British Invasion – My Career in Public Health

Apr 23 2013 :: Published in Member News, Public Health Preparedness & Response

By Andrew C. Cannons, Ph.D., HCLD (ABB), Laboratory Director, Florida Bureau of Public Health Laboratories, Tampa

“What do you want to be when you grow up?” In England, students have to make these decisions early on, and at 14 my answer was a doctor or a chef. If you asked me back then what public health was I would have said “the health of the public!”

Andrew Cannons as a child

I was not to become a doctor, due to poor study habits as a child and I did not become a chef (except in my own kitchen), but I did get to university where I acquired a good tutelage in Eastern culture at the city of Bradford –known more for its excellent authentic curries and high volume of pubs than education. Four years later, I graduated with a degree in applied biology. I had a thirst for research, but no acquaintance yet with public health.

Having discovered I was good at research I stayed on at the University of Bradford to complete my Ph.D. in biochemistry, and followed that with a four-year post-doctorate at the University of Wales in Swansea where I also picked up a Welsh accent. I was trying to determine what I wanted to do, and quite frankly I drew a blank. As luck would have it, I soon met one of my field’s most world-renowned scientists at a conference in Spain.  He offered me a three-year post-doc opportunity in his lab at the University of South Florida (USF) in Tampa. I was excited, flattered and thrilled at the offer. And guess what… USF has a college of public health! I was getting closer to where I wanted to go without knowing it.

I had a blast for the first two years I was at USF, so much so that I wanted to stay. After a lot of work and a lot of payments to an immigration lawyer, I received my green card. But I was not really sure that research was my true vocation anymore. I had been an assistant professor in biology for five years and proved to be a good teacher, but it wasn’t fulfilling enough. During this time I met the assistant director of the Florida State Public Health Laboratory in Tampa. He was doing his Ph.D., and asked me to be on his dissertation committee. We became good friends and I started to find out more about public health, albeit at a very superficial level.

The turning point for my career in public health came one October morning. It was 5:00 AM on October 6th, 2001, three days after the index anthrax case was identified in Boca Raton and I received this message –“Can you help us at the public health lab? We are expecting an onslaught!”  No kidding.  By 6:00 PM that day we had processed 40 suspicious samples for Bacillus anthracis. I was tired and hungry, but more importantly, I was hooked. This was important, meaningful, critical work. Sign me up! Not so easy as there had to be a job.

Andrew Cannons -- adult

The following year I was asked if I had considered a career in public health, and specifically about directing a state public health laboratory. I had the Ph.D., the administration skills, and a research background. I just lacked some (a lot!) public health knowledge, and there was the small issue of a Florida Clinical License. So I spent the next eight years directing the research lab, volunteering in the public health lab, studying and building up my clinical licensure one level at a time. I also joined the Association of Public Health Laboratories (APHL) as an individual member and applied for and became a member of the Emergency Preparedness and Response Committee (now the Public Health Preparedness and Response Committee).  This was a really smart thing to do.  It was such an eye opener to understanding more about public health laboratories, the Laboratory Response Network (LRN) and a host of other partners as well as their operations! This was a tremendous education and learning experience for me. Joining APHL became crucial to honing my public health knowledge and skills. In addition to serving on the Public Health Preparedness and Response Committee, various sub-committees and participating in the national meetings, in 2010 I was given the chance to be a member of the APHL Emerging Leaders Cohort III, which seeks to engage APHL members who will play a crucial role in sustaining future leadership in the public health laboratory system. This was a tremendous opportunity to 1) network and share operational experiences with other emerging leaders; 2) enhance my professional development; and 3) collaborate to deliver a product that promoted public health laboratory science.

In 2011 I became qualified as a High-Complexity Clinical Laboratory Director through the American Board of Bioanalysis (ABB) and received my Florida Clinical Laboratory Director License. I was ready, and in April 2012 I assumed the position of Laboratory Director, Bureau of Laboratories (now Bureau of Public Health Laboratories), Tampa.  I acquired a great facility and a wonderful group of dedicated, hardworking and loyal staff, which has made this move so much easier and more fulfilling.

