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Public Health Laboratory Testing

 

Capability 12: Public Health Laboratory Testing

 

Definition: Public health laboratory testing is the ability to conduct rapid and conventional detection, characterization, confirmatory testing, data reporting, investigative support, and laboratory networking to address actual or potential exposure to all-hazards. Hazards include chemical, radiological, and biological agents in multiple matrices that may include clinical samples, food, and environmental samples (e.g., water, air, and soil). This capability supports routine surveillance, including pre-eventor pre-incident and post-exposure activities.

 

Functions and Associated Performance Measures: This capability consists of the ability to perform the functions listed below. Associated CDC-defined performance measures are also listed below.

 

Function 1: Manage laboratory activities

  • Measure 1: Time for sentinel clinical laboratories to acknowledge receipt of an urgent message from the CDC Public Health Emergency Preparedness (PHEP)-funded Laboratory Response Network biological (LRN-B) laboratory 
  • Measure 2: Time for initial laboratorian to report for duty at the CDC PHEP-funded laboratory

Function 2: Perform sample management

  • Measure 1: Percentage of Laboratory Response Network (LRN) clinical specimens without any adverse quality assurance events received at the CDC PHEP-funded LRN-B laboratory for confirmation or rule-out testing from sentinel clinical laboratories
  • Measure 2: Percentage of LRN non-clinical samples without any adverse quality assurance events received at the CDC PHEP-funded LRN-B laboratory for confirmation or rule-out testing from first responders
  • Measure 3: Ability of the CDC PHEP-funded Laboratory Response Network chemical (LRN-C) laboratories to collect relevant samples for clinical chemical analysis, package, and ship those samples

 

Function 3: Conduct testing and analysis for routine and surge capacity

  • Measure 1: Proportion of LRN-C proficiency tests (core methods) successfully passed by CDC PHEP-funded laboratories
  • Measure 2: Proportion of LRN-C proficiency tests (additional methods) successfully passed by CDC PHEP-funded laboratories
  • Measure 3: Proportion of LRN-B proficiency tests successfully passed by CDC PHEP-funded laboratories

Function 4: Support public health investigations

  • Measure 1: Time to complete notification between CDC, on-call laboratorian, and on-call epidemiologist
  • Measure 2: Time to complete notification between CDC, on-call epidemiologist, and on-call laboratorian

Function 5: Report results

  • Measure 1: Percentage of pulsed field gel electrophoresis (PFGE) subtyping data results for E. coli O157:H7 submitted to the PulseNet national database within four working days of receiving isolate at the PFGE laboratory
  • Measure 2: Percentage of PFGE subtyping data results for Listeria monocytogenes submitted to the PulseNet national database within four working days of receiving isolate at the PFGE laboratory
  • Measure 3: Time to submit PFGE subtyping data results for Salmonella to the PulseNet national database upon receipt of isolate at the PFGE laboratory
  • Measure 4: Time for CDC PHEP-funded laboratory to notify public health partners of significant laboratory results

Public Health Laboratory Testing: Online Trainings

 Anatomy of a Foodborne Outbreak [1]

Sentinel laboratories are usually the first to receive patient samples related to foodborne illness and therefore, they fill a vital role in the early detection and investigation of foodborne outbreaks. In this short course, you will see the story of three victims of illness related to food contamination. By following the steps leading from initial food ingestion, to an epidemiological investigation and the final identification of the contaminated food, you will learn the importance of making timely and appropriate decisions for submissions to the state public health laboratory. The course also offers a training section and a checklist for the detection, isolation and submission of STECs. When you have completed the course, you will be able to print a certificate suitable for your competency training records.

 Electronic Bioterrorism Workshop for Sentinel Labs [2]

This course is intended for laboratorians who handle biological and microbiological samples in clinical, reference, public health, animal, research or teaching laboratories. The course consists of a Virtual Bioterrorism Workshop. In this interactive workshop you will determine whether to rule out or refer several organisms that are considered potential agents of bioterrorism by applying Laboratory Response Network protocols for Level A (sentinel) laboratories. When a possible agent of bioterrorism cannot be ruled out, you will view a video describing the clinical presentation and etiology of the agent. 

