Lab Matters Fall 2024 | Page 115

APHL 2024 POSTER ABSTRACTS

( DOH ) recreational beach program has demonstrated an increase in the number of waterbodies impacted by cyanobacterial blooms and total beach closure events within the last decade . For this study , NYSDOH partnered with Putnam County , a county in NYS that has consistently had multiple lakes with extended beach closures due to CyanoHABs , to evaluate the efficacy of current NYSDOH beach reopening protocols . The current NYSDOH protocol for beach closures is based on the visual presence of an algal bloom . However , per NYSDOH protocol , beach re-openings can occur only after two criteria have been met : the bloom must no longer be present in the designated swim area for at least a day before collecting and submitting a beach water sample and the sample must have total microcystin levels < 4 µ g / L based on measurements using the ELAP accredited EPA Method 546 , an enzyme linked immunosorbent assay ( ELISA ). Putnam County Department of Health staff collected time series samples in two lakes ( Lake Carmel and Lake Casse ) during the summer seasons of 2019-2021 and designated samples as pre-bloom , bloom , or post-bloom . The time series samples were analyzed for total microcystin ( EPA Method 546 ), a cyanobacteria specific 16S gene and the mcyE gene , the gene responsible for microcystin synthesis , via droplet digital PCR ( ddPCR ). Data from these two methods was compared to beach specific closure and re-opening data to evaluate current NYSDOH CyanoHAB beach reopening protocols .

Presenter : Madelyn Caldwell , madelyn . caldwell @ health . ny . gov

Implementation of a Mobile Lab-in-a-van to Expand Access to Saliva-based PCR Testing for Respiratory Infections in Underserved Communities

B . Choate 1 , A . Wyllie 2 , R . Sardana 2 , K . Fajardo 2 , J . Sinard 2 , C . Liu 2 , A . Levi 2 , SalivaDirect 1 , Yale 2

Introduction : By partnering with community leaders and public health officials to implement a mobile lab-in-a-van we aim to expand access to clinical diagnostic testing . This program addresses the ongoing need for diagnostic testing in underserved communities and works to overcome the inability or unwillingness to test due to patient concerns surrounding cost , transportation , or invasiveness . This is critical as many individuals will no longer have access to pandemic response testing , which previously alleviated capacity constraints and offered alternatives for individuals that lack a primary care provider , cannot access reliable health information , or have limited financial resources .

Methods : Through a RADx-UP grant supported by the NIH , a van equipped to provide high-complexity testing was secured and is operational under the Yale University School of Medicine ’ s department of pathology CLIA license to deliver onsite SARS-CoV-2 PCR results within two hours . By working with community partners in Connecticut we aim to identify , promote and deploy the mobile lab-in-a-van to offer saliva-based testing to underserved settings at trusted host sites . To increase uptake , we will evaluate the mobile lab by observing the utilization of testing sites and surveying community perspectives . Additionally , mobile lab personnel and signage will disseminate evidence-based public health information , educating the communities served about respiratory infection prevention , control and treatment .

Results : This project is ongoing . Results to date include successfully designing , delivering and deploying the mobile lab-in-a-van . Community partnerships have been secured to inform the overall project , specifically engagement efforts and ensure impactful van deployment . In collaboration with community partners , we use an online scheduling platform to organize events where individuals can receive free , saliva-based testing for SARS-CoV-2 . We have also laid the groundwork for analysis of the mobile testing experience by developing an IRB-approved survey . Results from the mobile van deployment and accompanying survey will inform future strategies for addressing the testing needs of underserved populations .

Conclusions : Operationalizing the mobile lab allows us to gain insights into how onsite testing programs can best serve target communities . We are also able to increase testing of respiratory viruses in underserved communities while providing care and evidence-based health education to vulnerable and underserved populations . We are gathering quantitative public health data around factors that influence community engagement and testing rates and hope to use the results to inform future innovative strategies to support pandemic preparedness .

Presenter : Brittany Choate , brittany @ salivadirectinc . org

Public Health Collaboration in the Detection , Characterization and Surveillance of a Neisseria meningitidis Serogroup Y Statewide Outbreak in Virginia

E . Craig 1 , L . Turner 1 , L . Fink 1 , A . Lorentz 1 , M . Robinson 2 , J . Crain 2 , Virginia Division of Consolidated Laboratory Services 1 , Virginia Department of Health 2

Background : Neisseria meningitidis ( Nm ) is a Gram-negative diplococcus and the causative agent of meningococcal disease , an invasive , vaccine-preventable illness that often presents as meningitis and / or septicemia . The bacterium is transmitted from person-to-person by direct contact with respiratory secretions or airborne droplets . The major virulence factor and basis for Nm serotyping is the polysaccharide capsule . Serogroups B , C and Y are responsible for the majority of meningococcal disease in the United States . As the Virginia state public health laboratory , the Division of Consolidated Laboratory Services ( DCLS ) receives Nm isolates from clinical laboratories for confirmation , additional characterization and surveillance as part of the Virginia Department of Health ( VDH ) reportable disease requirements . Determining the serogroup of Nm isolates , as well as sequence type , is critical for identifying outbreaks and initiating public health response , including postexposure prophylaxis ( PEP ) and vaccine administration .

Methods : DCLS utilizes commercial antisera to determine the serogroup of confirmed Nm isolates and reports the slide agglutination results to the submitter and VDH with a turn-aroundtime of 2-4 days . Between August and September 2022 , DCLS identified four isolates as Neisseria meningitidis serogroup Y ( NmY ), providing initial evidence to VDH of a potential outbreak . DCLS partnered with VDH and the Centers for Disease Control and Prevention ( CDC ) to coordinate shipment and whole genome sequencing ( WGS ) of NmY isolates to characterize the outbreak strain . Testing confirmed an outbreak based on genetic relatedness . Through further collaboration with VDH and CDC , DCLS began performing wet-lab WGS in November 2023 and provides data to the CDC for bioinformatic analysis .

Results : From August 2022 to January 2024 , DCLS identified 30 NmY isolates as part of this statewide outbreak . WGS was performed on all available isolates , either at CDC or DCLS and