The LRN’s job is to prepare, detect and respond. But what exactly does that mean?

The LRN’s job is to prepare, detect and respond. But what exactly does that mean? | www.APHLblog.org

As one of the nation’s emergency response systems, the Laboratory Response Network (LRN) is known for detecting and responding to all types of health threats. Its mission is to maintain an integrated network of laboratories that can respond to bioterrorism, emerging infectious diseases, chemical terrorism and other public health emergencies. During an emergency, one of the LRN’s most critical functions is ensuring that US laboratories have the right test at the right time.

When a public health threat emerges, one of the first tasks of public health systems is to make sure that laboratories are able to test for the causative agent, whether biological, chemical or radiological. However, the Centers for Disease Control and Prevention (CDC) quickly works with these laboratories and other partners to get the tests in place using equipment found in LRN reference laboratories. For instance in 2014, CDC partnered with the Department of Defense (DoD) and the LRN deployed a test for Ebola. The network  rolled out training and other programs to ensure quality testing and reporting. This approach ensured laboratories such as the Texas Department of State Health Services Laboratory was ready to test for Ebola before it struck. Similarly, CDC quickly worked with the Food and Drug Administration (FDA) to secure an Emergency Use Authorization (EUA) assay for Zika and again deployed the test via the LRN to laboratories across the country. Where training was needed, CDC partnered with APHL to deliver these skills to public health laboratory scientists. Whatever the testing needs may be, the LRN jumps into action to ensure testing capabilities are in place for an effective response.

So what exactly does the LRN do to support and expedite development and deployment of such tests? The LRN:

  • Collaborates with the specialized laboratory developing the test. This may be a laboratory at a government agency, such as CDC or DoD, or a private entity.
  • Optimizes the test to ensure it provides reliable results, operates on instrumentation available nationwide and integrates with systems for reporting of test results.
  • Prepares and submits a request to the FDA for use of the test on an emergency basis. This Emergency Use Authorization (EUA) details test detection limitations, reagents, instruments, authorized users and other technical information.
  • Issues proficiency tests to assure laboratory scientists across the network are capable of properly performing the tests and generating accurate results.
  • Quickly deploys the test to LRN laboratories with the capability to test for the agent.
  • Provides a mechanism for standardized electronic data exchange of test results.
  • Facilitates communications across partners such as APHL, DoD, FBI and other stakeholder.

Here are examples of public health emergences where the LRN made sure the proper test was at the proper laboratory just in time to initiate the response:

As a founding partner, APHL recognizes the value of the LRN and celebrates its accomplishments across the last 20 years. The LRN, via funding from CDC’s Public Health Emergency Preparedness Cooperative Agreement, provides a warm base for public health laboratories, positioning them to respond to all threats including the 2009 pandemic influenza and the recent opioid epidemic. Though many Americans have never heard of the LRN, the Network is nonetheless there, keeping us safe from threats known and unknown.

For more information about the Laboratory Response Network, visit CDC’s “The Laboratory Response Network Partners in Preparedness” webpage.

The post The LRN’s job is to prepare, detect and respond. But what exactly does that mean? appeared first on APHL Lab Blog.

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.

 

 

The post Q&A with Iowa lab’s safety officer, Drew Fayram: How the CDC/APHL biosafety and biosecurity program created a culture of safety appeared first on APHL Lab Blog.

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

 

If you’re enjoying Lab Culture, please rate and review on iTunes and/or Stitcher!

The post Lab Culture Ep. 6: What is the Biosafety Peer Network? appeared first on APHL Lab Blog.

Hurricane preparation and response resource list

Hurricane preparation and response resource list | www.APHLblog.org

Updated September 15, 2017

In the wake of hurricanes Harvey and Irma, public health laboratories in affected regions will be busy testing for potential environmental contamination, monitoring for increased water- and mosquito-borne diseases, or repairing damage to their own facilities. APHL has activated its Incident Command System (ICS) to support member laboratories with their response. The ICS team is participating in CDC’s Emergency Operations Center (EOC) State/Local and Partner Conference Calls, and will assist member labs with their response, facilitate communications between CDC and member labs, and share lab needs/stories with policy makers and the public.

