Leveraging Public Health Laboratory/First Responder Partnerships

Sep 11 2013 :: Published in Public Health Preparedness & Response

This month is National Preparedness Month.  Follow APHL on our blogTwitter and Facebook for preparedness information and discussions all month!



By: Christopher Chadwick, MS, specialist, Public Health Preparedness & Response, APHL

Since the morning of September 11, 2001, the American view on terror has changed drastically, and with that, so has public health preparedness and response. Over this last decade, terrorism has become not only a household word but also a public health priority. As we enter Preparedness Month, we’re reminded of the events 12 years ago that caused public health preparedness and response to focus on both natural disasters and intentional attacks.

The fall of 2001 was a defining time for public health laboratories. It was the anthrax letters mailed to several media outlets and United States Senators that brought this form of bioterrorism in the U.S. to the forefront of national news. Still in its infancy, the Laboratory Response Network (LRN), which was created in 1999 to increase bioterrorism and chemical terrorism response capabilities, established itself as a key force for national security as the anthrax letters circulated. In fact, a Florida LRN laboratory was one of the first to recognize inhalational anthrax from a sick person, thus beginning the influx of human samples and laboratory tests conducted by the LRN. These events highlighted the importance and strength of the LRN, and although it wasn’t a household name, the LRN certainly became a name that the public health world knew and valued.

Testing for anthraxFast-forward to 2013 and public health laboratories have added a variety of gadgets to their utility belts to uphold their public health preparedness and response core function (they actually have 11 core functions total that support all of public health). The laboratories continue testing for anthrax but also other potential bioterrorism and chemical terrorism agents, including the recently infamous ricin toxin. These utility belts contain not only actual gadgets (e.g., advanced diagnostic technologies) but also active partnerships comprised of an intense network of players, including hospital and private laboratories, law enforcement, fire departments, and federal programs.

In 2001, the partnerships between the public health laboratories and first responders (e.g., police, fire, hazardous materials teams) facilitated the anthrax response, and since then, these partnerships have only grown stronger. Daily, states continue to see letters and packages containing suspicious powders. And although these powders are typically of the powdered sugar or baby powder varieties, first responders and public health laboratories continue to respond as rapidly as ever. Who knows when the next suspicious powder with an actual threat will emerge (this year’s ricin letters showed us that this form of terrorism is still quite popular), but what we do know is that the public health laboratory/first responder partnerships will always be leveraged to ensure that the nation’s security is upheld.

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Shifting my perspective: Why I love working for the public health lab

Jul 09 2013 :: Published in Public Health Preparedness & Response

Shifting my perspective: Why I love working for the public health lab; Royden Saah, North Carolina Public Health Laboratory Bioterrorism Coordinator | www.aphlblog.org

By Royden Saah, North Carolina Public Health Laboratory Bioterrorism Coordinator

It was the summer of 2001.  I had defended my master’s thesis in microbiology about a year and a half prior when I noticed an open position in the state public health laboratory in the area of bioterrorism.  My preconceived opinion of public health microbiology was not great.  Spoiler alert: Converts make the most ardent advocates!  I thought public health microbiology was dull; I thought public health microbiology was monotonous; and I thought public health microbiology was not for a research-minded bacteriologist.  But this position was in bioterrorism!  Maybe it was worth a look.

September 6, 2001 – five days before my 33rd birthday – I had two job interviews on the same day.  My nine o’clock was at the public health lab; my 11 o’clock was at a start-up company in the Research Triangle Park.   Both interesting positions, both were associated with great teams, and both interviews went very well.  Of course, I immediately weighed which job I would accept if I got two offers.  It was truly a toss-up since there were some really nice points to each position.  The tie-breaker came on my birthday, September 11, 2001.  The tragedy of that day made the service aspect of the public health position outweigh the benefits of working with a start-up (i.e., higher compensation, less bureaucracy).  Unfortunately, the wheels of authorization do move slower in government.  On September 13th, I received and declined the start-up position offer without assurances of being selected for the public health lab position.  I was making a leap of faith that was ultimately justified after the first wave of anthrax letters was discovered.  My journey into public health had begun as it continues – chaotic, eventful and wholly fulfilling.

