member spotlight up here permanently, I would jump at that opportunity.” It came in 1999, when Jilly got a call from an Alaska colleague who reported that the state PHL director had just resigned. Jilly applied for the job and assumed the post in 2000.
Staff
The laboratory has 38 staff positions, down from 60 in 2000, before world oil prices began collapsing, prompting a series of budget cuts. The day Jilly was interviewed for this article, his health physicist retired. Jilly said,“ He was the only radiation expert in the whole state. I’ m supposed to have two, but I could never fill the second position.” Current staff include 25 microbiologists, three chemists, two physical plant workers and seven administrative staffers. The laboratory is actively recruiting for a Chemist 4 with mass spectrometry experience and a PhD-level scientist with molecular diagnostic experience to head the LRN-B lab.
Revenue
The laboratory’ s $ 7.5 million annual budget comes from federal grants($ 3 million), entrepreneurial contract work($ 0.5 million) and state funds($ 4 million).
Testing
The laboratory’ s test menu is skewed toward infectious diseases, especially TB( for which it is the sole test provider in Alaska), Chlamydia, gonorrhea, hepatitis and viral influenza. It is a member of the Laboratory Response Network( LRN) for biological and chemical testing and the CDC Select Agent Program.
Molecular work ranges from identifying drug resistance and sensitivity markers in hepatitis C to sequencing clinical and foodborne isolates associated with foodborne disease outbreaks. The laboratory is the sole Alaska member of the APHL-CDC PulseNet foodborne disease surveillance network.
Laboratory chemists participate in the LRN for chemical testing. Work includes:
• 24 / 7 toxic alcohol and ethylene glycol analysis for local hospitals.
The microbiology staff at Alaska PHL
• Trace drug analyses for the state’ s Children of Need program, mostly looking for exposure to illicit drugs to inform decisions about household safety.
• Limited work for the state medical examiner, mostly analyses of potential carboxyhemoglobin- or methemoglobin-containing specimens.
• Occasional testing for fentanyl, synthetic cannabinoids and the like.
• Finally, the laboratory maintains the only near real-time EPA radiation monitoring station in Alaska, which is situated atop the Anchorage facility.
Success Stories
Securing funding for two Illumina ® MiSeq next generation sequencing platforms. Scientists hope to present a paper on the Clostridium botulinum genome at an upcoming whole genome sequencing conference.
Building a succession plan:“ I managed to snag one of the last APHL-CDC Emerging Infectious Disease fellows, Jennifer Eastman, PhD, and she is my lab manager in Anchorage. I’ m hoping for her to take my place when I retire. Additionally, the manager of the Fairbanks lab, Jayme Parker, is finishing her doctorate and is an active consultant for APHL’ s international influenza activities.”
Investigating an invasive Group A Streptococcus aureus outbreak this past winter:“ The main outbreak started in Fairbanks and exploded among the homeless population in Anchorage. We had over 100 specimens / day for a few days. We found that a really unusual emm type of strep seemed to be causing the symptomatic disease.”
Challenges
Funding:“ There’ s never enough money to go around and an ever increasing amount of work to do. Because we are a specialty lab, we end up with the new and weird things that arise.”
Staffing:“ Usually we get people because their spouse relocates to Alaska. We have no medical school up here and only a small med tech program. There’ s no pool to recruit from.”
Transportation:“ Only two cities are connected by road here, Anchorage and Fairbanks. If nurses go to a remote village to do a TB sweep, they have to travel by boat or, in winter, by snowmobile and bush plane. It can be challenging to get a specimen to the lab. Average transport is about a week when things go well. We’ ve had some specimens not get to us in 30 days. And for something like a TB specimen, that’ s real close to when the specimen goes south. Getting supplies and equipment up here is pretty expensive, because everything has to come by air.”
Informatics:“ The state government consolidated most IT staff in the central bureaucracy, so it is increasingly hard to get IT support familiar with all the complexities of the lab. We’ ve managed to hang onto two IT staff here in the lab, but they are technically part of another group.”
Dealing with the rapid spread of culture-independent assays:“ How will we do our investigations when they’ ve destroyed the bug [ in initial testing ]?”
Goals
“ I hope to keep the lab outfitted with the best technology we can get and to remain at the peak of our scientific capabilities. Right now, we’ re upgrading our laboratory information management system, so we can finally entertain electronic test ordering and results reporting. We hope to be operational within the next 12 months, so we can get away from snail mail. Mail can take up to a month to get to certain places [ in the state ]. Electronic reporting will be more efficient and cost-effective. Ultimately, I’ d like to keep the lights on and the doors open and do the best we can.” n
PublicHealthLabs @ APHL APHL. org
Summer 2017 LAB MATTERS 37