Lab Matters Fall 2019 | Page 39

MEMBERSHIP Disease Manager Debbie Rutledge, MBA, MT (ASCP); Biosafety Official Gregory Hovan, MBA; Laboratory Manager Clover Carlisle, MLT; Laboratory Manager Karen Pollard, MLT (ASCP), MSHS; Laboratory Manager Emily Hanlin, MPH; Quality Assurance Manager Fred Franze, MT (ASCP); and Laboratory Manager Margaret Zimmerman, ASQ-CQA. Overall, the staff includes 18 microbiologists, five chemists, seven managers, two IT professionals (one shared with state services and one full time at the laboratory), seven administrators, six couriers/water sample collectors, a quality assurance manager, CLIA compliance officer, a housekeeping professional, building maintenance engineer, biosafety officer, and senior leadership. Revenue The laboratory’s annual budget runs to about $6 million. Roughly $2.3 million of that total comes from federal grants, and the remainder is state funding. Testing DE PHL performs over a million analyses each year. The highest volume clinical test area—50,000 tests/year—is for sexually transmitted diseases. Clinical microbiology and sequencing is another high-volume area. The laboratory is a member of the Antibiotic Resistance (AR) Laboratory Network, the national PulseNet foodborne disease surveillance network and the Food Emergency Response Network. Since poultry is big business here, the laboratory partners with the DNREC to test chickens on a weekly basis for mosquito-borne illnesses, such as West Nile virus and Eastern Equine Encephalitis. The molecular biology laboratory also performs human rabies and vaccine-preventable disease testing, and conducts surveillance for human influenza virus, arboviruses and norovirus. On the environmental side, the PHL performs about 120,000 tests per year on drinking water to measure levels of bacteria, 25 different inorganic compounds and 70 organic compounds. PublicHealthLabs @APHL For just $4.00, the state’s 80,000 private well owners can submit initial well water samples to test for nutrients and bacteria. Recently, the laboratory began a Legionella test program. Finally, as a member of the Laboratory Response Network for both biological and chemical agents, the PHL tests unknown samples to detect and/or rule out a suite of potential threat agents. Success Stories The Delaware PHL: • Was one of the first laboratories in the US to join CDC’s AR Laboratory Network and to be up and running in 2017 with validated methods. It was also one of the first state PHLs to use APHL’s AIMS portal to transfer AR test data to CDC’s national AR database. • Was one of the first states to move from serology and PFGE to whole genome sequencing for all enteric disease testing to enhance foodborne disease surveillance. (The laboratory also employs WGS to support surveillance of hospital-acquired infections.) • Is the only Delaware laboratory with capability to track foodborne pathogens. Just last year, the PHL identified an internal, Salmonella enteritidis outbreak linked to a vendor supplying food to homeless people. “Only internal state analysis would have picked this up.” • Is the only Delaware laboratory that can test for Ebola virus, novel corona virus and other emerging pathogens. In 2017, the PHL detected a case of chikungunya virus. Challenges • The laboratory facility: “The facility was fine for its time in the early 1990s. But technologies have become more sensitive and sophisticated, requiring a more narrow and precise range of temperature and humidity exposure, for example. It’s a challenge to maintain that level of control, and that means increased costs.” APHL.org • The workforce: “Because we’re surrounded by major cities, we have to put extra effort into finding qualified personnel. We have people who are ‘active’ seven days per week, if necessary. Private labs don’t require that level of commitment and can offer significant sign-on bonuses. That makes it difficult for us to recruit.” • Procurement: “We have to work within a political system that has institutional protocols that move slower than what the laboratory requires to meet operational needs.” Goals • To continue to adopt cutting-edge technology. “It has to be done; we cannot stay with the old technologies or we get run over. Often, we don’t even wait for proven technologies; we’ll adopt technologies that are still being tested.” • To make the public health laboratory a center of excellence for the US. “We will be the experts to come to over time. And we have the expertise to do that.” • To raise salary levels over time, a goal requiring legislative action. • To consolidate Delaware’s state public health, environmental and agricultural laboratories. “We have blueprints for a new laboratory building to be constructed, ideally, at our Smyrna site. Cabinet secretaries have supported this, and our state legislature is considering it. Economically, it’s a good move.” • To intensify data-mining. “We have more than 40 years of data on surface waters, ground waters and other areas of interest that can be used for various reasons, from permitting to assessments to predicting future outcomes. No one has used these comprehensively. We’ve proposed a high-level group that will do only data-mining to identify health and environmental ‘hot zones,’ inform resource management and gauge impacts on public and environmental health.” n Fall 2019 LAB MATTERS 37