Since transitioning to a director of a major public health laboratory, I have worked on large-scale national events such as the Republic National Convention.  As a 14-year-old boy, I never thought I would end up partnering with the US Secret Service, the Federal Bureau of Investigation, the Department of Homeland Security, and the Centers for Disease Control and Prevention to protect the public’s health from all sorts of threats. Public health was the perfect career choice for me even though it took several forks in the road for me to get here.

Through it all, I’ve held to the motto: Keep Calm and Carry On!

 

No responses yet

Anthrax in Minnesota? The Laboratory Response Network Springs Into Action

Mar 05 2013 :: Published in Public Health Preparedness & Response

By Kara MacKeil, Associate Specialist, Public Health Preparedness and Response, APHL

Picture a small rural hospital in northern Minnesota.  A man walks into the emergency room late in the afternoon complaining of flu-like symptoms. He’s admitted and at first seems stable, but rapidly deteriorates.  As he is transported by helicopter to a larger hospital for advanced treatment, his condition plummets en route and survival seems increasingly unlikely.  The backstory: The man was three weeks into a road trip and could have passed this fast-acting, apparently lethal bug on to any number of people.  Sounds like the script pitch for Contagion 2, right?  Mystery illness in Minnesota, I can see it now.*

But while it sounds like a script pitch, this actually happened in the fall of 2011, with Bacillus anthracis, as the causative agent of anthrax, as the starring villain.  There was one very important change to the storyline though.  Thanks to the efforts of the laboratorians at Lake Region Healthcare in Fergus Falls, Minnesota, and the Minnesota Department of Health Laboratory Response Network (LRN) staff, the mystery bug was identified in time to provide treatment, and the patient is alive and well today. Maureen Sullivan of the Minnesota Public Health Laboratory told us the story of the legwork that went in on the laboratory side, and it would definitely make for a pretty good movie!

First, a word on the LRN.  The LRN was developed in 1999 by the Centers for Disease Control, APHL, the Federal Bureau of Investigation (FBI) and the Department of Defense.  Today, there are two main arms of the LRN: chemical and biological threats preparedness and response (LRN-C and LRN-B), which provide a strong, unified system of laboratories that can respond to any threat.  There are standard protocols for everything, and regular trainings to keep everyone up-to-speed. In the LRN-B, Sentinel Level laboratories like the Lake Region Healthcare Laboratory can rely on reference laboratories such as the Minnesota Public Health Laboratory, and the Minnesota Public Health Laboratory, in turn, can call on resources within the CDC. Further, the Minnesota Public Health Laboratory can leverage partnerships with the local law enforcement, FBI and the National Guard Civil Support Team.  From the first culture to the final treatment, the Minnesota anthrax case was a perfect illustration of what dedicated laboratory and first responder professionals can do with the strength of the LRN behind them.

Testing for anthrax

Back to our story.  The patient in question was a 61-year-old Florida man who had been driving through the northern plains states for the past few weeks with his wife, taking in your standard tourist attractions and enjoying the scenery. (Can’t you picture the opening montage of our movie?)  He had a previous history of pneumonitis and had been exposed to Agent Orange in the Vietnam War, but was otherwise healthy.  When he arrived at Lake Region Healthcare on a Thursday afternoon, there wasn’t anything to suggest that he might be infected with a deadly biological agent, so the hospital began its standard protocol for flu-like symptoms and sent blood cultures to the laboratory.  These cultures were examined that Friday morning and, after finding all four to be positive, the laboratory technician followed LRN sentinel protocols and plated all four to watch for growth.  Normally samples like these would have been checked again at about noon on Saturday, but the laboratory technician was suspicious and made a point to look at them again later Friday afternoon.  Cue the ominous music and enter the Minnesota Public Health Laboratory, an LRN Reference Lab, at camera left, because those plates had growth!