Below are helpful resources for those communities hit by the recent storms. Many of these resources are useful for any severe weather event, not just Hurricanes Harvey and Irma.

Preparing for and weathering the storm

Hurricanes, Preparation and Response, EPA
Hurricane Preparedness Checklist, FDA
Preparing for a Hurricane or Tropical Storm, CDC
Flooding Toolkit, National Public Health Information Coalition
Disaster Assistance.gov, US government platform for locating disaster-related resources
Federal Emergency Management Agency (FEMA) Toll-free FEMA hotline for survivors of Hurricane Harvey: 1-800-621-FEMA

Keeping your family and community healthy after the storm

Food Safety:
Food Safety Tips for Areas Affected by Hurricane Irma, USDA press release
Protect Food and Water Before, During and After a Storm, FDA

Infectious Diseases:
Emerging and Zoonotic Infectious Diseases, CDC
Vector-borne Diseases, CDC​​​​​​​
Waterborne Disease Prevention, CDC

Drinking Water:
Drinking Water Safety and Testing Information for Texas, Texas Commission on Environmental Quality (accredited labs for microbial testing of drinking water, advice for customers of public water systems, disinfecting your well, etc.)
Drinking Water Testing and Information for Houston, TX, City of Houston
Private Wells: What to Do after the Flood, EPA
Private Wells: Water-related Diseases and Contaminants, CDC
Health Department Laboratory, Drinking Water Testing and Information, City of Houston

Other:
Carbon Monoxide Poisoning – Clinical Guidance, CDC
Mold: Cleanup and Remediation, CDC
Mold: Flood Cleanup, EPA
Waste Management, EPA

Rebuilding and repair

Cleanup after a Hurricane, CDC
Status of Systems in Areas Affected by Harvey, Texas Commission on Environmental Quality – drinking water, waste water and sewage, residential wells, flood waters, water infrastructure

The post Hurricane preparation and response resource list appeared first on APHL Lab Blog.

7 times public health preparedness proved critical

7 times public health preparedness proved critical | www.APHLblog.org

Our nation’s public health system responds to emergencies such as natural disasters, infectious disease outbreaks, bioterrorism attacks and more both domestically and globally. There’s no way to know what the next threat will be or when it will strike. To quickly and effectively respond to these threats, the public health system – including public health laboratories – must be prepared.

Here are seven stories that highlight the value of public health preparedness and response:

  1. Massive Molasses Mess and the Laboratory Response
  2. Testing for MERS-CoV: The Indiana Lab’s Story
  3. System Built for Responding to Bioterrorism Confirms Plague in Colorado Girl
  4. September 30, 2014: As Ebola Arrived, the Texas Public Health Lab was Ready
  5. Anthrax in Minnesota? The Laboratory Response Network Springs Into Action
  6. Responding to the Animas River disaster: Who’s testing what?
  7. Not Even Superstorm Sandy Could Stop Newborn Screening in New Jersey

CDC Emergency Operations Center: Always on Alert

CDC Emergency Operations Center: Always on Alert | www.APHLblog.org

By Tyler Wolford, senior specialist, Laboratory Response Network, APHL

Positioned among administrative offices, high containment laboratories and extensive corridors at the US Centers for Disease Control and Prevention (CDC) headquarters is the state of the art Marcus Emergency Operations Center (EOC), a dedicated central location for CDC staff and other public health partners to coordinate responses to public health threats domestically and internationally. This multi-million dollar facility is a significant step forward from when emergency response planning would occur in whatever conference room, office or hallway was available at the time, such as during the 2001 anthrax attacks.

(Bernard Marcus, founder of Home Depot, contributed $2 million through the Marcus Foundation to build the EOC and called upon other corporations to provide their support. In response to his appeal, 15 other companies donated or provided discounted equipment through the CDC Foundation.)

