MEMBERSHIP
• Electronic test ordering and reporting
(ETOR): Supported by a grant from
the state’s County Medical Services
Program, the laboratory was the first
California public health laboratory
to establish a bidirectional interface
with local providers using a health
information exchange network for
ETOR. The system went live April 1,
2018.
Challenges
Back row (from l to r): Annayal Yikum, Roy Fuller, Jeremy Corrigan, Paula Moon, and Clara Bolster. Front row (from l to r): Kelsey
McMahan, Kylee Hee, Heather Maddox and Jessica Reynolds. Photo: Humboldt PHL
come through the laboratory en route to
either Sonoma PHL or the state public
health laboratory.
about $260,000 of federal public health
emergency preparedness funding,
$82,000 of federal homeland security
funding (for the purchase of a GeneXpert
testing platform), $220,000 from fee
income (which, under California law,
cannot exceed the actual cost of service
provision) and $773,000 of county public
health funds.
Success Stories
Humboldt PHL performs about 5,000 tests/
year, 3,000 of which are for childhood
blood lead testing. Core environmental
services include oyster testing; tick
speciation; Lyme disease testing for Ixodes
pacificus, the western black-legged tick;
animal rabies testing; beach water testing;
and drinking water testing in state parks
within the county and for a slew of local
festivals. Molecular tests run the gamut
from respiratory pathogens and childhood
vaccine preventable diseases to select
agents and emerging infectious diseases.
Just this year, the laboratory implemented
a test for dengue, chikungunya and Zika
viruses. • Microbial source tracking: For the
past several years, Humboldt County
has been home to the #1 “bad beach”
in California, according to an annual
report card issued by a local, non-profit
environmental group. Clam Beach
had the highest levels of total and
fecal coliforms measured in state
coastal waters. With funding from
the California State Water Resources
Control Board and technical support
from Sonoma PHL, Humboldt PHL
developed tests to differentiate human
fecal contamination from avian,
ruminant or canine contamination in
beach water. After almost three years
of testing, “we found that most of the
problem was from birds,” said Corrigan.
The state control board will soon make
recommendations to mitigate the
problem. Corrigan said, “I’m very proud
of this work.”
To simplify specimen submission, the
laboratory runs a courier service for
hospitals and clinics within the 50-to-60
square mile area around the local health
department, where most residents are
clustered. It also provides reference
testing and consultation services. Said
Corrigan, “If we can’t do the testing,
we will find somebody who can and
facilitate that testing with information
on sample type, holding temperature and
proper shipping conditions.” All suspect
tuberculosis specimens, for example, • Vibrio testing: Five or six years ago,
Humboldt PHL became the first public
health laboratory in California to begin
molecular testing for V. parahaemolyticus
in oysters. Earlier this year, the
laboratory was the first in the state to
implement the latest version of that
test, newly approved by the US Food
and Drug Administration’s National
Shellfish Sanitation Program. “We can
use this test to investigate a human
illness related to V. parahaemolyticus
from oysters,” said Corrigan.
Testing
PublicHealthLabs
@APHL
APHL.org
• Recruitment and retention of
microbiologists. “Of all the California
laboratories, we’re one of the lower-
paying laboratories. I’ve trained five to
six microbiologists, and they all end up
going someplace else to work.”
• “Getting samples to us is sometimes
difficult, because our population is so
spread out.”
Goals
• Bring tuberculosis testing in-house by
the end of 2018.
• Bring on syphilis screening and
confirmatory testing by the end of 2018.
• Connect local hospitals to the
laboratory’s electronic ETOR system.
• Conduct another microbial source
tracking research project to investigate
additional county beaches. n
Clara Bolster with a western blacklegged tick specimen which
will be tested for Borrelia burgdorferi, the causative agent of
Lyme disease. Photo: Humboldt PHL
Fall 2018 LAB MATTERS
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