Realizing what she might have on her hands, the sentinel laboratory technician made a call to the MN public health lab to let them know what was happening, and then personally packaged the samples and drove them to the delivery drop box to ensure they would arrive at the state laboratory the next day. Thanks to her diligence, the plated samples arrived at the state laboratory about 24 hours early, at 11 AM Saturday morning, and Sullivan says when the on-call molecular biologist opened the box, “she looked at the colonies, closed it right up, went and called her husband and said ‘I think I might be here for a while.’”

Sullivan got the call with positive results for B. anthracis spores at 2:30 PM that afternoon (while on a family vacation, I might add) and started making phone calls.  The submitting hospital had to be notified so treatment could begin as soon as possible, but positive anthrax findings don’t stop with identification.  Because anthrax is so dangerous, the Minnesota LRN-B’s next task was to determine whether this patient was deliberately infected.  This is the point in our script where the military enters, in the form of the National Guard’s 55th Civil Support Team (CST).  The Minnesota laboratory conducts regular trainings in conjunction with the 55th CST, and they have a great working relationship. In conjunction with the National Institute for Occupational Safety and Health (NIOSH), the 55th CST and two representatives from the Minnesota laboratory (Sullivan included) spent a day combing over the patients rental car, removing anything that might give them a clue as to where the spores had come from.  Altogether they collected over 50 samples, including the patient’s boots and a set of deer antlers.  While none of the samples collected from the car tested positive, Sullivan notes, “It was a very good collaboration with the CST team and with our partners at CDC to put the environmental sample plan together.”

Testing for anthrax

Meanwhile, the patient’s condition had deteriorated.  On Sunday, he was loaded into a medevac helicopter and sent south to a larger hospital for treatment. Despite a nail-biting collapse en route, doctors were able to stabilize him, and the following day a team from the CDC administered emergency treatment.  It’s important to note that this treatment would not have happened without the positive B. anthracis identification from the Minnesota State Public Health Laboratory. That treatment, coupled with the early changes to the patient’s antibiotic regimen after the positive identification, is likely the reason the patient recovered completely.

Like any good movie, this story leaves a few questions behind.  First, where did the anthrax come from? While the movie version of this story would probably end with some hint at nefarious origins in order to create a sequel, the truth is it was probably a complete coincidence.  Anthrax is found naturally in all seven continents and lies dormant in soil for hundreds of years.  The spores can reactivate when they are kicked up and inhaled, commonly by grazing animals.  Our patient had spent some time on his road trip collecting rocks from riverbeds, and at one point drove past a large herd of grazing buffalo.  It’s probable that he inhaled some spores (and it would only take one) in one of these locations, but we will truly never know. You may also be wondering why the patient’s wife didn’t get sick, despite being in all the same places and presumably getting the same exposures.  It’s possible that the patient’s history of lung problems might have made him more susceptible, but again, there is no way to know.  She may have just been very lucky.

Despite these questions, the reality remains that without the smooth functioning of the LRN-B, this could have been a very different story.  But thanks to the dedication of a wide variety of people, the patient was on the road to recovery a mere four days after the initial blood cultures were drawn.  “I think what this really showed us was that all of the efforts we’ve put forth for our training really have made a difference,” says Sullivan. “All of those things really came together and we had a very successful response.”

In conclusion, Contagion 2: LRN in Action.  Get the popcorn!

*Speaking of Contagion, my friends in Minnesota would probably like me to point out that this case study does an awesome job of refuting the movie Contagion’s very unflattering portrayal of Minnesota public health and emergency response systems.  Despite what Steven Soderbergh may have you believe, when trouble arrives in real life, Minnesota is on its game!

One response so far

Laboratory Response Network: Texas Style

Feb 21 2013 :: Published in Public Health Preparedness & Response

By Kara MacKeil, Associate Specialist, Public Health Preparedness and Response, APHL

Dallas County Police

When was the last time you went on an evening hayride at a meeting, or had homemade barbecue brisket for dinner? If you’re part of the Texas Laboratory Response Network (LRN), it wasn’t that long ago.

