New Lab Matters now available: Unsustainable

According to data published by the advocacy group Trust for America’s Health, there is a $4.5 billion gap between current funding levels and what is needed to achieve “an adequate level of public health protection” nationwide. Even though budget news for FY2020 is better than it has been, it continues a worrying, long-term trend of public health underfunding and public health laboratories being forced to draw on short-term crisis funding to maintain day-to-day activities. In this issue’s feature article, we examine the challenges that public health laboratories face, especially during the COVID-19 response.

Here are a few of this issue’s highlights:

Read the full issue.

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APHL EVALI response spurred by strong communication

Person vaping

Whether it be a disease outbreak, a natural disaster or a devastating lung condition, regular, responsive communication drives response to public health emergencies. In the summer of 2019, with cases of E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) steadily rising, partners at federal, state and local health agencies, health associations, hospitals, poison control centers and other players were in constant contact.

APHL Director of Environmental Health Julianne Nassif recalls, “At the height of the EVALI response, I spent most of my day on conference calls with [the US Centers for Disease Control and Prevention (CDC), US Food and Drug Association, Council of State and Territorial Epidemiologists] and member labs. It was many long hours fortified by a lot of caffeine, but these calls kept us up-to-date and on-task in a rapidly evolving situation.”

EVALI Community Links Members, Partners

APHL facilitated the exchange of time-sensitive information by creating an EVALI community of practice, linking member laboratories, federal agencies and others working on the issue. Building upon relationships developed through various laboratory networks, the group held conference calls to brainstorm ideas and discuss surveillance reports, testing methodology and legal considerations. Experts in testing for e-liquids in vaporized products joined the calls to explain methods unfamiliar to many public health laboratories. The community also served as a nexus for rapid distribution of sampling guidance and analytical methods to scientists working on analysis of EVALI case-related specimens and products. For example, CDC deployed standards for collection of bronchial lavage specimens through the EVALI community. The community continues to hold routine conference calls to exchange notes on recent findings.

APHL also polled member laboratories to solicit their advice on resources and services needed for EVALI response. They returned six recommendations:

  1. Elevation of the EVALI response to an agency-wide level
  2. Addition of experts in environmental and occupational medicine and in epidemiology
  3. Guidance for specimen collection and storage
  4. A template for submitting data to CDC
  5. Extending the time allotted for collection of samples
  6. Building non-targeted testing capability for 1000s of chemicals and providing technical support to assist states with chemical analysis

When APHL forwarded these recommendations to CDC’s Emergency Operations Center, the response was prompt: CDC would provide almost all that APHL had requested.

Existing Relationships Facilitate Response

So why did APHL laboratories and partners communicate so well during the peak of the EVALI outbreak? In short, because they knew each other. By participating in the Laboratory Response Network for Chemical Threats (LRN-C), the National Biomonitoring Network, Opioid Biosurveillance and the APHL Community of Practice for Cannabis Testing, they knew each other personally and trusted one another. Through these same networks, they had also built relationships with hospital staff, poison control specialists, epidemiologists and forensics scientists. In an emergency, these connections proved invaluable.

Learn More

A plenary session about how strong communications enhanced the laboratory response to the EVALI outbreak had been planned for the APHL 2020 Annual Conference, which unfortunately has been canceled due to the COVID-19 pandemic. There are plans underway to turn the session into a webinar, so keep an eye out on the APHL Webinars page for more information.

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Lab Culture Ep. 21: 2019 Year in Review

Collage of photos depicting APHL's 2019 year in review

Are we already at the end of 2019?! While to many of us it felt like the year flew by, APHL staff, members and partners accomplished a LOT in an effort to protect the public’s health. In this episode, Scott Becker, APHL’s executive director, reviews some of the highlights of the year along with Gynene Sullivan, APHL’s manager of communications, who is finalizing our Annual Report.

Follow APHL on TwitterFacebook and Instagram so you don’t miss anything!

Links:

APHL: Lung Injury Response Associated with Vaping

CDC: Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products

APHL work on opioids

Data: Elemental to Health advocacy campaign

Supporting rapid exchange of public health data is urgent, crucial and laden with challenges

APHL AIMS Platform

Lab Matters (Fall 2019): Making Data Fly

NewSTEPs Data Repository

APHL Newborn Screening Systems Quality Improvement Projects Award Recipients Announced

APHL Public Health Laboratory Fellowships

APHL Emerging Leader Program

Lab Culture Ep. 9: What is the APHL Emerging Leader Program?