The initial long hours of work responding to the anthrax attacks delayed my discovery of the field of public health laboratories, but as the turbulence of late 2001 subsided, an unexpected world was opened to me.  My prejudices – my judging without knowing – regarding those tedious areas of the public health laboratory were destroyed by my observations around the lab.  By talking to my colleagues in the different sections of the lab, I discovered the fascinating complexities of the public health laboratory science area.  While they weren’t making basic scientific discoveries with which I had been previously involved at the university, the public health laboratory discipline held a myriad of questions waiting to be answered.  Indeed, seeing the application of the ongoing science (trouble shooting, novel assays, even process management!) was surprisingly more satisfying to me than the basic research.  I had a Green Eggs and Ham moment.  I could not get enough of hearing about the issues in the TB lab or knowing my baby’s bloodspot card was rapidly working its way through the newborn screening lab.

I discovered that public health laboratory operations touch the lives of every person in a lab’s jurisdiction – this had a profound impact on me.  From the safety of drinking water, to the screening of all infant children for serious diseases – public health labs directly affect my family and my community!  I found it easy to be passionate about my new field… “Zealous” may be a better adjective.

I hope that sharing my experience and my shift in perspective encourages others to explore the activities and careers of their local or state public health lab.  You may find that a career helping to improve the health of a population is something that interests you – it did for me!

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Anthrax in Minnesota? The Laboratory Response Network Springs Into Action

Mar 05 2013 :: Published in Public Health Preparedness & Response

By Kara MacKeil, Associate Specialist, Public Health Preparedness and Response, APHL

Picture a small rural hospital in northern Minnesota.  A man walks into the emergency room late in the afternoon complaining of flu-like symptoms. He’s admitted and at first seems stable, but rapidly deteriorates.  As he is transported by helicopter to a larger hospital for advanced treatment, his condition plummets en route and survival seems increasingly unlikely.  The backstory: The man was three weeks into a road trip and could have passed this fast-acting, apparently lethal bug on to any number of people.  Sounds like the script pitch for Contagion 2, right?  Mystery illness in Minnesota, I can see it now.*

But while it sounds like a script pitch, this actually happened in the fall of 2011, with Bacillus anthracis, as the causative agent of anthrax, as the starring villain.  There was one very important change to the storyline though.  Thanks to the efforts of the laboratorians at Lake Region Healthcare in Fergus Falls, Minnesota, and the Minnesota Department of Health Laboratory Response Network (LRN) staff, the mystery bug was identified in time to provide treatment, and the patient is alive and well today. Maureen Sullivan of the Minnesota Public Health Laboratory told us the story of the legwork that went in on the laboratory side, and it would definitely make for a pretty good movie!

First, a word on the LRN.  The LRN was developed in 1999 by the Centers for Disease Control, APHL, the Federal Bureau of Investigation (FBI) and the Department of Defense.  Today, there are two main arms of the LRN: chemical and biological threats preparedness and response (LRN-C and LRN-B), which provide a strong, unified system of laboratories that can respond to any threat.  There are standard protocols for everything, and regular trainings to keep everyone up-to-speed. In the LRN-B, Sentinel Level laboratories like the Lake Region Healthcare Laboratory can rely on reference laboratories such as the Minnesota Public Health Laboratory, and the Minnesota Public Health Laboratory, in turn, can call on resources within the CDC. Further, the Minnesota Public Health Laboratory can leverage partnerships with the local law enforcement, FBI and the National Guard Civil Support Team.  From the first culture to the final treatment, the Minnesota anthrax case was a perfect illustration of what dedicated laboratory and first responder professionals can do with the strength of the LRN behind them.

Testing for anthrax

Back to our story.  The patient in question was a 61-year-old Florida man who had been driving through the northern plains states for the past few weeks with his wife, taking in your standard tourist attractions and enjoying the scenery. (Can’t you picture the opening montage of our movie?)  He had a previous history of pneumonitis and had been exposed to Agent Orange in the Vietnam War, but was otherwise healthy.  When he arrived at Lake Region Healthcare on a Thursday afternoon, there wasn’t anything to suggest that he might be infected with a deadly biological agent, so the hospital began its standard protocol for flu-like symptoms and sent blood cultures to the laboratory.  These cultures were examined that Friday morning and, after finding all four to be positive, the laboratory technician followed LRN sentinel protocols and plated all four to watch for growth.  Normally samples like these would have been checked again at about noon on Saturday, but the laboratory technician was suspicious and made a point to look at them again later Friday afternoon.  Cue the ominous music and enter the Minnesota Public Health Laboratory, an LRN Reference Lab, at camera left, because those plates had growth!