CDC Emergency Operations Center: Always on Alert | www.APHLblog.orgThe EOC is a 7,000 square foot communications hub that is always on alert. Operating 24/7 year-round, the EOC houses more than 30 telephone operator stations to triage information (they receive over 27,000 phone calls per year), a cutting edge multi-display wall of television screens broadcasting response information in real-time, advanced technology systems to stay ahead of threats and several designated conference areas. Even when there is no specific public health threat, the EOC has dedicated staff monitoring information. These same individuals may be called in to support a response should one arise.

How it Works

The EOC is operated by the Office of Public Health Preparedness and Response (OPHPR) Division of Emergency Operations (DEO). Within the DEO, there are seven branches—operations, planning, logistics, situational awareness, administration/emergency staffing, emergency risk communication and capacity development—which must work together like a well-orchestrated symphony. When the DEO first receives information about a potentially widespread threat (e.g., an increase in the incidence of a virus) via public health partner briefings or field operations intelligence, a team of subject matter experts within the DEO and from across CDC gather to determine whether EOC activation is needed. The team’s assessment is reported to the OPHPR director who then consults with the CDC director to provide recommendations for action. If there is a request to activate the EOC, they will determine which level is necessary for the particular response based on staffing needs and necessary resources:

  • Level 1 is the highest level of response requiring the largest number of staff to work 24/7. This level of action is needed for large scale, national and international threats. To date, there have been four Level 1 responses: Hurricane Katrina in 2005, the 2009 H1N1 influenza outbreak, the 2014 Ebola outbreak and the 2016 Zika
  • Level 2 requires CDC subject matter experts to lead the response with a large number of supporting staff from the relevant program area. A large number of EOC staff may also assist with the response.
  • Level 3 requires CDC subject matter experts to lead the response with some of their own staff. EOC staff may also assist with the response.

APHL’s Public Health Preparedness and Response team recently toured the Marcus EOC and had an opportunity to meet with the DEO director, Jeff Bryant. During the 2014 Ebola outbreak, Bryant was deployed for three months to work on Ebola-related activities in Germany and Liberia. He then returned to the US and assumed the role of DEO director. At that time, approximately 200 highly dedicated staff worked hard for more than 600 days to ensure the EOC’s success in supporting CDC’s response to the unprecedented Ebola outbreak in West Africa.

CDC Emergency Operations Center: Always on Alert | www.APHLblog.org(Pictured: Jeff Bryant (CDC), Amy Pullman (APHL), Tyler Wolford (APHL), Chris Mangal (APHL))

“It didn’t feel brand new to me,” said Bryant of his new role. “I immediately realized that the DEO had response and partner needs that had to be met very quickly. My biggest challenge was carving out time to familiarize myself with the DEO while also ensuring that response needs were met.” When asked what ingredients are behind DEO’s success, Bryant responded, “Innovation, creativity, long hours and the ability to surge quickly.” Bryant credits the DEO’s success to its staff, team leads and branch chiefs.

EOC in Action

Since its inception in 2003, CDC’s EOC staff have responded to more than 50 public health emergencies, providing assistance in all phases of response including planning, action and evaluation. In addition to emergencies, the EOC may also be activated for scheduled events such as presidential inaugurations. Due to its success in these capacities, the CDC received accreditation from the Emergency Management Accreditation Program (EMAP) and is the first federal entity to attain full accreditation.

Public Health Responses Supported by CDC’s Emergency Operations Center (EOC)

The Future of Threat Detection

CDC’s new Red Sky program could be the future of public health threat awareness. Named after the old sailor’s adage, “Red sky at night, sailor’s delight. Red sky in the morning, sailors take warning,” Red Sky is a digital dashboard that displays public health outbreaks on a global map. Users can interact with each outbreak or cluster to access outbreak reports, data tables and other information. Red Sky depends on outbreak data entered by public health laboratories, health departments and other public health officials around the world. As the program progresses, the data obtained could be used to map outbreaks in real-time, dramatically decreasing the time it takes to respond.