Everything really is bigger in Texas, and the Texas slice of the LRN is no exception. Texas has ten member laboratories at the Reference Level, and those labs work extensively with organizations such as the Texas State Chemist, the Brooke Army Medical Center, and the Federal Bureau of Investigation (FBI). This makes for a large, varied network of people and, while conference calls have their place, once a year or so the Texas Department of State Health Services (TX-DSHS) convenes these laboratories and other partners for an in-person meeting. It’s a great chance for the laboratories to address issues specific to Texas, share successes and problems, and build relationships for a stronger network. I was lucky enough to be invited to observe the meeting this year, along with two other APHL staff members, Chris Mangal, director of public health preparedness and response (PHPR), and Peter Kyriacopoulos, senior director of public policy.

Texans being Texans, this meeting doesn’t take place at some sterile airport hotel.  As you might guess from the aforementioned hayrides and barbecue, this meeting was held at a dude ranch, specifically the Mayan Ranch of Bandera, TX. Far from being distracting, the relative isolation of the ranch completely cuts out the usual attrition to local tourist spots. And unlike meetings in big cities, the cost is low and there’s only one place (and time) for meals and limited activities for your evenings, so you end up spending a lot more time with your fellow attendees than you might otherwise.  It’s all Texas laboratory talk, all the time, and the end result is a lot more brainstorming than you often get at large meetings.

Packaging & Shipping Training

Like any state, the laboratories of Texas have some unique challenges and it was interesting to learn more about them.  One issue that never occurred to me as a native New Englander was fertilizer control.  Texas is a big agricultural state so there are plenty of farmers who need fertilizer for their soil, but it can also be used for bomb-making. To prevent this, the Texas State Chemist’s office has put some very strict controls in place to limit who can buy this fertilizer and in what quantities. Only certain dealers are allowed to sell it, and when they encounter any customer who seems suspicious, they can call the Chemist’s office to get a second opinion. Incidentally, the Texas State Chemist is authorized to make arrests.

Another benefit to this meeting was that some of the lesser-known laboratories and agencies were able to re-introduce themselves to the rest of the network and emphasize the services and help they’re able to offer. In addition to the Texas State Chemist, we saw some great presentations from the Chemical Threat Laboratory for the Texas Department of State Health Services, as well as presenters from the nearby Brooke Army Medical Center, the National Guard 6th Civil Support Team, and Texas-office FBI Weapons of Mass Destruction Coordinator. Turnover can be high in public health, so reminders like this are valuable to maintain current information and contacts.

Key takeaways from this meeting:

  • The LRN is strong across Texas with the Austin laboratory being a central resource
  • The LRN does more than terrorism preparedness – laboratories are actively engaged in influenza surveillance and other routine public health activities
  • Inexpensive in-person meetings in isolated locations are great ways to network
  • And things really are bigger in Texas!

No responses yet

Bio-Buzz Words and CDC’s Select Agents Program

Oct 25 2012 :: Published in Public Health Preparedness & Response

By Christopher Chadwick, MS, Specialist, Public Health Preparedness and Response, APHL

In the bio world, scientists throw around several words that tend to confuse people: biosafety, biosecurity, biodefense and bioterrorism.   What do these buzz words mean?

Bioterrorism and biodefense are probably the terms with the most straightforward definitions.

  • Bioterrorism: the unlawful or threatened use of certain microbes or toxins (“BT agents”) to harm or scare people
  • Biodefense: the measures taken to prevent, detect, respond to and recover from harm or damage caused by BT agents.  Biodefense measures include surveillance systems or networks for detection, such as the Laboratory Response Network (LRN), and medical countermeasures for response and recovery, such as vaccines and antimicrobials.

The laboratories are vital in the detection and characterization of potential BT agents, but what protects the laboratories and the laboratorians from exposure to the agents or from accidentally releasing them to the public? Biosafety and biosecurity!