Realizing what she might have on her hands, the sentinel laboratory technician made a call to the MN public health lab to let them know what was happening, and then personally packaged the samples and drove them to the delivery drop box to ensure they would arrive at the state laboratory the next day. Thanks to her diligence, the plated samples arrived at the state laboratory about 24 hours early, at 11 AM Saturday morning, and Sullivan says when the on-call molecular biologist opened the box, “she looked at the colonies, closed it right up, went and called her husband and said ‘I think I might be here for a while.’”

Sullivan got the call with positive results for B. anthracis spores at 2:30 PM that afternoon (while on a family vacation, I might add) and started making phone calls.  The submitting hospital had to be notified so treatment could begin as soon as possible, but positive anthrax findings don’t stop with identification.  Because anthrax is so dangerous, the Minnesota LRN-B’s next task was to determine whether this patient was deliberately infected.  This is the point in our script where the military enters, in the form of the National Guard’s 55th Civil Support Team (CST).  The Minnesota laboratory conducts regular trainings in conjunction with the 55th CST, and they have a great working relationship. In conjunction with the National Institute for Occupational Safety and Health (NIOSH), the 55th CST and two representatives from the Minnesota laboratory (Sullivan included) spent a day combing over the patients rental car, removing anything that might give them a clue as to where the spores had come from.  Altogether they collected over 50 samples, including the patient’s boots and a set of deer antlers.  While none of the samples collected from the car tested positive, Sullivan notes, “It was a very good collaboration with the CST team and with our partners at CDC to put the environmental sample plan together.”

Testing for anthrax

Meanwhile, the patient’s condition had deteriorated.  On Sunday, he was loaded into a medevac helicopter and sent south to a larger hospital for treatment. Despite a nail-biting collapse en route, doctors were able to stabilize him, and the following day a team from the CDC administered emergency treatment.  It’s important to note that this treatment would not have happened without the positive B. anthracis identification from the Minnesota State Public Health Laboratory. That treatment, coupled with the early changes to the patient’s antibiotic regimen after the positive identification, is likely the reason the patient recovered completely.

Like any good movie, this story leaves a few questions behind.  First, where did the anthrax come from? While the movie version of this story would probably end with some hint at nefarious origins in order to create a sequel, the truth is it was probably a complete coincidence.  Anthrax is found naturally in all seven continents and lies dormant in soil for hundreds of years.  The spores can reactivate when they are kicked up and inhaled, commonly by grazing animals.  Our patient had spent some time on his road trip collecting rocks from riverbeds, and at one point drove past a large herd of grazing buffalo.  It’s probable that he inhaled some spores (and it would only take one) in one of these locations, but we will truly never know. You may also be wondering why the patient’s wife didn’t get sick, despite being in all the same places and presumably getting the same exposures.  It’s possible that the patient’s history of lung problems might have made him more susceptible, but again, there is no way to know.  She may have just been very lucky.

Despite these questions, the reality remains that without the smooth functioning of the LRN-B, this could have been a very different story.  But thanks to the dedication of a wide variety of people, the patient was on the road to recovery a mere four days after the initial blood cultures were drawn.  “I think what this really showed us was that all of the efforts we’ve put forth for our training really have made a difference,” says Sullivan. “All of those things really came together and we had a very successful response.”

In conclusion, Contagion 2: LRN in Action.  Get the popcorn!

*Speaking of Contagion, my friends in Minnesota would probably like me to point out that this case study does an awesome job of refuting the movie Contagion’s very unflattering portrayal of Minnesota public health and emergency response systems.  Despite what Steven Soderbergh may have you believe, when trouble arrives in real life, Minnesota is on its game!

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Preparedness and Politics in Florida: All in a Day’s Work

Aug 28 2012 :: Published in Public Health Preparedness & Response

By Chris N Mangal, MPH, Director of Public Health Preparedness and Response, APHL; Rick France, PhD, MPH, Chemical Threat Coordinator, Bureau of Public Health Laboratories – Tampa, Florida Department of Health

Many of us are keenly aware of the upcoming presidential elections. The 24 hour cable news is inundating the public with the minutia of each campaign tactic, misfire or other rhetoric — it’s hard to miss that this is a critical time for the American people. So first pitch, whatever party you support – ensure you vote.