Public health emergency response has benefited considerably from the addition of the CDC Marcus EOC. The EOC provides the resources and environment for CDC subject matter experts and other public health partners to effectively and efficiently respond to a variety of public health emergencies. For more information, please visit the CDC EOC website.

 

Zika: Old virus, new challenges

Zika: Old virus, new challenges | www.APHLblog.org

Even though Zika is not a new virus, this recent outbreak has brought forth many new challenges and questions. Our partners and colleagues within the public health community are working hard to better understand this outbreak and its effects while also trying to control its spread. As in any outbreak, public health laboratories play a vital role in disease detection and surveillance.

Last updated February 25, 2016

Twelve public health laboratories are testing for Zika – this number will be growing over the next few weeks as the Centers for Disease Control and Prevention (CDC) rolls out the testing protocol to more laboratories. Additionally, CDC is working with the Food and Drug Administration (FDA) to develop the emergency use authorization (EUA) that would enable distribution of test kits. This will allow public health laboratories to more quickly implement testing.

Zika fact sheets, guidance and other general information:

Best way to prevent Zika? Prevent mosquito bites. Here’s how:

What we’re reading about Zika:

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

 

Building Connections and Recognizing Excellence at the 2015 LRN National Meeting

By Kara MacKeil-Pepin, associate specialist, Public Health Preparedness and Response, APHL

At the 2015 Laboratory Response Network (LRN) National Meeting in Atlanta, members gathered to learn from each other, solve problems, and finally put a face to the disembodied voices they’ve heard over hours of conference calls.

The LRN is a system of state and local public health laboratories, sentinel clinical laboratories, federal facilities such as the Centers for Disease Control and Prevention (CDC), international laboratories, and partners from the intelligence, military and first responder communities. Members train together, share common procedures and standards, and maintain a strong communication network to promote rapid detection and response. Thanks to strong relationships across these varied groups, the LRN is able to respond quickly and comprehensively to a wide variety of deliberate and naturally occurring threats, from the 2013 ricin letters to singular cases of endemic anthrax in Minnesota. The LRN National Meeting is an essential part of building these strong relationships. While members are in frequent contact with each other throughout the year, allowing face-to-face contact and collaboration with members from across the network offers a level of relationship building that can’t be achieved with an e-mail.

Sessions often reflect lessons learned from recent biological and chemical threats. This year was no exception, with several big-picture discussions of the 2014 Ebola Virus outbreak and a presentation on chemical weapons security from Dr. Hugh Gregg, head of the Organisation for the Prohibition of Chemical Weapons Laboratory. Practical sessions included topics like data security, training strategies, need for standards for field screening devices, and radiological preparedness. Attendees were also treated to video addresses by Dr. David Nabarro, special representative to the United Nations Secretary-General, and Dr. Tom Frieden, director of the CDC.

Awards

The National Meeting also gives members a chance to honor a few select agencies and individuals who have gone above and beyond the already demanding work of the LRN. Ebola response featured heavily among the winners: the Dallas County Health and Human Services Laboratory and the Texas Department of State Health Services Laboratory Services Section each received awards for Excellence in Public Health Response for the 2014 Ebola Outbreak, and the US Army Medical Research Institute of Infectious Diseases (USAMRIID) was honored with the Excellence in Partnership award for their work in developing assays to respond to and rule out Ebola in the US.

Partnership continued to be emphasized with the other awards presented. The Indiana State Department of Health State Health Laboratories was recognized with the Outstanding Sentinel Training Program award for their exemplary outreach to sentinel clinical laboratories which paid off when the lab identified the first US case of Middle East Respiratory System Coronavirus (MERS-CoV). The West Virginia Department of Health and Human Resources Office of Laboratory Services was also honored for their partnership efforts in the wake of the Elk River chemical spill in 2014, winning the award for Outstanding Outreach to Poison Control Centers or Hospitals. Finally, the Minnesota Department of Health Public Health Laboratory received the Innovative Collaborations with First Responder Communities award for their well-known and wide reaching program of training, exercises, and networking with first responder agencies throughout the state of Minnesota.