CDC: US Measles Cases and Outbreaks in 2019

“Launching Whole Genome Sequencing in the Public Health Realm” Lab Matters (Fall 2013)

Accreditation for Human and Animal Food Labs

APHL Conferences

Lab Culture Extra: Progress in Sierra Leone

APHL Global Health Program: Countries we serve

Global Laboratory Leadership Programme (GLLP)

Laboratory Response Network (LRN)

Lab Culture Ep. 20: 20 Years of the Laboratory Response Network

“Two Decades of Preparedness Excellence: The Laboratory Response Network” Lab Matters (Fall 2019)

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

Strengthening Lab Biosafety & Biosecurity

“Ensuring Readiness for Rabies in Puerto Rico” Lab Matters (Spring 2019)

“Public Health System Recovery in Full Swing: Hurricane Response in Puerto Rico and the US Virgin Islands” Lab Matters (Spring 2019)

In Puerto Rico, a new molecular bacteriology lab allows better control of foodborne outbreaks

APHL Publications

“US officials identify ‘strong culprit’ in vaping illnesses” Associated Press (video interview)

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CDC findings mark a breakthrough in investigation of lung injury associated with vaping

Man vaping

Statement from Scott J. Becker, executive director, Association of Public Health Laboratories

Silver Spring, MD, November 8, 2019 — “Test results announced today by the Centers for Disease Control and Prevention mark a breakthrough in the ongoing investigation of lung injury associated with e-cigarette use or vaping.

“Laboratory scientists testing samples of lung fluid from 29 patients found vitamin E acetate present in all samples. These results provide direct evidence of this toxin at the primary site of injury within the lungs. They also complement tests conducted by the Food and Drug Administration and state public health laboratories that identified vitamin E acetate in e-cigarette or vaping products.

“While this is a big step in helping us understand what may be causing these injuries, these findings do not rule out the potential for other compounds or ingredients as contributing factors. There may be more than one cause of the outbreak.

“APHL applauds state public health laboratories, CDC, FDA and partners including the Council of State and Territorial Epidemiologists for their extraordinary collaboration and tireless and innovative work.

“This has been a complex investigation, and the work continues. But good science takes time, and public health laboratory work is critical to helping solve this important health challenge and stopping the outbreak.”

# # #

More APHL’s support of the EVALI response

The post CDC findings mark a breakthrough in investigation of lung injury associated with vaping appeared first on APHL Lab Blog.

CDC findings mark a breakthrough in investigation of lung injury associated with vaping

Man vaping

Statement from Scott J. Becker, executive director, Association of Public Health Laboratories

Silver Spring, MD, November 8, 2019 — “Test results announced today by the Centers for Disease Control and Prevention mark a breakthrough in the ongoing investigation of lung injury associated with e-cigarette use or vaping.

“Laboratory scientists testing samples of lung fluid from 29 patients found vitamin E acetate present in all samples. These results provide direct evidence of this toxin at the primary site of injury within the lungs. They also complement tests conducted by the Food and Drug Administration and state public health laboratories that identified vitamin E acetate in e-cigarette or vaping products.

“While this is a big step in helping us understand what may be causing these injuries, these findings do not rule out the potential for other compounds or ingredients as contributing factors. There may be more than one cause of the outbreak.

“APHL applauds state public health laboratories, CDC, FDA and partners including the Council of State and Territorial Epidemiologists for their extraordinary collaboration and tireless and innovative work.

“This has been a complex investigation, and the work continues. But good science takes time, and public health laboratory work is critical to helping solve this important health challenge and stopping the outbreak.”

# # #

More APHL’s support of the EVALI response

The post CDC findings mark a breakthrough in investigation of lung injury associated with vaping appeared first on APHL Lab Blog.

Lab Culture Ep. 20: 20 Years of the Laboratory Response Network

Stefan Saravia and Maureen Sullivan at the Minnesota Public Health Laboratory

This year marks 20 years since the inception of the Laboratory Response Network (LRN). Founded by APHL, CDC and the FBI, the LRN exists to protect the public from biological and chemical threats. How did the LRN get its start? And how has it evolved over the past 20 years? This episode of Lab Culture features an interview with two public health laboratory scientists and LRN experts.

Listen here or wherever you get your podcasts:

Maureen “Moe” Sullivan
Emergency Preparedness and Response Laboratory Supervisor
Public Health Laboratory, Minnesota Department of Health

Stefan Saravia
Biomonitoring and Emerging Contaminants Unit Supervisor
Public Health Laboratory, Minnesota Department of Health

Links:

Minnesota Laboratory Emergency Preparedness
About the Laboratory Response Network (APHL.org)
The Laboratory Response Network Partners in Preparedness (CDC.gov)
What is biomonitoring? (Video)
“Pine County man charged with government center threats, more” (StarTribune)

 

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Lab Culture Ep. 19: Dr. Mona Hanna-Attisha- Storytelling and the Flint Water Crisis

Michelle Forman interviewing Dr. Mona Hanna-Attisha.

Dr. Mona Hanna-Attisha, author of What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City, joins us for an interview about the importance of storytelling in public health. Did Dr. Mona’s successful use of narratives allow Flint’s story to be as resilient as the people who lived it?

Listen here or wherever you get your podcasts.

Links

Is water in Flint safe to drink? It’s not just a question of chemistry. [Op-ed by Dr. Mona Hanna-Attisha]

What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City

The post Lab Culture Ep. 19: Dr. Mona Hanna-Attisha- Storytelling and the Flint Water Crisis appeared first on APHL Lab Blog.

