BIOTERRORISM A New Role for Laboratories

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BIOTERRORISMA New Role for Laboratories

• Mary J. R. Gilchrist, Ph.D.
• Director, University Hygienic Laboratory

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Problems with On Site Tests

• Handheld SmartTickets
• False positive results in 2001
• False negative results
• Rapid PCR tests not yet adequate to detect low
  levels of organisms
• R.A.P.I.D. tests may also confound and deplete
  resources
• Data on tests expected soon

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Other On-Site Testing

• Biowatch
• Monitors air around major cities
• Filters removed daily
• Sophisticated testing modalities
• Positive signals refereed
• False positives minimal

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On-Site Testing Expected

• U.S. Postal Service
• Continuously monitor air in sorting facilities
• Currently prototyping in few facilities
• Will institute throughout the U.S. at end of
  trial
• Plan to shut down facility with each positive
  signal

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Laboratory Response Network Clinical Laboratories
- A Level Public Health Laboratories - B
Level Advanced Public Health Laboratories - C
Level Federal Laboratories -D Level (CDC, DOD,
FBI, DOE)
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Role of Sentinel Laboratories(Clinical
Laboratories)

• Detect cases of disease due to bioterrorism when
  they are not suspected or known to be occurring
• Forward suspect organisms for Level B/C labs for
  confirmation
• Forward specimens to Level B/C labs when
  bioterrorism is suspected or known to be occurring

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Sentinel Laboratories in Iowa
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Interactions with Sentinel Laboratories

• Early ICN presentations 1999-2002
• Survey 2002-2003
• On site training 2003
• Wet laboratory training
• Specimen collection kits
• Bioterrorism kits

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Role of Level B/C Labs
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Testing Strengths at UHL

• PCR
• Q fever
• Plague
• Anthrax
• Tularemia
• Brucellosis
• Glanders

• Other
• Meliodosis
• Ricin
• SEB

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Partnerships

• Medical Community
• Emergency Responders
• State and Federal Law Enforcement
• Public Health
• Industrial Hygiene and Safety
• Iowa Industry
• Iowa public information and citizenry

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Whats Next?

• Chemical instrumentation and protocols
• Survey Deficiencies
• Biosafety cabinets
• Procedures protocols
• Training
• Improving Communication Tools
• On line real time result reporting
• Connectivity with sentinel labs

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Mature State Laboratory Communications
System
In-state Micro Labs
CDC

Military Partners
UHL
In-state Reference Labs
APHL/LRN
Public Health Labs in adjoining states
Out-state Reference Labs
HANNEDSSEPI-X Broadband ISPs
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