  • Biosafety: the policies, practices, safeguards, and equipment that protect laboratorians, the environment, and the public from the accidental exposure to BT agents. Essential to biosafety is the Biosafety in Microbiological and Biomedical Laboratories (BMBL) guidance document, a voluntary guide to standard practices, safety equipment, facility structure (e.g., biosafety levels 1-4).
  • Biosecurity: the protection, control and accountability for agents to prevent misuse or intentional release.

CDC’s Select Agent Program

Chris Chadwick's Halloween pumpkin -- yes, he *really* made this

Recently, biosecurity has been a hot topic among the laboratories with the release of the final rule of the Select Agents Regulation by the Department of Health and Human Services Centers for Disease Control and Prevention. The Select Agents Regulation, more formally known as the Rules for Possession, Use, and Transfer of Select Agents and Toxins or 42 CFR Part 73, provides biosecurity guidance on a specific list of agents and toxins, including the popular BT agents anthrax, botulism, plague and smallpox, in order to implement provisions of the Public Health Security and Bioterrorism Preparedness and Response Act of 2002.

On October 5, 2012, the final rule was published with a variety of revisions that were met with support and criticism by the public health laboratory community. The most notable revision is the establishment of 11 Tier 1 agents that pose the greatest risk of misuse and potential for mass casualties (e.g., anthrax, botulism, Ebola). With this new designation, laboratories that handle these agents must develop additional facility safeguards and personnel reliability to ensure biosecurity, thus putting a financial burden on the laboratories. Physical safeguards include establishing an intrusion detection system and three security barriers that would delay someone attempting to reach the agents, while IT safeguards include additional information security to protect against viruses and spyware that may compromise confidential records.

Revisions to the actual list of select agents include the addition of the SARS, Lujo, and Chapere viruses; the removal of 11 agents and toxins; and the retention of Bacillus anthracis (aka, anthrax) Pasteur strain (but not as a Tier 1 agent). Public health labs were quite happy to learn that LRN member laboratories can use exempt attenuated strains of some agents for proficiency tests and that Coccidioides immitis, a soil fungus endemic in the southwestern United States, was removed from the list.

The revisions to the Select Agents Regulation are a great reminder that biosecurity and biosafety efforts are always changing in the laboratory. Technologies are shifting, the workforce is evolving, and new infectious diseases are emerging so these efforts to maintain biosecurity and biosafety are becoming even more important. With that, in the spirit of Halloween, the Public Health Laboratory Division at the Minnesota Department of Health says: Don’t Be a Zombie, Follow Safe Laboratory Practices!

 

No responses yet

What We’re Reading — A Month of Blog Posts

Sep 27 2012 :: Published in What We're Reading

National Preparedness Month and Newborn Screening Awareness Month

As you probably know, this month has been both National Preparedness Month and Newborn Screening Awareness Month.  And as you may have noticed, our blog has been BLOWING UP (don’t worry, we were prepared) with fantastic posts honoring each of those months.  Just in case you missed any of these great stories, here is a rundown of posts by APHL staff, members and partners:

National Preparedness Month:

- My Path To Public Health Preparedness and Response by Christopher Chadwick, MS, Senior Specialist, Public Health Preparedness and Response, APHL

- System Built for Responding to Bioterrorism Confirms Plague in Colorado Girl by Larry Sater, MS BT/CT Coordinator, Colorado Department of Public Health & Environment Laboratory Services Division

- National Preparedness Month and Serendipity by Jim Garrow, Guest Blogger, Operations and Logistics Manager for the Bioterrorism and Public Health Preparedness Program at the Philadelphia Department of Public Health

Newborn Screening Awareness Month:

- It’s all about the babies by Pat Blake, Strategic Communications Director, State Hygienic Laboratory at the University of Iowa

- Happy Birthday to Ary — 10 years of Living With Sickle Cell by Michelle Forman, Senior Media Specialist, APHL

- Raising Baby Caroline: Life With PKU by Michelle Forman, Senior Media Specialist, APHL

- Breathing a Sigh of Relief Thanks to Newborn Screening by Elizabeth Jones, MPH, Specialist, Newborn Screening and Genetics, APHL