Second pitch – prior to voting, learn some more about the candidates and their platforms. That is, learn more about the services they support and how those services in turn support your community.

Republican National Convention

Speaking of supporting your community… a big part of our jobs is to educate people about public health, specifically public health laboratories and their role in protecting the nation’s health. Given that the country is ablaze with hot button political issues and the Republican National Convention kicked-off yesterday, we thought this is a great time to highlight Florida’s Bureau of Public Health Laboratories (BPHL), a critical component of the Florida Department of Health, charged with protecting the public health, safety and welfare of the citizens of the state. The BPHL supports Florida’s county health departments, physicians, hospitals and other Florida Department of Health program components by providing public health diagnostic and reference laboratory services.

The four BPHL laboratories (located in Jacksonville, Tampa, Miami and Pensacola), in addition to the Bureau of Food Laboratories of the Florida Department of Agriculture and Consumer services, comprise the Laboratory Response Network (LRN) in Florida. In addition to their daily functions, these laboratories have been planning for over a year to be ready for the activities surrounding the Republican National Convention (RNC) in Tampa, convening from August 27 to August 30. The four laboratories continue frontline efforts to prepare for and respond to all hazard threats such as natural disasters (What if Hurricane Isaac wreaks havoc on the Gulf states?); acts of terrorism (Remember anthrax 2001?) or emerging infectious diseases (West Nile Virus).

The Florida BPHL is not new to unusual biological events. In October 2001, they received a specimen from a patient at a south Florida hospital. The specimen was identified as positive for B. anthracis – anthrax. This turned out to be the index case for the American Media Inc. intentional release, and the subsequent Amerithrax (as it came to be known) Outbreak.

What do Florida’s public health laboratories do on a routine basis?

The LRN laboratories provide rapid detection of threat agents and expand the ability of the Centers for Disease Control and Prevention (CDC) to analyze a large number of patient samples by using unique high-throughput analysis capabilities when responding to large-scale exposure incidents.  Additionally, the LRN for Biological Terrorism Preparedness (LRN-B) has continued to provide training to the sentinel clinical laboratories for the packaging and shipping of infectious agents.

What is being done specifically for the Republican National Convention?

  • The LRN-B component of the public health laboratory has stepped up their outreach and training with first responders on sample collection for white powder and other incidents.
  • The LRN for Chemical Threat Preparedness (LRN-C) has been doing more outreach and training with the local health and medical community on awareness of and preparedness for chemical threats and exposure. In fact, the BPHL-Jacksonville is one of ten chemical surge capacity laboratories for the CDC and is able to detect metabolites of toxic chemical agents including blister agents, blood agents, nerve agents, hazardous industrial chemicals, toxic elements and biological toxins.
  • More importantly, these four laboratories worked together with the LRN-B and LRN-C to conduct a joint biological and chemical statewide exercise in preparation for the RNC. The exercise, conducted in February 2012, involved over twenty local, state and federal agencies as well as numerous hospitals and county health departments.
  • The BioWatch Program, a Department of Homeland Security (DHS) nationwide effort to detect the release of biological pathogens in the air, will also be on heightened awareness with an increase in surveillance. Additional staff have been brought in to assist with these increased surveillance efforts.
  • The BPHL will continue working closely with the Hillsborough County Health Department’s epidemiology program, which will be “extra vigilant” with their surveillance activities during the RNC. Epidemiologists will be paying close attention in particular to any reports of patients with an unusual rash, a food-related illness, cases of bloody diarrhea, any unexplained severe infectious illness or death in an otherwise healthy person.

The Florida BPHL has planned and prepared extensively for the upcoming RNC. Although there is always the possibility of the unexpected occurring, with increased outreach, training and exercises the laboratories are prepared to be on the frontlines no matter what.  It’s all in day’s work!

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APHL Annual Meeting Day 3

May 22 2012 :: Published in Annual Meeting

Meet Laurie Garrett

by Kim Ross, senior specialist of Communications, APHL

The threat of a major pandemic might scare the daylights out of most of us. But hats off to science writer Laurie Garrett who writes about it all the time—and enjoys it!

Laurie Garrett

Laurie, a Pulitzer-prize winning journalist, studies global health and disease prevention and has penned several bestsellers about epidemics worldwide. The author of two major public health books, Betrayal of Trust and The Coming Plague, she tells the frightening stories of diseases like the avian flu, tuberculosis, malaria and SARS—and the world’s vulnerability to them.

