDC with the subject line “Confirmation” finally arrived at 1:43 pm. I felt like I was about to hear a courtroom verdict. I took a deep breath and continued to read the email: “CDC confirms Indiana MERS-CoV on 5/2/2014 at 1:30 pm.”

”WE DID IT!” I shouted with great relief. I couldn’t wait to share the news with the rest of the team. While it was not good news to hear that MERS-CoV had made its way into the US, it was extremely validating to know that our team quickly and successfully accomplished the task at hand. I was very proud of my colleagues.

After the detection of the first MERS-CoV case on May 1, the ISDH laboratory brought in two additional microbiologists, Stephanie Dalenberg and Brian Pope, to help with testing. During two consecutive 13-hour days, ISDH lab microbiologists, supervisors and directors tested a total of 124 specimens from all of the patient’s direct contacts, including health care workers and household contacts. All contacts continue to be observed, and there have been no additional cases to date.

The ISDH laboratory staff’s quick response, safe testing and accurate results were critical to detecting and containing MERS-CoV. Once again, our national laboratory first responders had quietly and effectively done their job to protect the public’s health.

Top Photo: Jamie Yeadon-Fagbohun in the BSL-3 laboratory

Bottom Photo (from left to right): Dr. Lixia Liu, Dr. Omar Perez, Stephanie Dalenberg, Stephanie Dearth, Jamie Yeadon-Fagbohun, Brian Pope, and Dr. Judith Lovchik 

Photo credit: Indiana State Department of Health Laboratories staff