No responses yet

System Built for Responding to Bioterrorism Confirms Plague in Colorado Girl

Sep 13 2012 :: Published in Member News, Public Health Preparedness & Response

By Larry Sater, MS BT/CT Coordinator, Colorado Department of Public Health & Environment Laboratory Services Division

When the Laboratory Response Network (LRN) was established in 1999, the goal was to establish accurate, rapid testing methods to confirm or rule out dangerous bacteria, viruses and toxins that bioterrorists might unleash on the American public.  However, those same laboratory tools and trained staff do not sit idle waiting for a bioterrorist threat. A great success of the LRN is the day-to-day use of these resources in detecting the presence of select agents in people, pets, livestock and food during everyday life.  If you do not believe me, speak with a seven-year-old Colorado girl and her parents.

Colorado Bioterrorism Lab

Each year, and especially during the summer, the Colorado Department of Public Health & Environment Laboratory Services Division (CDPHE) laboratory is busy testing for West Nile Virus, rabies, plague and other diseases in both clinical and environmental samples.  On August 27, 2012, the lab received another one of these calls, but this one was very different.  A seven-year-old girl was critically ill and determination of the cause of her illness was critical to quickly proceed with appropriate treatment.  A courier from Presbyterian/St. Luke’s Rocky Mountain Hospital for Children delivered the specimens to the state laboratory just before noon on that day.

This was the story: While at a Colorado campground, the little girl found a dead squirrel and insisted on giving it a proper burial.  In the process, it is suspected that fleas containing the plague bacteria left the squirrel carcass and contacted the girl, inflicting several bites. The child soon became ill with a fever of 107 and required airlifting to St. Luke’s.  There, an alert physician checked both symptoms and the literature, concluding bubonic plague was a possible culprit.

The hospital collected specimens for culture and could not rule out the presence of Yersinia pestis, the bacteria causing plague.  At this point, the Laboratory Services Division was contacted and specimens collected from the girl were sent to us for confirmation testing.

Before the LRN, bacteria had to be grown in a culture for at least 1-2 days before the organism could be detected and colonies sampled for testing. However, thanks to rapid technologies adopted by LRN laboratories, the DNA for the plague bacteria was detected and identified within 2 hours of receipt of the specimens using a method called polymerase chain reaction (PCR).  A second rapid test, direct fluoroimmunoassay (DFA) which uses the antibody to the suspected bacteria, confirmed the presence of Yersinia pestis.

Thus within hours, the cause of the girl’s life-threatening illness had been identified as a presumptive positive and a confirmation test conducted that supported the physician’s suspicions.  Samples of the specimens were cultured overnight with microscopic observation of the organisms. Other tests confirmed the presence of the agent and the fact that it was still alive.

Earlier that month, two human cases of brucellosis were confirmed by the CDPHE laboratory, as well as several cases of plague in rabbits discovered in communities across Colorado.

Such specimens come in routinely to the CDPHE laboratory—all part of a day’s work for the staff.  While the LRN Network was established to rapidly confirm the presence of biological and chemical agents that could be employed in a terrorist attack, it has offered a bonus to the American public, protecting them from naturally-occurring health threats every day of the year.

No responses yet

Are you ready? September is National Preparedness Month

Sep 04 2012 :: Published in Public Health Preparedness & Response

Did you know that September is National Preparedness Month?  People around the nation are renewing their efforts to increase awareness of emergency preparedness in all areas of their lives.  APHL is joining in the fun!  Follow us via the channels listed below (click the icons) for more on the public health labs’ role in making sure the country is prepared for a public health emergency.

Like APHL on Facebook

Follow APHL on TwitterFollow APHL on Pinterest  Subscribe to APHL's Blog

 

 

 

 

One response so far

Preparedness and Politics in Florida: All in a Day’s Work

Aug 28 2012 :: Published in Public Health Preparedness & Response

By Chris N Mangal, MPH, Director of Public Health Preparedness and Response, APHL; Rick France, PhD, MPH, Chemical Threat Coordinator, Bureau of Public Health Laboratories – Tampa, Florida Department of Health

Many of us are keenly aware of the upcoming presidential elections. The 24 hour cable news is inundating the public with the minutia of each campaign tactic, misfire or other rhetoric — it’s hard to miss that this is a critical time for the American people. So first pitch, whatever party you support – ensure you vote.

