For many of us, having a “once-in-a-lifetime” experience means just once in our lifetime. But Wisconsin State Laboratory of Hygiene (WSLH) Cytology Laboratory Manager Erin McCarthy hopes that the time she spent in Tanzania in January and February will happen again and again.

Erin spent a month in the East African country completing an internship with Empower Tanzania, an Iowa-based non-profit organization that works in partnership with rural Tanzanians to improve their quality of life. Staff and volunteers in Tanzania and the U.S. work with Tanzanians to address the underlying issues that hinder resiliency in rural areas, such as health care, education, agriculture practices, markets for products, and increasing water supply and quality.

Erin’s internship was part of her Masters of Public Health (MPH) program at Des Moines University. With her interest in both women’s health and global health, Empower Tanzania was a perfect fit. The organization emphasizes education, economic empowerment and health care, especially for women in rural communities.

Erin spent 4 weeks in the Kilimanjaro region of the country helping collect data in the Same (SA-may) district where she was headquartered, as well as 4 neighboring districts, to be able to analyze population health outcomes. Empower Tanzania hopes to use this data collection and analysis approach to prove the efficacy of their work and pursue more sustainable funding opportunities. They also hope to expand their programs to other areas of the country.

Erin traveled to the hospitals in each district as part of the data collection, as well as to different villages where Empower Tanzania staff had worked with residents. She continues to work with Empower Tanzania staff remotely from Wisconsin wrapping up projects.

“The people I met were fantastic and so welcoming,” she said. “I think I made life-long connections.”

Erin even learned a bit of Swahili in order to have rudimentary conversations with the people she met.

“I loved Tanzania – the people I met, the food I ate and the weather,” Erin exclaimed. “And then I came home to Wisconsin winter. I can’t wait to go back.”

 

Wisconsin State Laboratory of Hygiene (WSLH) mycobacteriology laboratory staff have been named TB Elimination Champions by the Centers for Disease Control and Prevention (CDC). The honor comes as health agencies commemorate World TB Day on March 24^th with a goal of ending tuberculosis (TB) worldwide.

CDC developed the TB Elimination Champions program “… to recognize accomplishments and learn best practices from people who are making a significant contribution to preventing and controlling TB.”

The WSLH mycobacteriology laboratory serves as a primary diagnostic facility and reference laboratory for clinicians and private clinical mycobacteriology laboratories throughout Wisconsin, and as a public health laboratory serving the Wisconsin Division of Public Health (WDPH) Tuberculosis (TB) program and Wisconsin local public health agencies.

The WSLH award highlighted the close collaborative working relationship of WSLH mycobacteriology lab and WDPH TB program staff, using the 2013 Sheboygan TB outbreak investigation and response as an example.

In addition to TB case response, WSLH mycobacteriology lab and WDPH TB program staff work together to provide statewide, multidisciplinary TB educational opportunities for laboratorians, nurse case managers, clinicians and infection control practitioners.  The strong relationship developed over the years between WSLH and WDPH TB program staff is essential for quality TB laboratory services in support of TB treatment and control efforts in Wisconsin.

World TB Day is an annual event that commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes TB.

 

 

Data submitted by members of the Wisconsin Clinical Laboratory Network (WCLN) helped paint a picture of antibiotic resistance patterns in Wisconsin. The research findings are described in the latest issue of the Wisconsin Medical Journal.

The WCLN is comprised of 130+ clinical and hospital laboratories and is facilitated by the Wisconsin State Laboratory of Hygiene.

Usually in winter it’s Wisconsinites who head south for warmer weather. But in early February, it was two nurses from Puerto Rico’s newborn screening program who headed north to brave the cold and learn from the WSLH newborn screening staff.

Ledith Resto Melendez and Zulley Peńaloza Medina spent the first week of February learning about our newborn screening testing processes. Puerto Rico’s newborn screening program, which is affiliated with the University Pediatric Hospital in San Juan, received a NewSTEPS grant from the Association of Public Health Laboratories to implement Severe Combined Immunodeficiency (SCID) screening. They started testing for SCID in August 2015.

In 2008, Wisconsin became the first place in the world to routinely screen newborns for SCID. Babies with the disorder are born without a functioning immune system. Our newborn screening lab has served as a training center for many state and some international newborn screening programs that want to implement SCID testing. WSLH Newborn Screening Laboratory Co-Director Dr. Mei Baker has also traveled many miles consulting with labs on SCID testing implementation.

Even though Puerto Rico only began SCID testing months ago, Ledith and Zulley wanted to visit the WSLH NBS lab soon after implementation for quality assurance purposes.

“We want to review our processes with Wisconsin to make sure we are doing things well and see if there are any changes we need to make,” Ledith explained.

And since they were here, they decided to learn all they could about the testing processes for the other 43 disorders screened for in the WSLH NBS lab.

“We have had an opportunity to see every step for every test, from punching blood spots to data entry to testing to results reporting to follow-up,” Ledith said. “We’ve seen every piece of equipment and talked with all the staff.”

“The staff have been very helpful,” Zulley added.

