Lab Matters Fall 2024 | Page 84

APHL 2024 POSTER ABSTRACTS

determine if ingestion of supplements would result in detectable DNA in patient stool samples . Nonetheless , with the increased popularity of spirulina-based supplements , clinicians should consider inquiring about dietary supplement intake in patients to aid in the interpretation of results provided by molecular tests such as the GI Panel .

Presenter : Emily Verbrugge , emily . verbrugge . contractor @ state . mn . us

The Kibble Trail

M . Davis , D . Waggoner , S . Sweeney , South Carolina Public Health Laboratory

As part of routine surveillance , in August 2023 , a bag of dog food was collected by the South Carolina Department of Agriculture ( SCDA ) and delivered for testing at the South Carolina Department of Health and Environmental Control ( SC-DHEC ) Public Health Laboratory . As part of routine testing this sample was tested for Salmonella spp and Escherichia coli O157 . On August 19th preliminary findings of Salmonella spp were shared with the FDA and the SCDA . The sample was confirmed to be Salmonella Kiambu and whole genome sequencing ( WGS ) was completed . These findings were shared with the State Regulatory Program in the state where the dog food was manufactured . This positive Salmonella finding led to a recall of the lot of dog food that was tested . Analysis of WGS data by FDA was able to link the isolate recovered from the dog food tested at SC-DHEC to seven patients from seven states . Investigation by CDC into WGS linkage was able to provide epidemiologic evidence with the tested product . In early November 2023 , additional testing of product by the manufacturer ’ s third party testing laboratory identified Salmonella in additional products and there was an additional limited recall . A recall of all brands produced by this manufacturer at their Mount Pleasant , TX plant was initiated on November 9 , 2023 .

Presenter : Dana Waggoner , waggond2 @ dhec . sc . gov

The North Carolina State Laboratory of Public Health ’ s Role in the Nationwide WanaBana Fruit Puree Lead Recall

M . Komlos , T . Dunbar , K . Greene , D . Pettit , S . Shone , C . Goforth , North Carolina State Laboratory of Public Health

The North Carolina State Laboratory of Public Health ( NCSLPH ) is accredited through the American Industrial Hygiene Association Lead Assessment Program ( AIHA LAP , LLC ) to test traditional environmental samples ( dust wipes , paint chips and soils ) to detect the source of lead exposure . As blood lead action levels have lowered , environmental investigations have become more complex , requiring the collection and analysis of non-traditional matrices ( spices , ceremonial , powders , herbal remedies , cosmetics , toys and many types of foods ) to find the source of lead exposure . These testing services are provided to the North Carolina Childhood Lead Poisoning Prevention Program ( CLPPP ) within the North Carolina Department of Health and Human Services ( NC DHHS ) Division of Public Health ( NC DPH ). In late 2023 , NCSLPH detected extremely elevated levels of lead in WanaBana Apple Cinnamon Fruit Purée pouches leading to a national recall .

In September and October 2023 , CLPPP conducted environmental investigations at three homes ( four children ) whose blood lead levels were > 7.7 µ g / dl . Analysis of traditional environmental samples from the households did not indicate a source of lead exposure . However , each child had a history of frequently consuming WanaBana Fruit Purée pouches purchased from different locations of a national discount store chain . WanaBana Fruit Purée pouches present in the children ’ s homes were collected and submitted for analysis at the NCSLPH . Lead concentrations were found to be between 1.9 and 3.0 mg / kg in the WanaBana Apple Cinnamon Flavored Fruit Purée pouches . Analysis of other WanaBana flavors ( apple banana , pineapple banana and mango banana ) did not result in detectable lead concentrations . Subsequent testing of multiple lots of WanaBana Apple Cinnamon Fruit Purée pouches bought at various store locations implicated this product as the likely source of lead exposure .

Various lot numbers of this product were tested at the NCSLPH during subsequent environmental lead investigations across the state . All samples had lead concentrations > 1.9 mg / kg . Initial product testing by the NC Department of Agriculture and Consumer Services found concentrations within 10 % of NCSLPH results for the same lot numbers . Collectively , the findings from elevated blood lead investigations with NC DPH generated a coordinated public health response including WanaBana ’ s voluntary recall of the Apple Cinnamon Fruit Purée pouches ; a safety alert issued by the US Food and Drug Administration ( FDA ); multiple investigations by the FDA , Centers for Disease Control and Prevention ( CDC ) and foreign governments ; and nationwide media exposure to educate families about the dangers of toxic lead hazards .

This experience illustrates how state public health laboratories must be prepared to provide a robust response when presented with new hazards that may pose a risk to the general population . This response must not only take full advantage of the laboratory ’ s resources to provide timely and accurate data that informs public health decision making ; but it must also ensure that data is communicated with local , state and federal public health partners in a timely manner to allow for rapid confirmatory testing .

Presenter : Chris Goforth , chris . goforth @ dhhs . nc . gov

INFORMATICS

A Case Study of the Pros and Cons of Transitioning Computational Environments from On-premises to the Cloud

J . Arnn , T . Iverson , E . Young , K . Oakeson , Utah Public Health Laboratory

Purpose : Bioinformatic analyses are becoming an integral part of public health surveillance , from subtyping of pathogens to assisting in outbreak detections and responses to tracking viral variant transmission in the community . However ; The computational environment for bioinformatics can limit the speed , type and reproducibility of analyses that can be done . Moving from local resources to cloud computing represents a significant shift in how computational resources can be managed in the field of bioinformatics . On-premise computation requires electricity , dedicated hardware and occupied space . Its security and operational software must be updated and maintained . Cloud computing pushes those responsibilities to the provider and allows