Lab Matters Fall 2017 | Page 35

member spotlight

Society for Microbiology, the American Academy of Microbiology conferred upon Iwen the distinction of fellow.

Staff

NPHL directly employs 12 people( some partially supported through other university programs), including Iwen, six microbiologists, two chemists, an administrative assistant, a training coordinator and a state biosafety officer. Federal dollars also support positions in the NM clinical laboratory and in the NE-DHHS Public Health Environmental Laboratory in Lincoln.

Revenue

The annual budget fluctuates around $ 2 million, with most of that funding from federal grants coming through the NE-DHHS. The university supports basic functions, such as human resource assistance, security, sponsored programs management, IT support, environmental services, utilities and billing services. In addition, NPHL has access to electronic laboratory reporting( ELR) through the NM ELR system.

Testing

NPHL is responsible for roughly 50,000 public health tests a year. Those tests performed on site are highly specialized and include influenza and Zika virus PCR, epidemiological tests for foodborne pathogens, mosquito testing for arboviruses and tests for high-risk pathogens. As part of the latter, NPHL provides laboratory support for NM’ s Nebraska Biocontainment Unit( NBU)— one of ten regional US treatment centers that provide care for patients infected with a deadly infectious disease. As a member of the Laboratory Response Network for biological and chemical terrorism preparedness— and registered as a Tier 1 Select Agent laboratory— NPHL also performs select agent confirmatory testing and screens suspicious, unknown environmental samples. To control costs, Nebraska’ s newborn screening is contracted out to PerkinElmer, Inc.

Success Stories

• Collaborated to develop training on the safe handling / processing of specimens potentially containing a special pathogen through the National

Lead Technologist Vicki Herrerra trains staff of the National Ebola Training and Education Center on correct PPE use. Photo: NPHL

Ebola Training and Education Center, a federal program coordinated among UNMC, Emory University in Atlanta and Bellevue Hospital in New York City.

• Coordinated the laboratory testing for patients admitted to the NBU during the Ebola virus disease outbreak. NPHL was also the first public health laboratory to package and ship Ebola-infected specimens through a commercial courier.“ That was a big deal since no guidance was available at the time on how to do this,” Iwen said.

• Implemented a multiplexed PCR assay to detect gastrointestinal pathogens to include a program to provide culture services to support cultureindependent testing in Nebraska.

• Developed a web-based laboratory telemedicine service, STATPack TM, in collaboration with the University of Nebraska at Omaha. This program allows clinical laboratories to send digital images of suspicious or unknown organisms to the NPHL for identification or other consultation. More than 20 systems are now deployed in Nebraska, and the Oklahoma and Kansas state PHLs have also installed the system in their states.

• With UNMC, created a post-doctoral clinical microbiology fellowship training program, accredited by the Committee on Postgraduate Education Programs of the American Academy of Microbiology. The two-year program qualifies a fellow to sit for the examination for certification as a diplomat of the American Board of Medical Microbiology— a certification that qualifies PhD microbiologists to serve as laboratory directors under CLIA. Several individuals now working in public health have gone through this program at UNMC.

• Developed the Electronic Laboratory Information Reporting Technology( ELIRT) software to enable test ordering and reporting with NE-DHHS clinics. The system is integrated with the NM ELR( Sunquest System) and with the National Electronic Disease Surveillance System, through which Nebraska epidemiologists gain real-time access to reportable disease results.

• Established a statewide program to detect and confirm carbapenemaseproducing organisms.

• Produced an international quality assurance program for FTIR and Ramon devices.

• Set up a statewide specimen courier service in collaboration with UNMC Regional Pathology Services.

Challenges

• Providing services to a population spread across 77,000 square miles, including many“ completely rural” jurisdictions.

• Maintaining a highly competent staff of scientists in an environment of fiscal uncertainty.

• Adhering to the“ ever-changing regulatory requirements as defined by the Federal Select Agent Program and CLIA in a financially restricted environment.”

Goals

• Serve as a regional reference center for pathogens with high prevalence in Nebraska, such as West Nile virus and other arboviruses, Yersinia enterocolitica, Cryptosporidium and Francisella tularensis. Genetic characterization of F. tularensis is an ongoing collaborative research program among personnel at NPHL, UNMC and the US Department of Defense.

• Expand mutual research opportunities with UNMC faculty.

• Enhance relationships and integration with state epidemiologists, who are located in facilities 50 miles from NPHL.

• Continue upgrading the laboratory’ s information technology systems. n