Lt. Dee Dee Downie spoke to WSLH staff recently about the challenges and successes of her 2 deployments to Liberia to battle the Ebola virus.
Lt. Downie is a commissioned officer in the U.S. Public Health Service and serves as the CDC Public Health Advisor to the Wisconsin Department of Health Services’ Office of Preparedness and Emergency Health Care.
Webcast (1 hour long)
The Wisconsin State Laboratory of Hygiene (WSLH) has been chosen by the Centers for Disease Control and Prevention (CDC) to be 1 of 3 National Influenza Surveillance Reference Centers for the next 5 years (2015 – 2020).
The WSLH, along with the state public health laboratories in California and New York, will provide influenza virus isolation, neuraminidase inhibition (i.e. anti-viral medication resistance) and whole genome sequencing testing services.
Test result data will be used by CDC to speed influenza vaccine development and better understand what influenza viruses are circulating and how they may be changing.
The WSLH will provide testing for Wisconsin and 21 other states.
Since 2009, the WSLH has served as a CDC virus isolation project partner looking for antigenic shift and drift in influenza viruses. This latest project builds upon that partnership.
The WSLH’s contract with CDC to serve as a national Vaccine Preventable Disease (VPD) Reference Center also has been renewed for another 5 years. The WSLH provides routine testing capacity for measles, mumps, rubella and other vaccine-preventable diseases for other public health laboratories as well as surge capacity for CDC in case of a large-scale outbreak.
The WSLH is not only performing viral and bacterial VPD testing for Wisconsin and 17 other state and local public health laboratories across the country, it is also the only VPD Reference Center providing test performance evaluation panels to public health laboratories so that they can assure the quality of their testing.
The work WSLH scientists perform with both reference centers enhances our surveillance and outbreak response capabilities to support Wisconsin’s public health system and the health of Wisconsinites.
About 7:00 AM Monday through Saturday, chemists and support staff working in the Wisconsin State Laboratory of Hygiene (WSLH) Newborn Screening Laboratory gather round a table and open envelopes containing precious samples from the state’s newest residents – dried blood spot specimens collected from babies born within the previous couple of days.
The blood spots are sent to multiple stations in the laboratory where they are tested for 44 rare, serious disorders that, if not treated quickly, can lead to severe health problems and sometimes even death. Out of the 65,000 babies born in Wisconsin annually, about 135 will have one of the disorders.
For lab staff, these blood spots represent real-life babies. But rarely do they get to meet the actual people whose lives they have so profoundly affected.
Earlier this month they got their chance.
David, Kristi and Logan Schrimpf and Joelle Odor in the Wisconsin Newborn Screening Laboratory. Joelle was the first baby to test positive for PKU after newborn screening was consolidated at the WSLH in 1978. Logan is one of the most recent babies to test positive for PKU.
In celebration of Newborn Screening Awareness Month, two people living with PKU – one of the 44 disorders on the newborn screening panel – visited the WSLH Newborn Screening Laboratory.
PKU is a metabolic disorder that requires a lifelong, low-protein, low-phenylalanine diet to avert irreversible brain damage from the accumulation of phenylalanine in the body. People living with PKU drink liquid supplements and/or take pills to obtain needed nutrients for proper growth and development.
Joelle Odor was the first baby to test positive for PKU after newborn screening was consolidated at the WSLH in 1978. She told staff of her challenges staying on the restrictive PKU diet when she reached her teens and how changes in the formulation of supplements have allowed her to get back “on diet”.
Logan Schrimpf is only 3 months old so his parents Kristi and David did the talking for him.
Logan is the Schrimpf’s first baby and his PKU diagnosis has required some additional adjustments for the new parents. David recounted the emotional roller coaster he and Kristi were on the first few weeks of Logan’s life, including how important it was to learn the results of follow-up tests that monitored whether dietary changes were lowering Logan’s phenylalanine levels.
At 3 months, Logan is doing great and the Schrimpf’s are adapting to life with a child who has PKU.
Because diet and supplemental formula are crucial to managing PKU, two dietitians from the University of Wisconsin-Madison’s Waisman Center metabolic disorders clinic also spoke to the lab staff. Nikki Drilias and Therese Breunig brought along samples of some of the different formula options for staff to taste.
Joelle, Kristi, David and Logan also toured the newborn screening lab learning how the chemists detect the disorders in the dried blood spots.
For everyone involved the event was a chance to learn more about the people behind the lab results.
Wisconsin Newborn Screening Laboratory staff sample the different formulas people living with PKU drink daily to supplement their low-protein diet.
Wisconsin Newborn Screening Laboratory Co-Director Dr. Patrice Held (right) explains what happens in the lab to Kristi Schrimpf holding son Logan, Waisman Center dietitian Therese Breunig, David Schrimpf and Joelle Odor.
In 2014, there were 97 Wisconsin workers who died due to injury. This number remains unchanged from the final count published in Wisconsin for 2013. The number of workplace deaths in Wisconsin the past decade range from 77 to 125, and average 98 fatalities annually.
The preliminary count of occupational fatalities in the U.S. in 2014 is 4,679, a 2% increase from the revised total of 4,585 in 2013.
The Census of Fatal Occupational Injuries is conducted annually nationwide by the U.S. Bureau of Labor Statistics (BLS), and compiles a count of all work-related deaths.
Key findings for Wisconsin in 2014:
Worker Characteristics and Occupation
Of the 97 fatalities, 12 were in contractor status at the time of their death, which is an increase from 7 in 2013. Self-employed workers sustained 39 fatalities, a 44% increase from 2013.
The highest number of fatal work injuries occurred among age group 65 years and older with 25 deaths, followed by age 45 to 54 with 21, and age 55 to 64 with 19. These same age groups saw an increase in fatalities nationwide. Most fatal work incidents in Wisconsin occurred in the month of August.
Wisconsin transportation and material moving occupations sustained the greatest number of fatal injuries in 2014 at 22 incidents, followed by management occupations with 16 deaths. Construction and extraction occupations sustained 15 fatalities, and 14 deaths occurred among farming, fishing, and forestry workers.
Event
Transportation incidents comprised the highest number of fatal work injuries at 38, followed by contact with objects and equipment with 22, falls, slips, and trips with 16, and violence due to persons or animals with 15. Falls, slips, and trips declined 47% from 2013 while fatal contact injuries increased 47% from 15 to 22. Violent events increased from 11 in 2013 to 15 in 2014. Homicides declined by half from 2013, while suicides increased from 3 to 9 in 2014. Nationally, transportation incidents accounted for 40% of total fatal injuries, followed by falls (17%), violence (16%), and contact injuries (15%).
Industry
In 2014, 92 of the 97 work-related deaths in Wisconsin occurred within private industry. Public sector worker deaths decreased by more than half from the prior year. Agriculture, fishing, forestry, and hunting saw a 30% increase in fatalities from 2013 with 26. Fatalities in the professional and business services industry nearly tripled from 2013 to 2014, while the trade, transportation, and utilities decreased to 17. Fatalities in the construction industry increased slightly to 13. Manufacturing industry deaths rose slightly from 9 in 2013 to 11. Nationally, fatal injuries increased in agriculture, mining, manufacturing, and construction industries.
Background of Census of Fatal Occupational Injuries
The Census of Fatal Occupational Injuries, part of the BLS occupational safety and health statistics program, compiles a count of all fatal work injuries occurring in the United States during the calendar year. The program uses diverse state, federal, and independent data sources to identify, verify, and describe fatal work injuries. For more about the Census of Fatal Occupational Injuries, go to www.bls.gov/iif.
The Wisconsin State Laboratory of Hygiene (WSLH), 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 Program has a cooperative agreement with the U.S. Bureau of Labor Statistics to conduct the Census of Fatal Occupational Injuries in Wisconsin.
For more about occupational fatalities in Wisconsin, go to: www.slh.wisc.edu/bls.
A clinical trial led by Dr. Karen Hansen, associate professor of medicine at the University of Wisconsin School of Medicine and Public Health, has shown Vitamin D supplements may be ineffective in improving bone density or bone strength in postmenopausal women.
Wisconsin State Laboratory of Hygiene (WSLH) Trace Elements Clean Laboratory staff led by Dr. Martin Shafer performed calcium absorption studies using stable isotope testing on urine specimens from the 200+ women enrolled in the study.
WSLH staff used Hi-Res ICP-MS technology to quantify concentrations and ratios of calcium isotopes. This is the gold standard dual stable calcium isotope method.
Tests were performed both on baseline urine specimens and then on urine specimens taken after the women in the study groups drank orange juice containing the stable isotope 44Ca and were IV-infused with the stable isotope 42Ca.
The isotopes were used as markers for how much calcium was absorbed into the body and how much was excreted.
Dr. Shafer and the WSLH Trace Elements Clean Lab staff have collaborated with Dr. Hansen on several studies over the past decade and are just completing the research phase of a similar study related to magnesium absorption.
Vitamin D Study results are published in JAMA Internal Medicine — http://archinte.jamanetwork.com/article.aspx?articleid=2422066
New York Times story about the Vitamin D study — http://well.blogs.nytimes.com/2015/08/10/older-women-vitamin-d-supplements/
The Lancet Respiratory Medicine featured two articles in late August about the Influenza Incidence Surveillance Project (IISP) 2009-2013.
The IISP is the only multi-state, nationally representative network that can estimate influenza incidence in patients with influenza-like illness presenting to ambulatory care clinics in the USA.
Wisconsin is one of the participating study sites.
Wisconsin State Laboratory of Hygiene (WSLH) Communicable Disease Division Director Dr. Pete Shult and Respiratory Virus Team Leader Erik Reisdorf and WSLH staff collaborate with Dr. Jon Temte in the University of Wisconsin Department of Family Medicine on the project.
http://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2815%2900327-6/abstract
http://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2815%2900278-7/abstract
The first time parents hold their newborn baby, the rush of emotions and desire to protect their little one can feel almost overwhelming.
In addition to their parents, these youngest Wisconsinites are also protected by the umbrella of the Wisconsin Newborn Screening Program. September is National Newborn Screening Awareness Month.
Newborn screening includes a test performed on a few drops of blood from a baby’s heel, as well as having their hearing and heart checked.
Between 24 and 48 hours after a baby is born, hospital staff (or a midwife for home births) will prick the baby’s heel and a few drops of blood are put on a special newborn screening collection card. The card is sent to the Wisconsin State Laboratory of Hygiene’s (WSLH) Newborn Screening Laboratory where scientists test the dried blood spots for 44 rare, serious disorders that, if not treated quickly, can lead to severe health problems and sometimes even death.
If a baby tests positive for one of the disorders, the state lab immediately contacts the baby’s healthcare provider. More tests will be done to confirm the screening result.
Some of the disorders screened for include cystic fibrosis, phenylketonuria (PKU), hypothyroidism, sickle cell disease, severe combined immune deficiency (SCID) and galactosemia.
Dr. Mei Baker, Co-Director, Wisconsin Newborn Screening Laboratory
“We screen nearly 65,000 infants a year for these rare, serious disorders and about 135 will have one of the 44 disorders,” says Mei Baker, a UW-Madison pediatrics associate professor and co-director of Wisconsin’s Newborn Screening Laboratory. “For those babies, a few drops of blood from their heel saved their life and gave them a chance for normal growth and development.”
Babies also have their hearing and hearts tested at the hospital or by a midwife after a home birth. More than 100 babies a year are diagnosed with permanent hearing loss and 30 to 40 will have a serious heart defect, lung disease, or infection identified by heart screening.
If a baby’s newborn screening results are normal – and that’s the case for 99.9 percent of babies – the test results will be sent to the baby’s health care provider. Parents should be sure to ask their baby’s doctor for the newborn screening results.
Even though the vast majority of babies have normal newborn screening results, it’s still important to screen all of them.
“Nearly all of the 44 disorders, hearing loss, and critical congenital heart disease are unrecognizable at birth, at least by routine physical examination,” says Patrice Held, a UW-Madison pediatrics assistant professor and co-director of the Newborn Screening Laboratory.
Dr. Patrice Held, Co-Director, Wisconsin Newborn Screening Laboratory
Because of the importance of newborn screening to babies’ health, it’s crucial for hospitals and midwives to send the blood specimens to the WSLH quickly. More than 99% of babies’ blood specimens arrive at the WSLH within 4 days of the heel prick. The WSLH also sends hospitals and midwives a monthly quality report showing how quickly specimens are sent and whether there are any quality problems with the blood specimens.
In Wisconsin, newborn screening testing is mandatory, but parents can opt out for religious reasons or personal conviction. The comprehensive program is administered by the Wisconsin Department of Health Services and the Wisconsin State Laboratory of Hygiene. The program also includes physician consultants, genetic counselors and nutrition professionals from around the state.
For more information:
Wisconsin Newborn Screening Laboratory (WSLH)
Wisconsin Department of Health Services Newborn Screening
Written by: Jan Klawitter, WSLH Public Affairs Manager
Whole genome sequencing has the potential to revolutionize influenza vaccines. It also generates lots and lots of data.
Around the table from bottom left are Nick Beckloff (GenoLogics), Thomas Stark (CDC Influenza Division), Rob Hall (GenoLogics), Rich Griesser and Tonya Danz (WSLH) and Stephanie Chester (APHL).
In late July, representatives from the Centers for Disease Control and Prevention (CDC) and GenoLogics trained Wisconsin State Laboratory of Hygiene (WSLH) scientists on the CLARITY laboratory information management system (LIMS).
CLARITY is the LIMS used as part of a 3-year CDC-funded project at the WSLH to pilot Next Generation whole genome sequencing of influenza viruses submitted for surveillance from Wisconsin and other states.
The CLARITY LIMS will maintain and monitor quality assurance throughout the whole genome sequencing and data transfer process to CDC. GenoLogics developed the CLARITY LIMS.
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 of influenza viruses in state public health laboratories could potentially shave months off the vaccine development process.
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 Influenza Reference Public Health Labs since 2009.
The Association of Public Health Laboratories (APHL) is coordinating and facilitating the pilot project for CDC.
More Information: APHL/CDC Pilot Trumps WGS File Size for Fast Exchange of Flu Data
An eaglet in its nest. Photo from Wisconsin Department of Natural Resources.
A National Parks Service research project monitoring environmental contaminants via testing baby eagles’ blood and feathers was featured in a June 8th Milwaukee Journal-Sentinel article.
Wisconsin State Laboratory of Hygiene (WSLH) at UW-Madison scientists provide testing for this project.
The WSLH Organic Chemistry Section tests the eaglets’ blood for contaminants such as PCBs, PFCs, pesticides, flame retardants and other industrial chemicals, while the Clinical Metals Section tests the blood samples for lead.
Eaglet feathers are tested for lead in the Trace Elements Clean Laboratory and for mercury in the Metals Lab.
From the story –
“Eaglets are perfect for the study because they’re the ultimate locavores. Their parents bring food acquired a short distance from the nest, giving authorities a good insight into nearby contaminants, said Bill Route, an ecologist with the Great Lakes Inventory and Monitoring Program for the National Park Service.”
The WSLH Forensic Toxicology Section is featured in a quick video produced by the University of Wisconsin-Madison Office of Classified Staff.
Learn how WSLH Toxicology staff test for alcohol and drugs in allegedly impaired drivers and help medical examiners and coroners in death investigations.