Second pitch – prior to voting, learn some more about the candidates and their platforms. That is, learn more about the services they support and how those services in turn support your community.

Republican National Convention

Speaking of supporting your community… a big part of our jobs is to educate people about public health, specifically public health laboratories and their role in protecting the nation’s health. Given that the country is ablaze with hot button political issues and the Republican National Convention kicked-off yesterday, we thought this is a great time to highlight Florida’s Bureau of Public Health Laboratories (BPHL), a critical component of the Florida Department of Health, charged with protecting the public health, safety and welfare of the citizens of the state. The BPHL supports Florida’s county health departments, physicians, hospitals and other Florida Department of Health program components by providing public health diagnostic and reference laboratory services.

The four BPHL laboratories (located in Jacksonville, Tampa, Miami and Pensacola), in addition to the Bureau of Food Laboratories of the Florida Department of Agriculture and Consumer services, comprise the Laboratory Response Network (LRN) in Florida. In addition to their daily functions, these laboratories have been planning for over a year to be ready for the activities surrounding the Republican National Convention (RNC) in Tampa, convening from August 27 to August 30. The four laboratories continue frontline efforts to prepare for and respond to all hazard threats such as natural disasters (What if Hurricane Isaac wreaks havoc on the Gulf states?); acts of terrorism (Remember anthrax 2001?) or emerging infectious diseases (West Nile Virus).

The Florida BPHL is not new to unusual biological events. In October 2001, they received a specimen from a patient at a south Florida hospital. The specimen was identified as positive for B. anthracis – anthrax. This turned out to be the index case for the American Media Inc. intentional release, and the subsequent Amerithrax (as it came to be known) Outbreak.

What do Florida’s public health laboratories do on a routine basis?

The LRN laboratories provide rapid detection of threat agents and expand the ability of the Centers for Disease Control and Prevention (CDC) to analyze a large number of patient samples by using unique high-throughput analysis capabilities when responding to large-scale exposure incidents.  Additionally, the LRN for Biological Terrorism Preparedness (LRN-B) has continued to provide training to the sentinel clinical laboratories for the packaging and shipping of infectious agents.

What is being done specifically for the Republican National Convention?

  • The LRN-B component of the public health laboratory has stepped up their outreach and training with first responders on sample collection for white powder and other incidents.
  • The LRN for Chemical Threat Preparedness (LRN-C) has been doing more outreach and training with the local health and medical community on awareness of and preparedness for chemical threats and exposure. In fact, the BPHL-Jacksonville is one of ten chemical surge capacity laboratories for the CDC and is able to detect metabolites of toxic chemical agents including blister agents, blood agents, nerve agents, hazardous industrial chemicals, toxic elements and biological toxins.
  • More importantly, these four laboratories worked together with the LRN-B and LRN-C to conduct a joint biological and chemical statewide exercise in preparation for the RNC. The exercise, conducted in February 2012, involved over twenty local, state and federal agencies as well as numerous hospitals and county health departments.
  • The BioWatch Program, a Department of Homeland Security (DHS) nationwide effort to detect the release of biological pathogens in the air, will also be on heightened awareness with an increase in surveillance. Additional staff have been brought in to assist with these increased surveillance efforts.
  • The BPHL will continue working closely with the Hillsborough County Health Department’s epidemiology program, which will be “extra vigilant” with their surveillance activities during the RNC. Epidemiologists will be paying close attention in particular to any reports of patients with an unusual rash, a food-related illness, cases of bloody diarrhea, any unexplained severe infectious illness or death in an otherwise healthy person.

The Florida BPHL has planned and prepared extensively for the upcoming RNC. Although there is always the possibility of the unexpected occurring, with increased outreach, training and exercises the laboratories are prepared to be on the frontlines no matter what.  It’s all in day’s work!