A native of Los Angeles, Laurie graduated with honors in biology from the University of California and attended graduate school in the Department of Bacteriology and Immunology at UC Berkeley. But it was her job as a science reporter at a local radio station that sparked her interest in the global health crisis; in particular, the lack of attention and investment in public health.

Following a brief stint at the California Department of Food and Agriculture assessing the human health impacts of pesticide use, Laurie headed overseas to southern Europe and Sub-Saharan Africa reporting on everything from the AIDs epidemic in Africa to the “collapse of public health” in the former Soviet Union. She recalls watching a baby die in her arms of measles in Zambia, and the mother—whose older child died of the disease minutes before—fall into a near catatonic state of grief. “Africa taught me both how deep the chasm of health between rich and poor countries was, and the complexity of solutions,” she said in an interview with Lab Matters magazine. “That pushed me to study why public health had failed with HIV and seemed unable to deal with epidemics.”

She later became a science correspondent at National Public Radio before joining the science-writing staff of Newsday in the late 80s, and continued chasing outbreaks globally in the 90s.

Today, Laurie is the Senior Fellow for Global Health at the Council on Foreign Relations, where she recently traced the history of US pandemics like the Spanish flu outbreak of 1918 that killed more than half-million Americans. Check out her insights online at lauriegarrett.com. Laurie’s stories—written in her signature, blunt style—present a sobering wake-up call for the public and policymakers alike.

Quotes in this article were published in “15 Minutes with Laurie Garrett,” Lab Matters Magazine, Spring 2012, pg. 28, Association of Public Health Laboratories, http://www.labmatters-digital.com/aphl


Top Tweets


@go_vikes Large # of internationally acquired cases of disease reported in King County (WA) attributed to foodborne bugs! #APHL

@scottjbecker CDC’s MicrobeNet is a hit at the #APHL member experience! Labs value this excellent resource. pic.twitter.com/Mos9dtlR

@meganlatshaw Who said feds don’t cooperate? Emergency preparedness & response exercise coordinated by EPA included state labs CDC, FDA, USDA & FBI #aphl

@chrisnmangal Garrett: More than 400,000 false tips after anthrax. Millions of dollars spent responding although threats were not credible. #aphl

@sharishea23 The foods we consume today are not the same as the foods eaten 50 years ago. The food safety system needs to adjust to changing needs #aphl

See more top tweets from the day here!

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Public Health Laboratories: A Critical Component of the Public Health Puzzle

Apr 26 2012 :: Published in Public Health Preparedness & Response

This week is National Medical Laboratory Professionals Week and National Environmental Laboratory Professionals Week.  APHL is honoring the many individuals working public health and environmental laboratories around the world.  Stay tuned for blog posts this week featuring the work of many of those unsung heroes working to protect the public’s health.

By Sikha Singh, MHS, Senior Specialist, Laboratory Response Network, APHL

Photographer: Jim GathanyDate:Description: CDC laboratory workerCategories: Health Occupations; CDC Buildings and Facilities; CDC Laboratorians Jim GathanyDate:Description: CDC laboratory worker

Despite ongoing budget decreases, public health laboratories continue to support prevention and population-based surveillance activities.  Each component of the public health system including first responders, sentinel laboratories, epidemiologists, clinical hospitals and the public health laboratory perpetuate the continuum of sustained population health.  These components of the system are greater than the sum of their parts, with each being an essential contributor to public health victories.  These victories include support offered during a variety of events including:

  • Pandemics like the 2009 Influenza A H1N1 pandemic
  • Deliberate attacks  like the 2001 Anthrax attacks
  • Resurgence of vaccine preventable diseases
  • Unintended consequence of natural disasters like the 2010-2011 cholera outbreak in Haiti following a massive earthquake

However, even in the absence of major events such as those listed above, public health laboratories work behind the scenes to perform daily activities ensuring that population health is maintained.  Business as usual, even during challenging economic times, involves public health laboratories performing a wide array of services including, but not limited to, newborn screening, emergency response, disease surveillance and detection, strain typing, identification of emerging diseases, environmental testing, and so on.

It cannot be stressed enough that public health laboratories keep the public safe and remain an essential element of the public health system.


