MADISON – The Wisconsin State Laboratory of Hygiene’s (WSLH) emergency preparedness and training activities are featured in the 2007 Wisconsin Homeland Security Report presented to Governor Jim Doyle on Sept. 24, 2007 by Brigadier General (WI) Donald P. Dunbar, Adjutant General for Wisconsin.
The annual report highlights some of the major accomplishments made by state agencies this past year to ensure Wisconsin’s preparedness measures are at the highest level.
The WSLH’s pandemic influenza preparedness activities also were included in the news release sent by Governor Doyle’s office.
Hospital Preparedness — Laboratory Capabilities
The Wisconsin State Laboratory of Hygiene (WSLH) provides on-going educational opportunities and a communications network for members of the Wisconsin Laboratory Response Network (WLRN), comprised of more than 130 hospital and clinical laboratories throughout the state. This year, the WSLH developed a set of four emergency response competency assessment modules for these laboratories: Laboratory Biosafety, Emergency Laboratory Response, Laboratory Diagnostics, and Packaging and Shipping Laboratory Samples. Thirty-three laboratories have qualified for the award to date.
The WSLH also acquired instrumentation and developed testing capability to test Influenza A viruses for antiviral resistance. This capability, which had only been available at the Centers for Disease Control and Prevention (CDC), was developed in response to the announcement that more than 80 percent of Influenza A (H3N2) viruses were resistant to treatment by two of the four available antiviral medications. With this capability, the WSLH was able to test a sample of Influenza A viruses isolated in Wisconsin during the 2006-7 season. Having the ability to test for antiviral drug resistance is a vital element in Wisconsin’s and the nation’s preparedness for regular seasonal influenza and the potential for pandemic influenza.
The WSLH, a qualified Level One Laboratory in CDC’s Laboratory Response Networks, continues to expand its testing capability to analyze clinical samples for weapons of mass destruction. Wisconsin’s lab will provide expanded capabilities to the state’s citizens, while also serving as a surge capacity laboratory for the CDC in the event of a large chemical exposure in the United States.
E. coli Outbreak
The state’s response to the E. coli outbreak of 2006 highlights the important role of state laboratories in surveillance activities and the primary role the states and their laboratories have in responding to outbreaks by bringing expertise to bear in an emergency.
A study by the Scripps-Howard News Service indicates that Wisconsin has the nation’s best record in diagnosing the causes of food illness (The Detroit News, Nov. 24, 2006). This excellent record is the result of a strong public health and food safety system in Wisconsin. The factors that contribute to this strong system are evident in a review of the chronology of the events in the State response to the 2006 E. coli outbreak from bagged spinach.
• September 5 Wisconsin’s Department of Health and Family Services, Division of Public Health (DPH) is notified of several E. coli cases in the state.
• September 7 Wisconsin notifies the US Centers for Disease Control (CDC).
• September 8 Wisconsin’s State Laboratory of Hygiene posts the “DNA fingerprint” of the causative organism to a national data base. State public health professionals believe the evidence points to bagged spinach as the source of illness.
• September 14 Based upon data provided by Wisconsin and other states the U.S. Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA) issued a national alert, warning people not to eat bagged spinach.
• September 25 Working through the weekend, Wisconsin’s State Department of Agriculture Laboratory, using sophisticated DNA analysis technology and employing a wealth of experience in the analysis of food, detects and confirms the presence of E. coli O157 in spinach samples collected from patients by local health sanitarians.
• September 26 The State Agriculture Laboratory provides the E. coli O157 cultures isolated from food to the State Laboratory of Hygiene for further comparison testing.
• September 27 The State Laboratory of Hygiene confirms the strain isolated from food has an identical “DNA fingerprint” to the strain isolated from clinical samples.
As seen in the bagged spinach E. coli outbreak, the states are at the front line of the response. The surveillance by the state public health agency identified a problem and the state public health lab pulled the causative organism from clinical samples. The Wisconsin Agriculture Laboratory independently isolated the organism from the spinach and closed the loop on the Wisconsin investigation. The federal government acted as a facilitator for the national response and offered technical support to the states when needed. The better the response at the state level, the quicker the response will be at the national level.
Staff at the Wisconsin State Laboratory of Hygiene (WSLH), the state’s lead terrorism and emergency response laboratory, were the first in the nation to identify the bacterial strain that sickened hundreds and caused three deaths in the 2006 nationwide E. coli O157:H7 in spinach outbreak. The staff received the 2007 PulseNet PulseStar award from the Centers for Disease Control and Prevention (CDC) and the Association of Public Health Laboratories for their efforts.
Pandemic Influenza Planning
In spring 2007, the WSLH held six regional meetings for WLRN members across the state. This year’s day-long sessions included a facilitated discussion among laboratorians, hospital infection control practitioners and local public health representatives to identify laboratory-related issues and solutions resulting from an influenza pandemic. Information gleaned from these discussions was compiled into a Laboratory Checklist for Pandemic Influenza, which was provided to WLRN laboratories to aid them in pandemic response planning. The Laboratory Checklist has been shared with other states as well. Along with those six meetings, the WSLH conducted four hands-on workshops around the state for laboratorians to improve their diagnostic capabilities.
Drinking Water Security
In June 2007, a full-scale emergency response exercise simulating the response to a contaminated ground storage reservoir was conducted at the Madison Water Utility involving the Madison HAZMAT team, the 54th Civil Support Team, the DNR, the Wisconsin State Lab of Hygiene, the Madison Public Health Department, and other emergency response officials. As recommended by a follow-up to this exercise, sampling devices and a protocol for extracting potentially contaminated water from a ground storage reservoir were obtained and the devices will be placed at 27 locations around the state. Information about the samplers will be delivered to all municipal water systems in the state. The samplers are available for future training and exercises.
The DNR provided ongoing education to water utility managers and operators regarding procedures involving the emergency response drinking water collection kits placed around the state. The DNR also participated in partnership with the Wisconsin State Laboratory of Hygiene in three targeting training sessions to assist water utilities in the proper procedures following a contamination incident at a public drinking water supply.
With the state’s water security partners, the Wisconsin State Laboratory of Hygiene (WSLH) has evaluated water collection devices that can be used for collecting samples from a reservoir that has been threatened with chemical, biological or radiological agents. By partnering with the DNR, these devices have been funded and placed throughout the state so that they can be used with the Wisconsin Emergency Drinking Water Collection Kit. WSLH is also working with US Environmental Protection Agency Region V staff and the other states in Region V to develop an emergency response plan for drinking water
