public health preparedness and response
Public Health Laboratories:
A Resource for Sentinel Clinical Laboratories
by Sean Page, associate specialist, Public Health Preparedness and Response
Public health laboratories serve as
convener, trainer, coach and model for
sentinel clinical laboratories in their
jurisdiction. They provide trainings, tools,
exercises, assessments and guidance to
strengthen sentinel laboratories’ internal
operations and external connections with
laboratory system partners. In 2016 four
state public health laboratories sponsored
a range of activities designed to build
the capacity and capability of sentinel
laboratories in their states. Their efforts
offer instructive examples for other states
seeking to improve the performance of
their respective laboratory networks.
Iowa: Introducing Courier Service,
Training Laboratorians
The State Hygienic Laboratory at the
University of Iowa (IA SHL) expedited
delivery of specimens from clinical
sentinel laboratories by using Public
Health Emergency Preparedness
(PHEP) cooperative agreement funds
to support a statewide courier. In
2016, the courier conducted a total
of 11,939 regular transports and 229
urgent transports for the preparedness
and newborn screening programs.
Additionally, the IA SHL hosted trainings
for sentinel clinical laboratories
including a biological threat wet
workshop, a packaging and shipping
workshop and a bioterrorism “train-
the-trainer” workshop at its Center for
Advancement of Laboratory Science.
Specimen load at the State Hygenic Laboratory at the
University of Iowa
PublicHealthLabs
@APHL
North Carolina: Testing Emergency
Communications
Like the IA SHL, the North Carolina State
Laboratory of Public Health (NC SLPH)
used PHEP resources to engage sentinel
clinical laboratories in a notification
and communication drill designed to
gauge how quickly they could respond
to a request for information during an
emergency. Eighty-three laboratories
received the notification message
and a survey with instructions to
acknowledge receipt of the message
as soon as possible via email or fax. All
but two laboratories responded within
24 hours; 50% responded within 70
minutes and 90% within seven hours.
Nebraska: Improving Biosafety and
Biosecurity
University of Nebraska Medical Center’s
(UNMC’s) biosafety officer Roxanne
Alter, MS, MLS(ASCP), visited 77 sentinel
clinical laboratories in 2016 to train staff
in biosafety practices. APHL supports
training and resources for her work
under a three-year award from CDC to
strengthen biosafety for public health
and sentinel clinical laboratories.
Alter follows a three-step outreach
process. She begins by sending the
laboratory a series of questions about
its biosafety and biosecurity practices,
and biosafety resources developed
by CDC and APHL. She then visits the
facility and conducts a walkthrough
to examine the laboratory’s workflow.
Finally she gives a verbal report and
distributes a letter documenting areas for
improvement and an evaluation form.
In 2017 Alter is conducting follow-up
visits to monitor implementation of
recommended changes. Improvements
to date include supplying staff
with lab coats and proper PPE and
installing splash guards to prevent
unintended aerosol exposures.
APHL.org
Roxanne Alter reviews her clinical laboratory biosafety
checklist during a recent site visit
New Mexico: Utilizing Simulations
to Strengthen Collaboration
LRN-B staff from the New Mexico
Department of Health (NMDH) trained
members of the 64th Civil Support Team
(CST) to process respiratory specimens
under a scenario in which the Laboratory
Information Management Syste