 The Role of Sentinel Labs in Emergency Response [3]

This course provides an introduction to the Laboratory Response Network (LRN) architecture. Upon completion of the course, learners will be able to: describe and define a Sentinel Laboratory, understand the roles of basic and advanced Sentinel Laboratories in an emergency response, and identify and understand the use of available resources and reference materials relevvant to Sentinel Laboratories during emergency response. 

 Introduction to Public Health Laboratories [4]

Specifically designed for busy laboratorians, this course provides an introduction to the national laboratory system, an overview of how it functions, and information about a laboratorian's role within the public health lab system.

 Biosafety: Avoiding Lab Aquired Infections [5]

This course prepares laboratorians to understand the dangers posed by working pathogens commonly encountered in the laboratory and recovgnize how the consisten use of safe work practices can provide proection. Upon completion of the course, learners will be able to differentiate between the four biosafety levels in laboratories and know when each is used; explain how a biosafety cabinet (BSC) works, know how to use it properly and recognize when it is required for safety; identify several dangerous pathogens that have contributed to laboratory-acquired infections and recognize thet "trigger points" for safe-handling which are associated with each one; and define the responsibilities of management in creating a safe laboratory environment.

Public Health Laboratory Testing: Resources

Infectious Disease Emergency Response (IDER) Toolkit [6]
The Infectious Disease Emergency Response (IDER) Toolkit was developed to assist local health departments in developing and/or supplementing their infectious disease emergency response plans in order to strengthen their ability to prepare for and respond to infectious disease emergencies.  Whether a local health department utilizes the entire IDER Toolkit, or simply supplements an existing plan with specific items, the IDER Toolkit contains materials that are useful and appropriate for all types of local health departments. Users of the IDER Toolkit should be able to: Recognize how the Incident Command System may be adopted to plan for and respond to infectious disease emergencies; Discuss the necessary roles and responsibilities during an infectious disease emergency response; Describe how to develop an infectious disease emergency response plan.

 

Guidelines for the Public Health Laboratory Continuity of Operations Plan [7]
These guidelines build upon the 2007 Association of Public Health Laboratories (APHL) COOP Guidelines, as well as the FEMA Continuity of Operation Plan Template and Instructions for Federal Departments and Agencies (February 2011). The purpose of the guidelines is to assist state public health laboratories in developing a COOP to ensure continuation of their essential public health activities during events that may disrupt normal operations.

 

Preparedness for Specific Types of Laboratory Information [8]
An overview of the CDC’s Laboratory Response Network (LRN) and information on biosafety, response plans, testing, presumptive agent identification, guidance on specimen collection and shipping, training on coping with bioterrorism, and contacts for questions.

 

National Laboratory Training Network (NLTN) [9]
NLTN, a joint program of APHL and the CDC, develops and delivers education programs for professionals in both public and private sector laboratories. NLTN develops training products in multiple formats, presented by expert faculty, to address a variety of learners’ preferences, as well as level of training from broad overviews to intricate, step-by-step, detailed testing methods incorporating hands-on practical experiences. Training types include hands-on workshops, on-demand courses, teleconferences, and seminars.

 

Public Health Laboratory Testing: Drills & Exercises

National Planning Scenarios [10]
The Federal interagency community has developed 15 all-hazards planning scenarios (the National Planning Scenarios or Scenarios) for use in national, Federal, State, and local homeland security preparedness activities. The Scenarios are planning tools and are representative of the range of potential terrorist attacks and natural disasters and the related impacts that face our nation. The objective was to develop a minimum number of credible scenarios in order to establish the range of response requirements to facilitate preparedness planning.


Links
[1] http://go.prepareiowa.com/url/f6
[2] http://go.prepareiowa.com/url/it
[3] http://go.prepareiowa.com/url/f7
[4] http://go.prepareiowa.com/url/is
[5] http://go.prepareiowa.com/url/if
[6] http://apc.naccho.org/Products/APC20102190/Pages/IDER.aspx
[7] http://www.aphl.org/MRC/Documents/PHPR_2011Feb_PHL-Continuity-of-Operations-Guidelines.pdf
[8] http://www.bt.cdc.gov/labissues/
[9] http://www.aphl.org/training/nltn/pages/default.aspx
[10] https://secure.nccrimecontrol.org/hsb/planning/Planning%20Documents/National%20Planning%20Scenarios%202006.pdf