The Puerto Rico newborn screening program screens about 34,000 babies annually for 29 disorders. About 20-25 babies a year will test positive for one of the disorders. There are about 30 staff members who work in the program, which combines testing, short and long-term follow-up activities and genetic counseling.

Ledith and Zulley hope this trip is just a first visit in what will become a long-term collaboration.

“The staff have been great and Mei is a wonderful teacher,” Ledith said. “The people here really love what they’re doing.”

WSLH Toxicologist Kayla Neuman is presenting study data on the effect of synthetic cannabinoids on driving at the American Academy of Forensic Sciences annual conference on February 25, 2016.

Here’s an abstract of her presentation –

 

Synthetic Cannabinoids in Drivers: Clinical and Psychophysical Indications of Intoxication

Kayla M. Neuman, M.S., Wisconsin State Laboratory of Hygiene – Forensic Toxicology Section

Synthetic Cannabinoids, also known as “fake pot”, K2, and spice are growing in popularity amongst drivers in Wisconsin. Specialized evaluations performed by Drug Recognition Experts (DRE) to identify drugged driving impairment were examined. The data collected was used to determine the likely symptoms caused by these types of substances.

The Wisconsin State Laboratory of Hygiene (WSLH) with the cooperation of the WI Department of Transportation’s Bureau of Transportation Safety (BOTS), outsourced samples to other laboratories to test for synthetic cannabinoids. A total of 118 cases were sent out between March 2010 and May 2015, with 24 cases having all information required for the data collection. Of the 24 cases examined, 20 were male subject and 4 were female subjects. There were a total of 11 different types of synthetic cannabinoids found in these 24 blood specimens and negative results for the rest of the alcohol and drug testing. Examination of the police reports revealed that impaired drivers were commonly identified by poor driving and traffic crashes (71%).

Based on the DRE evaluations, the subjects consistently had poor balance and coordination (54%), bloodshot eyes (67%), droopy eyelids (54%), and were unable to cross their eyes (75%). These symptoms are also common with impairment seen by those who use cannabis. Impairment was also noticeable by the subjects speaking slowly and swaying while trying to balance during two of the tests used. However, the body’s responses (pulse rate, blood pressure, body temperature, pupil size, pupil reaction to light, and muscle tone) to synthetic cannabinoids were within normal DRE ranges for the majority of cases. There were a few cases that displayed specific indications of intoxication that were not within normal ranges including dilated pupils (46%), watery eyes (42%), uncontrollable shaking (21%), elevated pulse (42%), and elevated blood pressure (21%). This may be due to the specific type of synthetic cannabinoid used, the person’s body chemistry, or the amount of time between driving and the DRE evaluation. Overall, driver performance on DRE evaluations indicated that synthetic cannabinoids caused significant physical impairment and do impair a person’s ability to drive a car.

Abstract will be presented during the American Academy of Forensic Sciences annual conference in Las Vegas, NV, February 25, 2016.

(Information current as of 02/16/2017)

 

For individuals that meet Centers for Disease Control and Prevention (CDC) travel or exposure criteria, fee-exempt testing Zika virus testing is available at the Wisconsin State Laboratory of Hygiene (WSLH) upon approval by a Wisconsin Division of Public Health (DPH) epidemiologist. The most common Zika virus tests approved are the Zika virus IgM antibody assay on serum, the Arbovirus PCR Panel (Zika, Dengue and Chikungunya viruses) on serum, and the Zika virus PCR on urine.

 

The following information is for Wisconsin clinical and hospital laboratories.

 

Diagnostic Testing:

• If a physician suspects a case of Zika virus and would like testing performed, please contact the WI Department of Health Services (WDHS) Communicable Disease Epidemiology Section (phone: 608-267-9003). Once WDHS approves testing, they will provide your laboratory with a form that must be completed and accompany the specimen. For more information – https://www.dhs.wisconsin.gov/zika/lab-testing.htm

• For individuals that meet Centers for Disease Control and Prevention (CDC) travel or exposure criteria, fee-exempt testing Zika virus testing is available at the Wisconsin State Laboratory of Hygiene (WSLH) upon approval by a Wisconsin Division of Public Health (DPH) epidemiologist. The most common Zika virus tests approved are the Zika virus IgM antibody assay on serum, the Arbovirus PCR Panel (Zika, Dengue and Chikungunya viruses) on serum, and the Zika virus PCR on urine. NOTE: Specimens testing positive or equivocal for Zika virus IgM will still need to be forwarded to the CDC for confirmatory plaque-reduction neutralization (PRNT) testing because of the significant cross-reactivity between Zika and other Flaviviruses in the MAC ELISA assay. Also, requests for IgM testing for dengue and chikungunya viruses will continue to be sent to CDC.

• Specimen – Instructions for specimen collection and submission are provided at time of testing approval by WDHS.

• Transport – Specimens approved for testing by WDHS may be transported to the WSLH by calling Statmedex for pick-up. Specimens should be triple packaged as a Category B Biological Substance.

• Fee for Service Testing – No fee-for-service testing is being offered at this time. ALL Zika virus test requests must be approved by WDHS by calling 608-267-9003.