No responses yet

You Can’t Handle the Truth!

Mar 13 2012 :: Published in Public Health Preparedness & Response

By Tony Barkey, MPH, Former APHL Senior Specialist, Public Health Preparedness and Response

Tony Barkey

It’s hard to believe, but by the time you read this post, I will have ended my three and a half year tenure at APHL.  As part of the Public Health Preparedness and Response team, I have seen stressful, joyous, inspiring and did I mention stressful times.  As my going away present, I have decided to embrace our social media channels and give our loyal blog readers a look behind the scenes at APHL and a taste of the truth.  It has been a wonderful journey and I am thankful for all of the amazing members and staff that I was fortunate enough to work with.

Here is a list of things that I learned along the ride:

- There isn’t a magic bat signal to contact CDC, but there are great partnerships that have formed through years of working together.

- Preparedness staff don’t sleep in our offices, it just seems like it.

- None of us enjoy creating superfluous subgroups, taskforces, subcommittees, subforces, taksgroups or any other combination.  Much thought goes into creating any group and many factors are considered.

- The average daily roundtrip travel time for the four preparedness team members is over nine hours.  *Guess we need to work on our internal logistics.

- Creating the annual all-hazards survey and report is literally a year long process that includes survey development, partner and member input, survey launch, data validation, data sharing, crafting a white paper, developing a theme, writing the report, many levels of revision, creating online and print copy and distribution to members.

- Planning for the Laboratory Response Network (LRN) national meeting is even longer – an 18month process.

- Our program is primarily funded through CDC cooperative agreement funding, like many of our members. As funding decreases, we feel the impact as well.

- Sometimes even we get lost in the acronym jungle and in the legislative mumbo jumbo.

- Depending on the week, we have anywhere from five to infinity meetings with internal and external staff and partners.

Of all the projects that I have worked on, I’m proudest of increasing awareness of laboratory preparedness issues with state and federal policy makers and improving existing and creating new partnerships at the Federal Bureau of Investigation (FBI), Department of Homeland Security (DHS), National Guard Bureau Civil Support Teams, and numerous local law enforcement, first responder teams and hospital partners.

I’m most concerned that many preparedness efforts remain retroactive instead of proactive. Acting in this manner leads to a perpetual cycle of catch up that is unsustainable especially when funding isn’t strong.

In closing I will share what preparedness means to me.  Preparedness is something that we all do almost daily without even knowing it.  Going to the grocery store to get food for the week is really just you preparing for a future hunger event.  Similarly, washing your clothes ensures that you are able to dress appropriately for any situation. Trying to make specific preparations for a future event/threat that may or may not exist is a mistake.  Building systems that can be used to respond to anything is the key.

The LRN is a real example of a system that can and has worked for issues ranging from natural disasters, emerging and re-emerging disease and acts of man-made destruction.  To get to the next level, national preparedness efforts need to move from a top down approach and empower everyone.  Systems should be in place at the local level that provides training and base knowledge. Having additional awareness will bring new ideas and build capacity that goes well beyond any central agency.  By removing the shroud of secrecy and sharing information, people will be invested in their own health hand in hand with those tasked with protecting them.

So I end with a question:  Were you able to handle my version of the truth?

 

Related articles

3 responses so far

What We’re Reading: White Powder Edition

Feb 23 2012 :: Published in Public Health Preparedness & Response, What We're Reading

As you may have heard, letters containing white powder have been sent to several Congressional offices and media organizations.  Luckily the powder has been determined to be harmless.  How do we know that?  While information on exactly where the powder was tested has not been released for security purposes, it was likely sent to a public health lab.  Public health labs test suspicious powders like this on a routine basis.  It is part of their job.  And even though the vast majority of “white powder” samples that are sent to the labs are proven to be harmless, they are all treated as though they are the real deal.  It is just another way the public health labs are protecting the lives of all Americans.

 

 

One response so far

Older posts »