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