Reporting:

Zika virus has been added to the list of notifiable diseases/conditions. The WSLH will report any confirmed cases of Zika virus to WDHS.

 

Resources:

For information on Zika virus infection:

WI Department of Health Services: https://www.dhs.wisconsin.gov/zika/index.htm

CDC: http://www.cdc.gov/zika/index.html

Pan American Health Organization (PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688&lang=en

 

It sounds like something out of a late-night horror movie — thick green muck spreading across a lake and disrupting the drinking water supply for 400,000+ people. But it wasn’t Hollywood — it was Lake Erie and Toledo, OH in summer 2014.

That harmful algal bloom (HAB) and others are discussed in the ET&C Focus article “Are harmful algal blooms becoming the greatest inland water quality threat to public health and aquatic ecosystems?” published in the January 2016 issue of Environmental Toxicology and Chemistry. The article is co-authored by Wisconsin State Laboratory of Hygiene Environmental Toxicologist Dawn Perkins.

While the authors don’t have an exact answer to their question yet, they do outline the challenges ahead and the information that is still needed to ensure the story has a happy Hollywood ending.

From the article –

 

A pilot project at the Wisconsin State Laboratory of Hygiene (WSLH) to perform Whole Genome Sequencing on influenza viruses received the Excellence in Domestic Partnering Award from the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention (CDC).

The WSLH is in the first year of a 3-year project funded by the CDC to pilot Next Generation Whole Genome Sequencing of influenza viruses submitted for surveillance from Wisconsin and other states.

The WSLH is the first state public health laboratory in the country to collaborate with the CDC on this cutting-edge technology. The WSLH has been 1 of 3 CDC-designated National  Influenza Surveillance Reference Centers since 2009.

Genetic characterization of influenza viruses is important both for monitoring genetic drift (how the virus may be changing) and for selecting the virus strains to include in influenza vaccines. Next Generation Sequencing (NGS) in state public health laboratories could potentially shave months off the vaccine development process.

“This is a big recognition at CDC,” said Dr. Peter Shult, director of the WSLH Communicable Disease Division and Emergency Response. “I am very  proud of the hard work of our staff, especially (microbiologists) Tonya Danz and Rich Griesser, (electronic laboratory reporting coordinator) Mary Wedig, and our WSLH IT staff. This type of public health work is what the WSLH is all about.”

 

Previous Stories about the Project

Building a Better Flu Vaccine
Getting CLARITY on Whole Genome Sequencing

According to estimates from the U.S Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses (SOII), Wisconsin’s overall incidence rate of nonfatal occupational injuries and illnesses remained unchanged, at 4.0 cases per 100 equivalent full-time workers in 2014.

Nationally, the total injury and illness case rate per 100 full-time workers fell from 3.5 in 2013 to 3.4 in 2014. In surrounding Midwestern states (IA, IL, IN, MI, MN, NE, OH), Iowa had the highest total recordable case rate of 4.4 cases per 100 full-time workers while Ohio had the lowest rate of 2.9 cases.

SOII is the largest work injury data collection conducted nationwide. The Wisconsin SOII program collects data from a representative sample of 6,000 establishments in both the private and public sector.

Key Findings for Wisconsin:

• Private industry total incident rates fell slightly from 4.0 in 2013 down to 3.9 cases per 100 workers in 2014, while state and local government rates rose from 4.5 in 2013 to 4.7 in 2014.
• There were an estimated 86,300 total injuries and illnesses in Wisconsin workers with 25,300 (29%) requiring time off due to injury.  The number of cases with time off due to injury is up from the estimated 23,200 in 2013.
• Across all industries, Wisconsin workers averaged 7 days off due to injury.
• The leading nature of injury that required time off work in the private sector was sprains, strains and tears at 37.8% of lost time injuries. Soreness and pain was the second leading cause, at 16.3% of lost time cases.
• Establishments with between 50 to 249 employees had the highest rate of workers who had time off due to injury at 4.7 cases per 100 full-time workers. Employers with between 11 to 49 employees were second-highest, with a rate of 4.1 cases per 100 full-time workers.

The Wisconsin State Laboratory of Hygiene, a part of the University of Wisconsin-Madison, is the state’s public, environmental and occupational health laboratory. The WSLH’s Bureau of Labor Statistics/Occupational Safety and Health Statistics Unit have a cooperative agreement with the U.S. Bureau of Labor Statistics to conduct their annual Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries in Wisconsin.

For more information about nonfatal work injuries in Wisconsin, go to www.slh.wisc.edu/bls.

The Wisconsin Mycobacteriology Laboratory Network (WMLN) held its annual meeting on November 4, 2015.

The WMLN is an ongoing collaboration of all 31 laboratories in Wisconsin that perform some level of testing for TB, to share expertise and data critical to the state’s TB control efforts, and to improve TB testing quality overall in Wisconsin.

WMLN activities are coordinated by the Wisconsin State Laboratory of Hygiene and support statewide TB control efforts by the Wisconsin Department of Health Services’ Wisconsin Tuberculosis Program.

 

2015 WMLN Conference presentations