Association of Public Health Laboratories - APHL Public Health LabLog

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.

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.

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My Path To Public Health Preparedness and Response

Sep 05 2012 :: Published in Public Health Preparedness & Response

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

This month is National Preparedness Month. Follow APHL on our blog and our other social media networks for preparedness information and discussions all month!

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I’ve been at APHL for just over 90 days now. My path to public health preparedness and response has been a long, winding one with many pit stops and turns along the way. Strict science was always my anticipated destination but I was quick to make an unexpected turn here and there when I was persuaded by whatever aspect interested me at the time.

I began my science career working in a microbiology laboratory at Louisiana State University. Before my position in the microbiology laboratory, I was convinced chemistry was the only route for me, so my apathy for these microorganisms that I dealt with everyday grew almost as fast as E. coli in lactose broth (please excuse the gratuitous nerdiness). However, Becky Todd, my first mentor in the lab, and basically in science, helped steer me in the direction that would eventually become my career path. I began to grow fond of the laboratory and the vast microscopic world. As my undergraduate career came to a close, I was at a crossroad as to where I should go next. Although medical school was a driving factor for quite some time, I realized that I wished to further study infectious agents and their influence at the community level.

Realizing what public health had to offer proved to be my greatest scientific discovery. After I made a few pit stops in vaccine policy, biosecurity and food safety, I arrived at the Association of Public Health Laboratories (APHL), a premier non-profit public health organization at the forefront of innovative technologies and policies which will help shape health outcomes in the US and globally. My work is concentrated on preparedness and response, which leverages my expertise in microbiology, chemistry, public health and policy – an excellent fit and use of my skill sets.

During my time here, my respect for the laboratories that began during my days at LSU has only grown, and I’ve made some key realizations about public health, laboratorians, and the preparedness and response field:

The laboratorians we work with are extremely intelligent and well-respected in the science community as they are key responders in emerging infectious diseases, foodborne outbreaks, suspected terrorist attacks, newborn screening and environmental health issues.
We all have our microbe of interest. Mine happens to be dengue if you’re wondering.
We all play the ever-so-popular acronym game. Public health professionals in the greater Washington, DC area love to use as many acronyms or abbreviations in one sentence to see whom we can confuse. (Don’t act like you’ve never had that intention!)
The Centers for Disease Control and Prevention (CDC) is THE PLACE to be for public health, but you already knew that. My first trip there was one of the most exciting experiences and maybe a little emotional too (don’t tell anyone that last part). That said, all events happen locally. Strong CDC support enables state and local health departments to protect the nation.
The all-hazards approach of preparedness and response fuels my curiosity to learn all I can from other areas of public health (e.g., chemical and radiological threats). Plus, I get to use the knowledge all my pit stops provided me.

As preparedness month begins and we look ahead to the next hurricane, I am reminded why I chose this path. We southerners from the coastal states are guilty of playing in the rain as a hurricane approaches, but we are always prepared — although my knee may not have been prepared for that roofing tile flung at it by Hurricane Gustav during the summer of 2008. Perhaps my career and interest in preparedness began years ago when I insisted our dorm room have a kit with the necessities, such as ramen noodles and a flashlight. (That’s all you had at one point too, right?) As I’ve traveled the path towards preparedness and response, my kit has remained intact and evolved to better prepare me for all events and not just hurricanes. These additions forced me to remove the ramen noodles from the menu though.

Find me on Twitter or send me an email. I am happy to chat with budding scientists and/or folks with a curiosity for public health.

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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.

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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.

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!

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APHL Members Take to the Hill

Mar 21 2012 :: Published in Public Policy

By Annie Carlin, Senior Specialist, Public Policy, APHL

It’s March! Federal budget information is coming out fast and furiously. First we had the President’s Budget Requests and Executive Agency Congressional Justifications. Now we are starting to hear information from the House of Representatives on their proposed budget. Amidst all the excitement, APHL members from California, New York, Iowa and Wisconsin along with APHL staff are heading to Capitol Hill on Thursday for our annual Hill Day. We will be talking with members of Congress and their staff about public health laboratories and the importance of maintaining public health funding. Because the country’s financial situation is, shall we say, less than ideal, it is more important than ever to advocate for funding for public health laboratories to ensure they have what they need to accomplish their missions.