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Dispatches from the Newbie: The 2012 Public Health Preparedness and Response Summit

Feb 28 2012 :: Published in Public Health Preparedness & Response

By Kara MacKeil, Senior Technician, Public Health Preparedness and Response

Greetings from sunny southern California! By the time you read this I’ll be back in chilly DC, but as I write it’s over 70 degrees outside and the Tower of Terror is beckoning.  The 2012 Public Health Preparedness and Response Summit has just wrapped up, and I think it’s safe to say this has been a very important, but very fun week for everyone involved.  Even though we can see Disneyland from our hotel rooms, the APHL staff and members who attended this meeting have been making the most of a great opportunity to form new connections in the world of public health preparedness and share ideas for improvement.  As a relative newcomer, I’ve been really interested to see all of the different types of agencies that work in public health along with the laboratories.  The exhibit hall was full of different vendors, federal agencies, and other groups, all with interesting positions and experiences to contribute (and great decorations for my desk).  But thanks to the Fantastic Wheel of Fun, the APHL booth was definitely one of the most popular stops in the exhibit hall!  Super-secret plans are in the works to top ourselves next year…

APHL's Kara MacKeil at the 2012 Public Health Preparedness and Response Summit

When I wasn’t handing out giant microbes, I did manage to make it to a few sessions.  I particularly liked the town hall discussion, “A Family Vacation That Won’t Soon Be Forgotten: A Naturally Acquired Inhalational Anthrax Case.”  Collaboration between different agencies and labs is something we talk about a lot and this was a great example of these partnerships — a local hospital lab (in this case the Lake Region Healthcare Laboratory in Fergus Falls, Minnesota) working with the Minnesota Department of Health Laboratory and the Minnesota National Guard Civil Support Team to identify and then respond to a very sudden, very scary case of inhalational anthrax.   This story had been covered in the national news from a public safety perspective, but the presenters chose to follow from the point of view of the patient, from zero hour to present day.  Seeing the process laid out step by step made the role of each participating agency very clear, and I thought it gave the audience a great way to connect with the story and understand the importance of these networks on a really personal level. The best part was that the patient recovered thanks to this seamless response structure!

My favorite session this week was the closing session, a talk by D.A. Henderson, MD, MPH on the history of public health preparedness and where it needs to go in the future.  Even though most of the attendees have been in this game a lot longer than I have, I think everyone there was just as captivated as I was.  As you might guess, the trajectory Dr. Henderson presented was very much a before and after 9/11 trend, but he pointed out that since 2001 we haven’t had the steady increase in funding and training you might hope for.  The theme of this year’s Summit was “Regroup, Refocus, Refresh: Sustaining Preparedness in an Economic Crisis,” and Dr. Henderson tackled this problem head on with his Complacency Curve to show the general decline in public health preparedness funding since 2001.  My hope is that this curve will shift soon. This session also touched on a personal interest of mine with Dr. Henderson’s answer to an audience member’s question about declining vaccination rates and how we might convince parents to get their children immunized.  When you’re talking preparedness it is easy to stay focused on biological and chemical warfare, but as a former healthcare worker, declining vaccine rates scare me just as much.  While it might be a little gruesome, I had to agree that parents might be more willing to vaccinate if they knew just how bad some of the vaccine-preventable diseases can be.  On the other hand, I know there are some parents who are never going to choose vaccination no matter what they’re advised to do.  I’ll be interested to see where this issue goes as herd immunity gets weaker.

Aside from the early morning start-times (and the jet lag), we all had a great time and learned a lot.  I hope the new ideas from this meeting stay with us when we get home, but the sooner the ticking of that prize wheel leaves my dreams, the better…


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What We’re Reading: White Powder Edition

As you may have heard, letters containing white powder have been sent to several Congressional offices and media organizations.  Luckily the powder has been determined to be harmless.  How do we know that?  While information on exactly where the powder was tested has not been released for security purposes, it was likely sent to a public health lab.  Public health labs test suspicious powders like this on a routine basis.  It is part of their job.  And even though the vast majority of “white powder” samples that are sent to the labs are proven to be harmless, they are all treated as though they are the real deal.  It is just another way the public health labs are protecting the lives of all Americans.



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What We’re Reading This Week

Feb 01 2012 :: Published in What We're Reading

We are starting a new column on our blog: What We’re Reading!  Each week we will post particularly interesting articles that we are reading that relate to public health and science.  If you come across something that you think we should be reading, please leave a link in the comments!

