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State Public Health Laboratory Bioterrorism Capacity

Norman Crouch, PhD Director, Public Health Laboratory Minnesota Department of Health Chair, Emergency Preparedness & Response Committee Association of Public Health Laboratories February 24, 2005. CDC Public Health Preparedness Conference 2005.

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State Public Health Laboratory Bioterrorism Capacity

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  1. Norman Crouch, PhD Director, Public Health Laboratory Minnesota Department of Health Chair, Emergency Preparedness & Response Committee Association of Public Health Laboratories February 24, 2005 CDC Public Health Preparedness Conference 2005 State Public Health Laboratory Bioterrorism Capacity

  2. Objectives • To report results from APHL's 2004 Bioterrorism Laboratory Preparedness Survey • To describe improvements and remaining gaps in public health laboratory capability and capacity • To describe the current state of public health laboratory preparedness • To highlight the need to sustain funding for bioterrorism laboratory preparedness activities

  3. Method • APHL surveyed 50 states, DC, and 4 territories • 52 responses received (all 50 states, DC, and Puerto Rico) • Reflects bioterrorism capability and capacity as of August 31, 2004 • Includes activities from January 2003 through August 2004

  4. Data • Funding and benchmarks • Workforce • Facilities and biosecurity • Equipment and supplies

  5. Data • Smallpox preparedness • Training, laboratory connectivity, and integration • Transportation and courier service

  6. FY00-FY04 Public Health Lab Bioterrorism Funding

  7. Funding and Benchmarks • Federal and state funds cut • 22 labs had average reduction of 12% • 5 labs received funding from DOJ • 25 labs indicate having designated funds for testing of food after a recognized intentional contamination

  8. 2004 Bioterrorism Funding for Public Health Labs Total = $97,873,701 million

  9. Laboratory Response Network (LRN)

  10. CDC 1 lab Level 1 62 labs Level 3 5 labs Level 2 41 labs • Level 1+2 Activities • Mustards • Nerve Agents • Level 1 Activities • Cyanide • Toxic Metals • Competency in • Collection & • Shipment of • Clinical Samples • Comprehensive • Response Plan Chemical Testing Capability

  11. Public Health Laboratories: Backbone of the LRN • Testing of clinical and environmental samples • Over 25,000 “unknown” samples tested • 90% environmental samples • Threat letters, powders, unknown packages, food, and samples from the Postal Service • Validation of new protocols • Training and coordination of sentinel labs

  12. Public Health Laboratories: Backbone of the LRN • Coordination with epidemiologists • Coordination with public health response teams • Coordination with law enforcement

  13. Workforce • Over 132 new employees hired • States lost highly skilled laboratorians • Recruiting pool is dismal • Additional staff needed for all areas

  14. Facilities and BioSecurity • 25 states lack triage facilities • 46 states have BSL-3 suites • 70 additional BSL-3 suites needed • Many labs have upgraded security systems • Many labs continue to enhance their facilities

  15. Number of BSL-3 Suites

  16. Equipment and Supplies • Upgrade and purchase new instruments • Adopt new technologies • 34 Lack Luminex Technology • LRN Reagents • Much needed national repository of reagents to support LRN laboratories testing capacity

  17. PCR Instruments

  18. Smallpox Preparedness • 50 labs have rapid detection of VZV • 19 labs have a validated smallpox PCR assay • Gaps: • Electron microscopy (EM) facilities • PCR assays for other look-alike diseases • Herpesviruses • Enteroviruses.

  19. Training and Laboratory Connectivity • 49 labs sponsored sentinel training • Total of 717 courses • Over 9,000 laboratorians trained • Training covered rule-out testing, packaging and shipping, and biosafety guidelines

  20. Training and Laboratory Connectivity • 42 labs have a BT Training Coordinator • 51 labs maintain a sentinel lab database • 44 labs have conducted capability assessments of sentinel laboratories

  21. Transportation and Courier Service • 28 states have a intra-state courier system • 16 states provide full-state coverage for all types of specimens

  22. Gaps • Need for national guidelines to triage unknown samples • Need to address environmental sampling and testing of chemical and biological agents • Need for a National Repository of Reagents for the LRN

  23. Gaps • Need federal commitment to invest more in the education and training of a skilled public health laboratory workforce • Need continued investments in public health laboratories • Need sustained funding to ensure national readiness

  24. Resources • www.aphl.org • www.bt.cdc.gov

  25. Questions

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