APHL members will also be sharing stories from their states to emphasize the impact public health laboratory activities have on constituents. For example, Public Health Emergency Preparedness (PHEP) funding has allowed the State Hygienic Laboratory at the University of Iowa to establish relationships with sentinel (clinical) laboratories, law enforcement agencies, HazMat teams and Civil Support Teams. These partnerships are vital to the safety of the citizens of Iowa with regard to terrorism response and public health emergencies. PHEP is not unique to Iowa – awardees include all 50 states, four major metropolitan areas, and eight U.S. territories and freely associated states.

As we scheduled our appointments, it was heartening to hear that congressional staff members were happy to meet with us, and we were especially excited to be able to send APHL appropriations requests along to the congressional staff who work with the appropriate committees.

One exciting difference this year is that APHL made an effort to meet directly with Members of Congress in addition to their staff. As of now, we will be meeting Senator Tom Harkin (D-Iowa) at his weekly breakfast this morning and we will be meeting with Congresswoman Doris Matsui (D-California) tomorrow morning.

Some of the programs we will be highlighting this year at Hill Day are:

The Laboratory Efficiencies Initiative (LEI)

President Obama requested that $20 million be appropriated to CDC for the Laboratory Efficiencies Initiative. The goal is to build a sustainable public health laboratory system in the United States. State and local public health laboratories operate under intense pressures. Deep budget cuts have affected their resilience and led to reduced laboratory testing capacity, termination of certain types of tests, and in some cases, impaired support to outbreak investigation, surveillance, and emergency response. The LEI will help public health laboratories fully implement and maintain efficient management practices, which are the foundation of a strong platform for current and future test services.

Public Health Laboratory Response

APHL members will advocate to increase CDC Public Health Emergency Preparedness (PHEP) funding for public health laboratories to prepare for and respond to all threats and to increase funding to CDC to expand public health laboratory outreach, training and coordination with sentinel clinical, including hospital, veterinary, food and environmental laboratories where threat agents may first be detected. Members will ask Congress to maintain current funding at CDC for laboratory response to incidents involving chemical threats and provide funding to CDC to improve states’ ability to detect radiological exposure in humans.

Infectious Disease Detection

APHL members will ask Congress to enhance the nation’s ability to respond to emerging disease outbreaks by increasing capacity-building at CDC, develop and deploy diagnostic tests to state and local public health laboratories, and provide technical assistance and training to state and local public health laboratory professionals. They will ask for increased support for the Epidemiology and Laboratory Capacity (ELC) Program, to assist state laboratories and enhance national capacity to detect and prevent outbreaks of new infectious disease through the Emerging Infections Program. HIV/AIDs funding and funding for TB laboratory infrastructure will also be highlighted.

Food Safety Surveillance

APHL members will highlight the crucial role public health laboratories play in foodborne disease surveillance and the detection of foodborne outbreaks. Advances in testing methodologies and a highly-trained public health laboratory workforce coupled with key networks such as PulseNet and the Food Emergency Response Network (FERN) have resulted in the detection of a large number of nationwide outbreaks and subsequent food recalls. Members will advocate for funding for the maintenance of PulseNet, which is the only national laboratory-based surveillance system in the United States that uses DNA fingerprinting technology to detect clusters of foodborne pathogens. Without this network, many large national outbreaks will never be detected. Funding for FERN, which has been threatened in recent years with severe funding cuts and elimination, must also be maintained. FERN provides critical surge capacity for nationwide food emergencies, ranging from natural disasters such as the Deepwater Horizon oil spill in the Gulf of Mexico in 2010 to inadvertent contamination of the food supply including the recent Listeriosis outbreak linked to cantaloupe. APHL members will also advocate for funding to develop new technologies to respond to emerging threats, such as E. Coli O104 that sickened thousands of people in Europe, and to find new ways to conduct surveillance and detect outbreaks of pathogens given the increasing reliance on culture independent diagnostics.

