Lab Matters Fall 2017 | Page 35

member spotlight

Society for Microbiology , the American Academy of Microbiology conferred upon Iwen the distinction of fellow .

Staff

NPHL directly employs 12 people ( some partially supported through other university programs ), including Iwen , six microbiologists , two chemists , an administrative assistant , a training coordinator and a state biosafety officer . Federal dollars also support positions in the NM clinical laboratory and in the NE-DHHS Public Health Environmental Laboratory in Lincoln .

Revenue

The annual budget fluctuates around $ 2 million , with most of that funding from federal grants coming through the NE-DHHS . The university supports basic functions , such as human resource assistance , security , sponsored programs management , IT support , environmental services , utilities and billing services . In addition , NPHL has access to electronic laboratory reporting ( ELR ) through the NM ELR system .

Testing

NPHL is responsible for roughly 50,000 public health tests a year . Those tests performed on site are highly specialized and include influenza and Zika virus PCR , epidemiological tests for foodborne pathogens , mosquito testing for arboviruses and tests for high-risk pathogens . As part of the latter , NPHL provides laboratory support for NM ’ s Nebraska Biocontainment Unit ( NBU )— one of ten regional US treatment centers that provide care for patients infected with a deadly infectious disease . As a member of the Laboratory Response Network for biological and chemical terrorism preparedness — and registered as a Tier 1 Select Agent laboratory — NPHL also performs select agent confirmatory testing and screens suspicious , unknown environmental samples . To control costs , Nebraska ’ s newborn screening is contracted out to PerkinElmer , Inc .

Success Stories

• Collaborated to develop training on the safe handling / processing of specimens potentially containing a special pathogen through the National

Lead Technologist Vicki Herrerra trains staff of the National Ebola Training and Education Center on correct PPE use . Photo : NPHL

Ebola Training and Education Center , a federal program coordinated among UNMC , Emory University in Atlanta and Bellevue Hospital in New York City .

• Coordinated the laboratory testing for patients admitted to the NBU during the Ebola virus disease outbreak . NPHL was also the first public health laboratory to package and ship Ebola-infected specimens through a commercial courier . “ That was a big deal since no guidance was available at the time on how to do this ,” Iwen said .

• Implemented a multiplexed PCR assay to detect gastrointestinal pathogens to include a program to provide culture services to support cultureindependent testing in Nebraska .

• Developed a web-based laboratory telemedicine service , STATPack TM , in collaboration with the University of Nebraska at Omaha . This program allows clinical laboratories to send digital images of suspicious or unknown organisms to the NPHL for identification or other consultation . More than 20 systems are now deployed in Nebraska , and the Oklahoma and Kansas state PHLs have also installed the system in their states .

• With UNMC , created a post-doctoral clinical microbiology fellowship training program , accredited by the Committee on Postgraduate Education Programs of the American Academy of Microbiology . The two-year program qualifies a fellow to sit for the examination for certification as a diplomat of the American Board of Medical Microbiology — a certification that qualifies PhD microbiologists to serve as laboratory directors under CLIA . Several individuals now working in public health have gone through this program at UNMC .

• Developed the Electronic Laboratory Information Reporting Technology ( ELIRT ) software to enable test ordering and reporting with NE-DHHS clinics . The system is integrated with the NM ELR ( Sunquest System ) and with the National Electronic Disease Surveillance System , through which Nebraska epidemiologists gain real-time access to reportable disease results .

• Established a statewide program to detect and confirm carbapenemaseproducing organisms .

• Produced an international quality assurance program for FTIR and Ramon devices .

• Set up a statewide specimen courier service in collaboration with UNMC Regional Pathology Services .

Challenges

• Providing services to a population spread across 77,000 square miles , including many “ completely rural ” jurisdictions .

• Maintaining a highly competent staff of scientists in an environment of fiscal uncertainty .

• Adhering to the “ ever-changing regulatory requirements as defined by the Federal Select Agent Program and CLIA in a financially restricted environment .”

Goals

• Serve as a regional reference center for pathogens with high prevalence in Nebraska , such as West Nile virus and other arboviruses , Yersinia enterocolitica , Cryptosporidium and Francisella tularensis . Genetic characterization of F . tularensis is an ongoing collaborative research program among personnel at NPHL , UNMC and the US Department of Defense .

• Expand mutual research opportunities with UNMC faculty .

• Enhance relationships and integration with state epidemiologists , who are located in facilities 50 miles from NPHL .

• Continue upgrading the laboratory ’ s information technology systems . n