Lab Matters Summer 2018 | Page 84

APHL 2018 Annual Meeting Poster Abstracts

Preparedeness and Response advisor and USACE engineers , visited PRDH laboratories . Sites were systematically evaluated over the next six weeks to assess the hurricane ’ s impact on facilities , environmental health and operational capacity . Independent assessments from CDC and response partners were synthesized in the context of biosafety and laboratory quality management systems principles to strategically identify critical structural , resource and operational needs .

Results : The assessments identified structural and resource challenges to restoring services . Short-term needs included critical structural repairs ( e . g ., roof damage ranging from 1 % -30% surface area ), repair of essential equipment damaged by loss of power and replacement of essential reagents ( 69 % and 92 % of laboratories affected , respectively ). Long-term needs included restoration of power , facility reconstruction , mold remediation and equipment re-qualification . Laboratory needs analysis based on the Quality System Essentials framework informed strategic recovery efforts .

Conclusions : These assessments demonstrate a collaboration between PRDH , CDC and response and recovery partners including APHL , FEMA , USACE and HHS / ASPR . Integrated analysis of the facility assessments facilitated the transition to the recovery phase and laid the groundwork towards restoring PRDH laboratory capacity .

Presenter : Rita Stinnett , MHS , PhD , Centers for Disease Control and Prevention , Atlanta , GA , Phone : 404.718.6779 , Email : nrk2 @ cdc . gov

An Analysis of Laboratory Response Network for Biological Threat Preparedness ( LRN-B ) Member Laboratory Test Data , 2009 – 2016

J . Villanueva , B . Schweitzer , M . Odle and T . Aden , Centers for Disease Control and Prevention , Atlanta , GA

Created in 1999 , the objective of the Laboratory Response Network for Biological Threat Preparedness ( LRN-B ) is to ensure an effective response to bioterrorism by helping to improve the nation ’ s public health laboratory infrastructure . A biothreat incident , which may be an intentional attack or an introduction of a novel , emerging infectious disease , could occur anywhere in the United States . Therefore , a comprehensive public health plan for response is critical . The success of associated response activities will depend on rapidly and accurately identifying the biothreat agent associated with the event . The use of electronic reporting systems to rapidly communicate laboratory results has been utilized throughout the existence of LRN-B . Here we describe a subset of biothreat test data from LRN-B member laboratories from 2009 – 2016 . LRN-B member laboratories have the ability to test for multiple biothreat agents . The number of tests performed by LRN-B laboratories for biothreat agents has doubled in the past eight years , increasing from approximately 2700 tests in 2009 to almost 6000 tests in 2016 . Over the past eight years , LRN-B member laboratories have tested and reported results from an average of 686 environmental samples per year including white powder-like substances such as those contained in letters that reference anthrax . Since 2009 , LRN-B member laboratories have reported testing an average of 887 samples for B . anthracis per year . Since 2010 , the average percent positivity of samples for B . anthracis has averaged 0.3 % with only two samples reported positive from 2014-2015 . The percent positivity of samples for biothreats such as Brucella species , F . tularensis and Y . pestis have increased in the time period analyzed in this study . LRN-B member laboratories performed and reported more than 4600 tests for Brucella species from 2009- 2016 , with the number of tests performed increasing each year . Increases in testing volume may be related to increasing animal and human populations and the connection between the health of people , animals and the environment . Since many recent risk assessments highlight the zoonotic origin of most emerging infectious diseases in humans , developing and maintaining testing capability and capacity for these organisms is critical to public health protection . LRN-B member laboratories have demonstrated superior capability and capacity in managing the increases in testing volume through the past eight years . However LRN-B must continue to be a high priority in order to provide continued , real-time monitoring for biothreat agents .

Presenter : Julie Villanueva , PhD , Centers for Disease Control and Prevention , Atlanta , GA , Phone : 404.639.3851 , Email : jfv3 @ cdc . gov

Initial Public Health Laboratory Response in Puerto Rico after Hurricane Maria — Puerto Rico , 2017

B . White , Centers for Disease Control and Prevention , Atlanta , GA

Background : Hurricane Maria caused significant damage to Puerto Rico Department of Health ( PRDH ) laboratory buildings and equipment , rendering them largely inoperable . Consequently , PRDH was unable to detect and diagnose many infectious diseases that may affect Puerto Rico ’ s 3.5 million US citizens . In response to a request for assistance by PRDH , the CDC Infectious Disease and Medical Countermeasures Task Force Laboratory Team ( Lab Team ) sought to establish an alternative approach to laboratory testing to restore disease surveillance .

Methods : The Lab Team deployed to Puerto Rico to implement a system for shipping specimens to the continental US for surveillance , confirmatory , or diagnostic testing of five high priority infectious diseases ( rabies , influenza , leptospirosis , salmonella and tuberculosis ). The Lab Team collaborated with CDC Foundation to coordinate specimen shipments , partnered with CDC , APHL and state laboratories for testing and created a secure mechanism to report results to PRDH .

Results : Within 27 days of Hurricane Maria , the Lab Team identified 16 CDC and state health laboratories to perform specimen testing and began shipping specimens . During October 17 , 2017 – December 20 , 2017 , the Lab Team facilitated the transport of 1,306 specimens for testing . This novel , sustainable transport system allowed Puerto Rico to re-initiate disease surveillance and identified 138 cases of high priority infectious diseases . Testing results allowed PRDH to investigate cases , identify additional suspect cases and target public health messaging for food and water safety , prevention of leptospirosis and the importance of influenza vaccinations , as well as continued vigilance in diagnosing and treating tuberculosis .

Conclusions : The Lab Team developed and implemented a sustainable specimen transport system that reestablished clinical testing and surveillance of priority infectious diseases in Puerto Rico and informed public health interventions . This is an unprecedented example of federal , state and territorial collaboration to re-establish specimen testing and disease surveillance for an entire jurisdiction .

Presenter : Brunie White , Centers for Disease Control and Prevention , Atlanta , GA , Phone : 404.639.3673 , Email : wri2 @ cdc . gov