Environmental Health and Biomonitoring

APHL will tell Congress that increased funding for EPA’s Homeland Security Laboratory will allow the Office of Emergency Management to maintain funding for the state chemical warfare agents program, restore support for the state radiological grant program, increase efficiency of electronic data exchange, and review, develop and validate methods for transfer to state and local labs. They will ask that Congress provide EPA with $20 million to ensure continued function of the Water Laboratory Alliance (a nationwide laboratory network protecting our drinking water) to investigate areas to gain efficiency with regard to laboratory capacity across EPA, continue capability-building exercises related to the National Response Plan, develop and validate methods for transfer to local and state labs, build relationships between EPA, states and small water systems and to fund additional staff in the Water Security Division to carry out this work. Members will also ask Congress to provide increased funding to CDC’s National Biomonitoring program and increased funding to support state programs, develop methods, conduct studies and issue reports on chemical exposures in people.

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The Louisiana State Public Health Laboratory Staff Define Resilient

Mar 15 2012 :: Published in General, Member News

By Linette Granen, Director, Membership and Marketing

A few weeks ago, Scott Becker, APHL’s executive director, and I visited the Louisiana public health lab outside of New Orleans and had a very interesting tour of their facility. I have one word for those people—resilient. Their building in downtown New Orleans was completely shut down in 2005 following Hurricane Katrina. Right now, they are in a converted mental health clinic which in itself has caused a lot of interesting problems. The current building has been rigged (by the assistant director, Catherine Evans) to accommodate some of the laboratory’s instrumentation. The ventilation system in the photo of the ICM room is some of Catherine’s handy work! Steve Martin, the lab director, says that they have purchased a lot from a local hardware store. At any moment, one of the myriad of air conditioning units is usually down. In the molecular lab, there is no ceiling, thanks to rain damage. When it rains, it actually rains into the room. Often employees have to mop before they can test.

A new lab is in the process of being built. As you can imagine, the employees are extremely excited about their new building! This move is joyful, but it’s sobering too, since the lab will be located about 100 miles from its current location (inland in Baton Rouge—away from flooding). Many of the employees are at or near retirement age and will not move with the lab. Here is what is going to happen:

The old Louisiana Department of Environmental Quality lab (DEQ; closed down a few years ago) will become the environmental and chemical lab for the public health laboratory; a new building housing the biological testing is being built.
The DEQ lab building is not very old, so the facilities there are perfect to house the public health lab equipment and supplies.
The location of the new lab is on the Capital grounds so security will be provided by the Capital police. There will be a fence around the entire property.
There will be ample space for receipt of specimens, one floor with totally flexible bench space, and an open airy concept to the new building.

I used to work at the Louisiana public health lab. As you can imagine, it was bittersweet to see the people I used to work with; we reminisced about the days before and after Katrina. That’s why I can tell you that you would have to see this to believe it! The staff here has withstood such great tribulations and continues to carry on knowing that their mission – protecting the public’s health – is more important than anything!

As we talked to Catherine, she told us that the public health lab is still doing post-oil spill testing of the seafood that is coming from the Gulf (BP is paying for that testing). She has a great system set up for screening and has yet to find a positive for PAHs. As we talked about this, she mentioned that she was filmed doing these tests for MSNBC, and Jeff Corwin actually came into her lab with a film crew.

At the end of last year, there was an article in the Baton Rouge newspaper, The Advocate, regarding the new lab. Catherine told us that the construction is ahead of schedule (how often do you hear that?) and that they are scheduled to move in March 2013. Another interesting thing – when I was hired to work at the state public health lab in 1994, the lab director at that time (Dr. Henry Bradford) told me that we would be in a new building in about 2 years. Of course, that didn’t happen, but the architectural firm that did the plans for that first iteration of the building is the same one that did the plans for the new building. The head architect on the project, who was a staff architect on the proposed building in 1993, is excited to finally see this project to fruition!

Having been housed in the Louisiana State Public Health Lab from 1994 until 2005, I know very well the difficulties we all faced in the original building where asbestos remediation was under way on our floor immediately before Katrina hit. Since then, the lab has faced many challenges including Hurricane Katrina. The people who work in the Louisiana State Public Health Lab are resilient, to say the least. I can’t wait to see their new facility in Baton Rouge!

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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

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?