In the individual awards, Maureen Sullivan of the Minnesota Department of Health was recognized with the Excellence in Leadership honor for her long-standingefforts to shape public health emergency preparedness programs and policy in her home state and at the national level, and her irreplaceable contributions to first responder and clinical outreach programs in Minnesota.

The second and final individual honor, the award for Excellence in Public Service, was presented to Dr. Mary Ritchie, bioterrorism laboratory program advisor for the Florida Bureau of Public Health Laboratories. Dr. Ritchie has almost singlehandedly established and maintained an interagency laboratory workgroup for Florida, bringing together laboratories across Florida to communicate and share critical information.

The awards have a lighter side too, with winners selected at each meeting for the LRN Video and Photo Contest. Contestants submit their own original photos and videos, trying to capture what it means to be an LRN member on film.

2015 LRN Best Photo Award winner was the State Hygienic Laboratory at the University of Iowa | www.APHLblog.org

This year’s Best Photo Award winner was the State Hygienic Laboratory at the University of Iowa for their photo of laboratorians hard at work at their Annual Sentinel Laboratory Training Wet Workshop in 2015.

Finally, attendees were treated to a world-premiere showing of the Best Video Award winner, a pro wrestling-esque, Lego-inspired depiction of the Texas response to the 2014 Ebola outbreak submitted by the San Antonio Metro Health District Laboratory.

LRN Smack Down: Mr. Inactivator vs Ebola Virus (LRN *Best Video Award* winner) from APHL on Vimeo.

APHL congratulates all of this year’s winners!

PHPR_2015Sep_LRN-meeting-blog-post-group-photo

 

TIME’s 2014 Person of the Year: Recognizing the Ebola Fighting Laboratorians

By Chris N. Mangal, MPH, director, Public Health Preparedness and Response, APHL

TIME's 2014 Person of the Year: Recognizing the Ebola Fighting Laboratorians  | www.aphlblog.orgThis year saw the deadliest outbreak of Ebola in West Africa, specifically in Sierra Leone, Liberia and Guinea. The West African people, their governments and numerous international organizations have been on the frontline fighting to contain this outbreak and stop the transmission chain. We agree with TIME magazine’s choice to name The Ebola Fighters as their Person of the Year. The many doctors, nurses, ambulance drivers, researchers, volunteers, survivors and so many others who continue to work tirelessly to heal the sick, protect the healthy and contain this outbreak deserve the world’s applause. Of course, we at APHL especially want to recognize the laboratorians who are a vital part of these Ebola response teams at home and abroad. They work diligently to process thousands of samples and quickly determine whether or not an individual is infected with the deadly virus, utilizing safe laboratory practices to do so.

While domestically the public health laboratories authorized to perform the Ebola detection test have continued to state this is all in a day’s work for them, the significance of this test does not go unnoticed. As samples from suspect cases are rushed to public health laboratories, ample precautions have been taken to protect and reassure those outside of the laboratory of their continued safety. Tests are performed quickly and carefully to ensure the fastest possible turn-around and accurate results. Those results help doctors and other medical professionals determine the next steps in patient care; help researchers to develop targeted countermeasures such as vaccines and antiviral medications; and if positive, allow epidemiologists to begin contact tracing to contain the spread or, if negative, offer assurance to the public that the suspect case is negative. Thanks to swift testing in West Africa and in the US, we have seen many patients recover after early and appropriate treatment – in fact, many health professionals are now referring to Ebola Virus Disease as treatable.

Public health laboratorians join the long list of Ebola fighters worthy of being called Person of the Year. They have not turned away from their responsibility of protecting the population. The Ebola fighters will likely not rest over the holidays – they will continue to battle Ebola and protect the public’s health. For that, we are grateful.

Read more: