Finding “Flumps”: A Story of Electronic Lab Reporting and Surveillance

Spring-2015-Lab-Matters-coverThe Electronic Laboratory Reporting (ELR) system at the Wisconsin State Laboratory of Hygiene (WSLH) is featured in the latest issue of the Association of Public Health Laboratories Lab Matters magazine.

ELR involves sending laboratory test result information electronically rather than via paper reports. This speeds up the ability for public health departments to respond to potential disease outbreaks.

The WSLH has established ELR for test results from Wisconsin patients with reportable conditions such as measles, TB and E. coli O157:H7. The WSLH IT system is connected with systems at 52 hospital laboratories in Wisconsin and 5 national laboratories in order for those labs to send  test results to the WSLH.  Another 24 hospital labs in Wisconsin, Minnesota and Ohio send results via a secure web portal.

After being assigned identifier codes, these test results are sent via a secure system to the Wisconsin Electronic Disease Surveillance system (WEDSS), where staff at local health departments and the Wisconsin Division of Public Health (WDPH) can view the results and respond as needed to prevent further disease spread.

The WSLH also electronically reports results from tests it performs to the Centers for Disease Control and Prevention (CDC) for a variety of infectious disease pathogens. This is part of efforts by WSLH, WDPH and CDC to monitor what may be sickening people and where.

It was through these surveillance efforts, that WSLH and WDPH staff discovered cases of “flumps” last year. The story is recounted in the article by Bill Bellini, chief of CDC’s Measles, Mumps, Rubella and Herpes Viruses Laboratory Branch.

Last year, near real-time surveillance was responsible for identifying a possible new syndrome associated with influenza H3fluA. Clusters of patients with cold-like symptoms and clinical parotitis (swelling of the major salivary glands) were thought to have mumps. Said Bellini, “Finally, someone in Wisconsin had the bright idea to put [the suspected mumps specimens] through their respiratory panel, and it turned out to be H3flu.”

Dissemination of this finding had important public health implications: “It changes people’s mindset. Although the frequency of parotitis-associated H3fluA infections is still being evaluated, you have to start thinking about contacts and rapid follow-up, because flu spreads like wildfire.”

Lab Matters Spring 2015 issue

 

Lab Matters ELR Story icon-pdf

Happy Birthday, Dr. Papanicolaou!!!

Michelle Hopkins, CT (ASCP), of Oklahoma City, Oklahoma won the 2015 National Cytotechnology Day design and slogan contest.

Michelle Hopkins, CT (ASCP), of Oklahoma City, Oklahoma won the 2015 National Cytotechnology Day design and slogan contest.

Dr. George Papanicolaou was born on May 13, 1883, in Greece.  A pioneer in cytopathology and early cancer detection, Papanicolaou is most famous as the inventor of the “Pap smear” test to detect cervical cancer.

The Wisconsin State Laboratory of Hygiene (WSLH) began offering Pap smear testing in the late 1940s after WSLH Medical Technologist Normal Arvold went to Cornell University Medical School to train with Papanicolaou himself.

Upon returning to Wisconsin, Arvold started the WSLH Cytology Unit and also the educational program now known as the University of Wisconsin-Madison Cytotechnology Certificate Program.

Arvold also helped train two WSLH Medical Directors in cytotechnology – current Medical Director Dr. Daniel Kurtycz and emeritus Medical Director Dr. Stanley Inhorn.

Every year on this date National Cytotechnology Day is celebrated to honor Dr. Papanicolaou and his contributions to medicine.

Toxicology Awarded for Testing Turnaround Time Decrease

tox_pipetting_WEBThe WSLH Forensic Toxicology Team received a University of Wisconsin-Madison 2015 Administrative Improvement Award for their efforts to reduce turnaround time for impaired driver drug testing without compromising quality.

Increased demand for drug testing had caused average turnaround time to balloon from just over 60 days in 2003 to more than 260 days in 2012.

With process improvements put in place by the team, turnaround time for drug testing is now less than 60 days for 90% of samples. Importantly, law enforcement agencies that had decreased sending samples to the WSLH due to turnaround time delays have increased the number of samples they now send for testing.

The Administrative Improvement Awards recognize exceptional performance in UW-Madison administrative roles supporting academics, research, student services, outreach or administration. Emphasis is given to outstanding work that results in improved efficiency, increased revenue channels, cost savings or improved service delivery.

UW-Madison news story

WSLH Battles Re-emerging Vaccine Preventable Diseases

Cover_web_VPDAnnualReport_42015With measles and mumps making headlines again, the efforts of Wisconsin State Laboratory of Hygiene (WSLH) scientists to fight outbreaks of these and other vaccine preventable diseases (VPD) are featured in the latest report from the Association of Public Health Laboratories (APHL).

In 2012, the WSLH was designated as 1 of 4 vaccine preventable disease reference centers in the U.S. Funding and support for the work comes from the U.S. Centers for Disease Control and Prevention (CDC) and APHL.

The VPD Reference Centers use CDC test methods to provide routine VPD testing capacity for other public health laboratories as well as surge capacity for CDC in case of a large-scale outbreak. The 4 centers (Wisconsin, Minnesota, California and New York) also use HL7 messaging to electronically send test results to CDC, strengthening public health informatics capability between state labs and the CDC.

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 the WSLH performs as a VPD reference center enhances its surveillance and outbreak response capabilities in support of Wisconsin’s public health system.

APHL Vaccine Preventable Disease Annual Report (April 2015)  icon-pdf

APHL: VPD Reference Centers: Just in Time for Measles Outbreaks

Newborn Screening Specimen Collection and Submission Training Webinar Released

The Wisconsin Newborn Screening Program has produced a training webinar on the Basics on Newborn Screening Specimen Collection and Submission.