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What We’re Reading This Week

Mar 01 2012 :: Published in What We're Reading

The secret (and amazing) world of public health laboratories – Kim Krisberg took a tour of the Texas state public health lab. Her takeaway: public health labs are “seriously cool.” We happen to agree. Her post gives a terrific glimpse into a public health lab. This is definitely a must-read!
US disease agency in fiscal peril – The current federal budget situation is pretty grim across the board. This article does a great job explaining the budgetary woes with regard to CDC. Scott Becker, APHL’s executive director, likes to use the term “train wreck” to describe it (the budgetary situation, not the article).
New Facebook Feature Lets You Mark Yourself as ‘Safe’ After Major Disaster – After a disaster it can be hard to reach loved ones by phone or email to see if they’re ok. So now there is this app on Facebook that helps with that situation. Both cool and practical!
FIRST Lego League examines foodborne illnesses – File this under my favorite category: Awesome things that awesome kids are doing to make their world healthier. Teams of fourth through eighth graders in Iowa designed and built robots out of Legos and then wrote computer programs to solve problems with food safety in the food chain. I believe Whitney Houston had it right when she sang, “I believe the children are our future laboratorians…” Ok, so maybe I added the “laboratorian” part.

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Dispatches from the Newbie: The 2012 Public Health Preparedness and Response Summit

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

By Kara MacKeil, Senior Technician, Public Health Preparedness and Response

Greetings from sunny southern California! By the time you read this I’ll be back in chilly DC, but as I write it’s over 70 degrees outside and the Tower of Terror is beckoning. The 2012 Public Health Preparedness and Response Summit has just wrapped up, and I think it’s safe to say this has been a very important, but very fun week for everyone involved. Even though we can see Disneyland from our hotel rooms, the APHL staff and members who attended this meeting have been making the most of a great opportunity to form new connections in the world of public health preparedness and share ideas for improvement. As a relative newcomer, I’ve been really interested to see all of the different types of agencies that work in public health along with the laboratories. The exhibit hall was full of different vendors, federal agencies, and other groups, all with interesting positions and experiences to contribute (and great decorations for my desk). But thanks to the Fantastic Wheel of Fun, the APHL booth was definitely one of the most popular stops in the exhibit hall! Super-secret plans are in the works to top ourselves next year…

When I wasn’t handing out giant microbes, I did manage to make it to a few sessions. I particularly liked the town hall discussion, “A Family Vacation That Won’t Soon Be Forgotten: A Naturally Acquired Inhalational Anthrax Case.” Collaboration between different agencies and labs is something we talk about a lot and this was a great example of these partnerships — a local hospital lab (in this case the Lake Region Healthcare Laboratory in Fergus Falls, Minnesota) working with the Minnesota Department of Health Laboratory and the Minnesota National Guard Civil Support Team to identify and then respond to a very sudden, very scary case of inhalational anthrax. This story had been covered in the national news from a public safety perspective, but the presenters chose to follow from the point of view of the patient, from zero hour to present day. Seeing the process laid out step by step made the role of each participating agency very clear, and I thought it gave the audience a great way to connect with the story and understand the importance of these networks on a really personal level. The best part was that the patient recovered thanks to this seamless response structure!

My favorite session this week was the closing session, a talk by D.A. Henderson, MD, MPH on the history of public health preparedness and where it needs to go in the future. Even though most of the attendees have been in this game a lot longer than I have, I think everyone there was just as captivated as I was. As you might guess, the trajectory Dr. Henderson presented was very much a before and after 9/11 trend, but he pointed out that since 2001 we haven’t had the steady increase in funding and training you might hope for. The theme of this year’s Summit was “Regroup, Refocus, Refresh: Sustaining Preparedness in an Economic Crisis,” and Dr. Henderson tackled this problem head on with his Complacency Curve to show the general decline in public health preparedness funding since 2001. My hope is that this curve will shift soon. This session also touched on a personal interest of mine with Dr. Henderson’s answer to an audience member’s question about declining vaccination rates and how we might convince parents to get their children immunized. When you’re talking preparedness it is easy to stay focused on biological and chemical warfare, but as a former healthcare worker, declining vaccine rates scare me just as much. While it might be a little gruesome, I had to agree that parents might be more willing to vaccinate if they knew just how bad some of the vaccine-preventable diseases can be. On the other hand, I know there are some parents who are never going to choose vaccination no matter what they’re advised to do. I’ll be interested to see where this issue goes as herd immunity gets weaker.

Aside from the early morning start-times (and the jet lag), we all had a great time and learned a lot. I hope the new ideas from this meeting stay with us when we get home, but the sooner the ticking of that prize wheel leaves my dreams, the better…

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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.