February 1, 2012

  • This Is What A Scientist Looks Like: This isn’t actually an article, but is a Tumblr of photos of scientists.  The woman who manages the site lets people submit photos to be posted in an effort to dispel stereotypes of what scientists look like.  Such a simple thing yet it makes a big statement!  I love checking this site every day to see all the scientists.
  • RI screened 100 percent of newborns in 2011: In every state, parents may opt-out of newborn screening for their baby.  It is exciting to see that in Rhode Island, they were able to test every single baby born in that state in 2011.  Babies of Rhode Island, you’re good to go.
  • The Curse of the White Powder: How fake bioterrorism attacks became a real problem: This is an interesting take on the white powder hoax letters that are often sent to government and other offices around the country.  An APHL staff member did make a great point that it leaves out the lab — while these letters are ultimately fake, the labs take them just as seriously as if they contained anthrax.  When you consider the testing they do to determine that they are fake, it really shows the strength of our preparedness and response systems.
  • Inside the lost island of New York: Eerie pictures of the abandoned leper colony just 350 yards from the Bronx: Incredible story with incredible photos.  It is amazing to read this story and think about how far our public health system has come.  North Brother Island was a quarantine center for people with highly contagious diseases.  It became a leper colony, and was the home to “Typhoid Mary.”  This is a must read if you ask me.



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A Culture of Preparedness

Nov 01 2011 :: Published in Public Health Preparedness & Response

By Karthik R. Sivaraman, MPH Candidate, Intern at the Institute for Disaster and Emergency Preparedness, College of Osteopathic Medicine, Nova Southeastern University

Ten years ago anthrax filled letters were mailed around the US, resulting in death, sickness and mass hysteria. One letter was sent to Boca Raton, Florida, not too far from where I attend graduate school. My own university has had two separate white powder incidents. Public health laboratories and biohazard response teams determined that neither incident was positive for anthrax. The events at my university were resolved via conscious vigilance by the staff, students and local response efforts. The attacks in 2001 lead to the notion that it is not a matter of whether a disaster will happen, but more a question of when a disaster will happen. In turn, we as a society must pursue a culture of preparedness.

In the decade since September 2001, millions of hours and dollars have been spent to better secure our safety and stop threats before they have a chance to act. The dilemma now is finding ways to decrease loss caused by man-made and natural disasters. The Deepwater Horizon oil spill, the Japanese earthquake and ensuing tsunami, the Joplin, Missouri tornado and pandemic disease (such as avian and swine influenza) have influenced the national psyche and have instilled fear. These events devastated the local populations, the resources they depend on and/or diminished their livelihood.

As our society becomes more complex, how can we address the issue of disaster and emergency preparedness and reduce fear? As I see it, the answer comes in two parts: promote preparedness and encourage resilience. Promoting preparedness goes beyond stocking up on water, food and amenities for the occasional hurricane. A culture of preparedness indicates that all people should prepare for the eventuality of a disaster. Preparedness includes creating a plan, practicing that plan and having a “go kit” for when you may need to evacuate your home or office. Preparedness can be applied to public health laboratories as well. The ability to continue functioning during a pandemic or violent weather can be the difference between lives saved and lives lost. Building resilience is equally important; recovering from a disaster requires the ability to reclaim your life, reestablish lab functionality and, more importantly, reclaiming your identity and accepting a new normal.

During National Preparedness Month (September 2011), surveys of people on campus and in the local community revealed that they had the bulk of required items to mitigate a disaster (food, water, medical materials, clothing, etc.), but the majority of it was dispersed around the house. Even more disturbing were those that had no preparedness plan or kits at all, because of the expectation that “the government will help me.” Although the government can and does help during major disasters, the current economic turmoil we are experiencing makes it even more imperative to prepare, plan and remain resilient. Moreover, engaging people to take the initiative to foster preparedness and resilience within their own communities is both sustainable and empowering.

A culture of preparedness is not about being an alarmist or causing panic. It is an idea that revolves around fostering community awareness, empowerment and prevention. It is about people helping people. In addition, disaster and emergency preparedness requires the tools and talents of all public health entities: first responders, public health laboratories and healthcare providers. If we can foster resilience, promote a culture of preparedness and remove complacency from our national lexicon, we can truly, as Sir Winston Churchill said, “Let our advance worrying become advance thinking and planning.”

Meet Karthik at about.me/karthikrs or on Twitter (@KarthVader)



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