The 60-minute webinar provides guidance on proper newborn screening specimen collection and submission.

The intended audience is nurses, midwives, phlebotomists, and all health care workers who participate in the newborn screening process.

This program is co-sponsored by ASCLS-WI which is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® program. A total of 1.0 contact hours can be obtained by completing the training webinar. Level of Instruction: Intermediate

The webinar was produced with grant funding from the Association of Public Health Laboratories.

 

Additional Information

How to Collect a Blood Specimen for Newborn Screening Testing

Specimen Collection Flowchart  icon-pdf

Workers’ Memorial Day – April 28, 2015

2015_DOL_workers-memorial-day-imageStaff in the Wisconsin State Laboratory of Hygiene’s Occupational Health Division work every day to help keep workers safe.

Today – April 28, 2015 – the country takes a moment to remember all of those hard working people, who got up, went to work, but never came home because they died on the job.

In their memory, we rededicate ourselves to helping keep Wisconsin workers safe and healthy.

Presidential Proclamation for the Workers Memorial Day

More about WSLH Occupational Health Services

Building a Better Flu Vaccine

flu_virus_illustration_CDCAs this past flu season showed, determining exactly which strains of influenza virus to include in the annual flu vaccine can be tricky. And with influenza’s high infection and death rate and its ability to mutate, these decisions can be life or death.

Looking for a way to speed up the process to know exactly what influenza viruses are circulating, the Centers for Disease Control and Prevention (CDC) is funding a 3-year project at the Wisconsin State Laboratory of Hygiene (WSLH) 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 Influenza Reference Public Health Labs 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 process.

CDC staff recently spent two weeks at the WSLH training virology laboratory staff on the new technology and working with IT staff to establish a secure data pipeline to CDC that can handle the large amounts of data that is generated from sequencing.

THAT’S SICK: Headlines from the Public Health Laboratory Bench

baby-feet-blue-blanketThe Wisconsin Newborn Screening Laboratory is featured in “THAT’S SICK! Headlines from the Public Health Laboratory Bench”, an online virtual open house for students interested in careers in public health laboratory science.

THAT’S SICK includes modules that let visitors explore the role of the laboratorian in areas of critical importance to the health of the public, including foodborne outbreaks, vectorborne diseases, infectious diseases, emergency preparedness, newborn screening, and environmental health.

The project was developed by members of the Emerging Leader Program, sponsored by the Association of Public Health Laboratories.

Environmental Monitoring and Trends Seminar — March 3, 2015

Scientists and staff from the WI State Laboratory of Hygiene (WSLH) and WI Department of Natural Resources (DNR)  provided insight and updates about environmental monitoring and trends at a seminar held on March 3, 2015, at the WSLH’s Agriculture Drive facility in Madison.

The seminar was live-streamed on the web on March 3rd. Links to the archived webcasts are below.

 

Archived webcasts

You will need to access the archived webcasts using Internet Explorer. You will also need Microsoft Silverlight installed on your computer.

A.M. sessions webcast (NOTE: webcast starts at 04:41): https://slhstream2.ad.slh.wisc.edu/Mediasite/Play/f3b48a94a6744bd79267f5a2f2a78ce61d

P.M. sessions webcast (NOTE: webcast starts at 01:14): https://slhstream2.ad.slh.wisc.edu/Mediasite/Play/8bf5d354becd4b93916bd842a0b1afed1d

 

 

Webcast Session / Start Time
Topic Speaker
AM / 07:29 Well Assessment Sharon Long (WSLH)
AM / 25:00 Satellite Images and Monitoring Daniela Gurlin (DNR)
AM / 47:16 Radiochemistry Susan Percy (WSLH)
AM / 01:10:06 2, 4-D Study – Jim Kreitlow (DNR), Camille Danielson & Curtis Hedman (WSLH)
AM / 01:32:21 Cryptosporidium in Soil Zach Zopp (UW-Madison)
AM / 01:52:24 Particle Size Distributions Bill Selbig (USGS)
PM / 01:14 Workload TAT at WSLH Dave Webb (WSLH)
PM / 08:53 Eagle Trend Data Paul Rasmussen (DNR)
PM / 17:37 Future Wildlife Monitoring Sean Strom (DNR)
PM / 30:29 New Multi-Collector ICPMS Capabilities Pat Gorski (WSLH)
PM / 37:08 Microbial Source Tracking (MST) Jamie Stietz (WSLH)
PM / 47:19 Groundwater Dave Johnson (DNR)
PM / 52:55 Endocrine Disruptors Jocelyn Hemming (WSLH)
PM / 01:02:39 Great Lakes Fish Monitoring Candy Schrank (DNR)
PM / 01:09:23 Hexavalent Chromium Pat Gorski (WSLH)
PM / 01:15:44 Arsenic and NR812 DeWayne Kennedy-Parker (WSLH)

 

“Fightin’ Bob” La Follette and Food Poisoning

U.S. Senator Robert La Follette, Sr. Photo: Library of Congress

Sen. Robert La Follette, Sr. Photo: Library of Congress

The mystery surrounding U.S. Senator Robert “Fightin’ Bob” La Follette’s extreme gastrointestinal illness during his May 30, 1908 filibuster is explored in the latest issue of Madison magazine.

Reporter Adam Schrager looks at the historical records and talks to experts to determine whether La Follette was intentionally “drugged” as the Wisconsin senator claimed in letters to family back home, or was he merely a victim of the impact of hot Washington D.C. temperatures on the eggnog he was drinking for sustenance during his 18-hours-plus talking filibuster.

WSLH Foodborne Disease Program Manager and Communicable Disease Supervisor Tim Monson weighs in on the food poisoning angle.

Madison magazine story link