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters | www.APHLblog.org

In the spring of 2018 patients suffering from profuse bleeding swamped emergency rooms in Illinois and Wisconsin. The cause? Synthetic cannabinoids laced with rat poison

When an outbreak of contaminated synthetic cannabinoids reached Wisconsin in 2018, scientists at the Wisconsin State Laboratory of Hygiene (WSLH) rushed to develop the first quantitative method for diagnostic testing of brodifacoum, a powerful anticoagulant used in rat poison. Thanks to their work, patients with brodifacoum poisoning can now be treated with a precisely calibrated dose of vitamin K and that treatment can be ended when it is no longer medically necessary. Previously, physicians had to guess when to end treatment and re-start it if they guessed wrong.

WSLH’s Noel Stanton, Chemical Emergency Response Coordinator, and Bill Krick, an Advanced Chemist in the Chemical Emergency Response Unit, speak with Public Affairs Director Jan Klawitter about the test’s development and the outbreak that made it necessary.

 

 

Links:

Wisconsin State Laboratory of Hygiene (WSLH)

Accolades for WSLH’s Chemical Emergency Response Team

Synthetic Cannabinoids (K2, Spice) – Wisconsin Department of Health Services

Lab Matters: Indiana and Wisconsin Respond to Synthetic Cannabinoid Contamination

Laboratory Response Network (LRN)

APHL in Action archives

The post Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters appeared first on APHL Lab Blog.

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters

Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters | www.APHLblog.org

In the spring of 2018 patients suffering from profuse bleeding swamped emergency rooms in Illinois and Wisconsin. The cause? Synthetic cannabinoids laced with rat poison

When an outbreak of contaminated synthetic cannabinoids reached Wisconsin in 2018, scientists at the Wisconsin State Laboratory of Hygiene (WSLH) rushed to develop the first quantitative method for diagnostic testing of brodifacoum, a powerful anticoagulant used in rat poison. Thanks to their work, patients with brodifacoum poisoning can now be treated with a precisely calibrated dose of vitamin K and that treatment can be ended when it is no longer medically necessary. Previously, physicians had to guess when to end treatment and re-start it if they guessed wrong.

WSLH’s Noel Stanton, Chemical Emergency Response Coordinator, and Bill Krick, an Advanced Chemist in the Chemical Emergency Response Unit, speak with Public Affairs Director Jan Klawitter about the test’s development and the outbreak that made it necessary.

 

 

Links:

Wisconsin State Laboratory of Hygiene (WSLH)

Accolades for WSLH’s Chemical Emergency Response Team

Synthetic Cannabinoids (K2, Spice) – Wisconsin Department of Health Services

Lab Matters: Indiana and Wisconsin Respond to Synthetic Cannabinoid Contamination

Laboratory Response Network (LRN)

APHL in Action archives

The post Lab Culture Extra: How the Wisconsin state lab developed a test for brodifacoum and why it matters appeared first on APHL Lab Blog.

3 Reasons Why Handwashing Should Matter to You

Unseen woman washing her hands with soap in a sink.

Most of us are familiar with the parental-like voice in the back of our minds that helps guide our decision-making—asking us questions like, “Have you called your grandmother lately?” For many that voice serves as a gentle, yet constant reminder to wash our hands.

Handwashing with soap and water is one of the most important steps you can take to avoid getting sick and spreading germs to loved ones. Many diseases are spread by not cleaning your hands properly after touching contaminated objects or surfaces. And although not all germs are bad, illness can occur when harmful germs enter our bodies through the eyes, nose, and mouth. That’s why it is critical to wash hands at key times, such as after a flood or during a flu pandemic, when germs can be passed from person to person and make others sick.

Washing hands with soap and water is the best way to reduce the number of germs on them, however during a disaster clean, running water may not be available. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Here are three key reasons why you should always care about handwashing:Your hands carry germs you can't see. Wash your hands.

  1. Handwashing can keep children healthy and in school. Handwashing education can reduce the number of young children who get sick and help prevent school absenteeism.
  2. Handwashing can help prevent illness. Getting a yearly flu vaccine is the most important action you can take to protect yourself from flu. Besides getting a flu vaccine, CDC recommends everyday preventive actions including frequent handwashing with soap and water.
  3. Handwashing is easy! Effective handwashing is a practical skill that you can easily learn, teach to others, and practice every day to prepare for an emergency. It takes around 20 seconds, and can be done in five simple steps:
    1. Wet your hands with clean, running water, turn off the tap, and apply soap
    2. Lather your hands by rubbing them together with the soap
    3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice
    4. Rinse your hands well under clean, running water
    5. Dry your hands using a clean towel or air-dry them

Promote Handwashing in Your Community

Global Handwashing Day is celebrated annually on October 15 to promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world. This year’s theme, “Clean Hands—A Recipe for Health,” calls attention to the importance of handwashing at key times, such as before eating or feeding others, and before, during, and after preparing food.

Learn how you can get involved and promote handwashing at home, your child’s school or daycare, and your local community: