APHL 2021 Poster Abstracts
Infectious Disease / Informatics
Rebuilding Capacity for Rabies Surveillance in Puerto Rico : A One Health Approach
J . Sutton 1 , W . Rivera Diaz 2 ; 1 Association of Public Health Laboratories , Silver Spring , MD , 2 Laboratorio de Salud Pública y Bioseguridad , San Juan , PR
Rabies is a serious threat to human and animal health . Following hurricanes and other natural disasters , large numbers of displaced animals can have a significant impact on the transmission of rabies between animals and humans . Mongoose populations in Puerto Rico have become a reservoir for rabies . Usually , rabies cases in humans occur after a mongoose has bitten a dog and the dog then bites a human . To address this problem , the Puerto Rico Department of Health provides post-exposure prophylaxis ( PEP ) for anyone seeking medical attention after a bite . Unfortunately , PEP is expensive and can cost hundreds of dollars per dose . Improving surveillance activities can significantly decrease rabies cases in Puerto Rico , in turn , reducing the cost burden to the jurisdiction . In 2018 , the Association of Public Health Laboratories ( APHL ) was awarded a $ 16.7M cooperative agreement by the CDC Center for State , Tribal , Local and Territorial Support ( CSTLTS ) to support crisis response and recovery in Puerto Rico , US Virgin Islands and Houston , TX following Hurricanes Harvey , Irma and Maria . Via this funding , APHL ’ s Public Health Preparedness and Response ( PHPR ) program collaborates across the association , with CDC and other external partners to support laboratories and public health systems respond to and recover from public health crises . Rabies program activities at the Puerto Rico Department of Health ( PRDOH ) is one project supported under this cooperative agreement aimed at strengthening capacity to provide surge support for rabies testing for nearby jurisdictions , improve rabies surveillance and case management support , and increase awareness and professional education efforts . To strengthen surveillance capacity for Rabies in Puerto Rico , APHL ’ s PHPR program coordinated with the State Office of Animal Control ( also known as OECA ) within PRDOH to develop a collaboratively sourced , web-based platform for sheltered pets in Puerto Rico . The platform can serve as an electronic reporting database to collect statistics on the incidence and prevalence of stray animals across the island as well as educate the public on the prevention of zoonotic diseases and animal welfare . This poster will highlight development of the web-based platform and how data collected from it will be used to improve surveillance activities and help prevent the transmission of rabies in Puerto Rico .
Presenter : Wilma Rivera Diaz , Puerto Rico Public Health Laboratory , wilrivera @ salud . pr . gov
INFORMATICS
Migrating the 50 States to S3 : Revolutionizing Public Health Data Transport Across America
A . McShane , Ruvos , Tallahassee , FL
Bridges and roads require maintenance over time , and sometimes , physical infrastructure inevitably needs replacing if it cannot sustain the load it is asked to carry . Much like physical infrastructure , network infrastructure like the connections between the AIMS Platform and its many partners needs to be constantly maintained and improved . The Public Health Information Network Messaging System ( PHINMS ) is the CDC-provided transport protocol software that at one time was used by nearly all 50 states and was still used by dozens of states in the beginning of 2020 . At its inception , it was a revolutionary tool , satisfying the need at that time for a standard , secure , no-cost , bidirectional transport between the CDC and its partners . With a global pandemic and new methods of tracking and tracing infectious diseases constantly being created to improve safety and livelihood for all , the strain being placed on public health is not slowing down . In 2020 , these strains on existing information highways became evident when large files and increasing volumes caused existing transport protocols on AIMS to buckle . The PHA Migrations to S3 project was an initiative designed to maintain and improve the AIMS Platform , future proofing it from file size and volume increases for years to come . Enter : Amazon Web Services Simple Storage Service ( S3 ). This technology allows for seamless direct transmission of files to and from any trading partner on AIMS while also addressing the major problems with existing technology : Problem : PHINMS requires users to purchase , maintain , and regularly renew expensive digital certificates and exchange encryption keys with trading partners . Solution : S3 does not require digital certificates ; secure transmission and encryption are native , and partners do not need to exchange keys . Problem : PHINMS is unable to transmit large files . When PHINMS encounters a file that is too large to transmit , it creates a data clog and prevents any files intended for that destination from reaching that destination until the poller is restarted and files reprocessed from the engine . Solution : S3 can transmit vastly larger files than current loads require . No data clogs occur , significantly lowering required support , maintenance manpower , and downtime intervals & frequency . This project is approximately 75 % complete at time of writing this abstract , and we look forward to having it complete by the time of the Annual Meeting . We will share metrics on adoption rate , explain impacts and constraints , and share the benefits to overall public health .
Presenter : Alissa McShane , Ruvos , alissa . mcshane @ ruvos . com
The Role of eOrder in Reducing Human Error and Specimen Rejection Rates at the NYC Public Health Laboratory
S . Suleiman , R . Garcia Guzman , S . Di Lonardo , J . Rakeman and S . Hughes , New York City Public Health Laboratory , New York City , NY
eOrder , first introduced to the New York City Public Health Lab ( PHL ) test processing workflow in 2018 , is a web-based electronic test ordering and reporting system utilized by external submitters ( e . g . hospitals , private practices ). The goals of eOrder were to transition submitters from paper requisitions to electronic orders , reduce data entry errors , provide electronic reporting of results and streamline accessioning workflow . Transitioning from paper requisitions is key in improving workflow as delays in specimen processing were impacted by errors from manual recording of test orders . These problem specimens were tracked and noted by staff in the StarLIMS ( Lab Information Management System ) database upon arrival at the lab ; the data were then queried into a pre and post eOrder adoption report . The goal of this analysis is to evaluate the impact of eOrder on PHL ’ s rate of rejection , problem specimens and turn-around time ( TAT ). Implementation of eOrder was initially gradual (~ 25 % of test submissions via eOrder after 2 years ); however , required use of eOrder for SARS-CoV-2 test submissions drastically increased enrollment and by the end of April 2020 , 85 % of all orders were submitted to PHL via eOrder . During this period , submitter data entry errors accounted for 61 % of reported problem specimen issues before the mandatory January 2020 switch from paper to electronic orders . Between January 2020 and April 2020 , we enrolled 75 %
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LAB MATTERS Summer 2021 |
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