OUR IMPACTState
Hygienic Laboratory
www.shl.uiowa.edu
INFECTIOUS DISEASE THREATSBY THE DECADE
COMPONENTS OFDISEASE CONTROL
IOWA COUNTIES SERVED99
1970SLEGIONELLA
DISEASE CONTROL
16
2
45,061105,576
1,231
960
16
118
28,750
1,250
2,484
79
2,762 18
920
3,543
1,473
26
8,567
1,097
516
93
2,269
1,196
5,0021,540
301
7557
1,950
6,623
1,157
14,747
664
9361,556
11
1
321
0
86
1,024
47
975
36
1,324
674
92
13
50
202
1,458
1,063
24
10
1,110
3,586
36,877
1
654
58
86 2,4724,507
6,069
141
122
440
22510
3,580
958
152
1,122
879
2,314 0
9,687
1,750
15
10
27,481874
4,912
13,289 258
3
1,262
461
7,477
188 1,532
1,417
4,801
582,744
22,549
10
2,595
*Includes numbers not assigned to counties
Clinical Disease Analyses Performed for Iowaby the State Hygienic Laboratory
Fiscal Year 2016 = 90,385*
1980SMRSA
HIV
1990SNIPAH VIRUS
WEST NILE VIRUS
2000SMONKEYPOX
SARS
2010SANTIBACTERIAL
RESISTANCE
EBOLA *Based on fiscal year 2016 numbers
OUTBREAKINVESTIGATION
SURVEILLANCE RAPIDDIAGNOSTICS
24-HOURRESPONSE
NEW TECHNOLOGIESAND METHODS
STEPS IN ANOUTBREAK INVESTIGATION
DETECT A POSSIBLE OUTBREAK
FIND CASES IN AN OUTBREAK
GENERATE HYPOTHESESTHROUGH INTERVIEWS
TEST HYPOTHESESTHROUGH ANALYTICSTUDIES ANDLABORATORY TESTING
SOLVE POINT OFCONTAMINATION ANDORIGINAL SOURCE OFOUTBREAK VEHICLE
CONTROL OUTBREAKTHROUGH RECALLS,FACILITY IMPROVEMENTSAND INDUSTRY COLLABORATION
DECIDE AN OUTBREAKIS OVER
If cases continue
If cases stop
Not findingassociations
RECALL
RECALL
OUR IMPACT - DISEASE CONTROL
SURVEILLANCE
The State Hygienic Laboratory identifies the incidence and location of illnesses that affect population health, and does so in partnership with:
• Iowa Department of Public Health and local health departments• The Centers for Disease Control and Prevention• Health care facilities across Iowa• Laboratory Response Network• Food Emergency Response Network
OUTBREAKS
The laboratory’s Disease Control Division helps limit the spread of illnesses by rapidly identifying pathogens that cause outbreaks.
• Multiple foodborne outbreaks-Salmonella, Listeria• Mumps primarily in Iowa’s Regent universities • Noroviruses often in long-term care and child-care facilities
SPECIALIZED TESTINGAs Iowa’s public health laboratory, the State Hygienic Laboratory maintains expertise and capacity in many areas of specialized testing.
• Environmental Microbiology – food and water testing and foodborne outbreaks
• Microbiology – statewide antimicrobial resistance monitoring, rabies testing, foodborne pathogen testing
• Molecular – influenza surveillance• Serology – Zika virus screening• Maternal Screening – identification of genetic dispositions
NATIONAL LEADERSHIP
Our laboratory scientists lead the nation in many areas of public health. • Organism genotyping (Mycobacterium, Salmonella, Shigella,
E. coli)• Detecting Cryptoporidium and Cyclospora• Laboratory Response Network (LRN) and Food Emergency
Response Network (FERN) responses• Advanced methods to detect pathogens at the molecular level
OUR IMPACTState
Hygienic Laboratory
www.shl.uiowa.edu
COMPONENTS OFEMERGENCY
PREPAREDNESS
EMERGENCY PREPAREDNESS
BiosafetyLevels
forTesting
PATHOGENS SUCHAS HIV AND STAPH
INFECTIONS
HIGHLY INFECTIOUSPATHOGENSSUCH AS ZIKA
LOW-RISK MICROBESSUCH AS E. COLI
BSL1
BSL2
BSL3
DANGEROUSMICROBES SUCH
AS EBOLA
BSL4
PREPAREDNESSBY THE NUMBERS
Counties and LocalPublic Health Agencies
Hospitals
EMS Providers
Health Care Coalitions
Sentinel Laboratories
HazMat Teams
99118
93474
126
PARTNERING TRAINING
DETECTINGTHREATS DISASTER
PREPAREDNESSRESPONSIVENESS
22
PARTNERS
10
PATIENTS
COMMUNITIES
NATIONAL &GLOBAL HEALTH
OUR IMPACT - EMERGENCY PREPAREDNESS
NETWORK
A network of teams that specialize in preparedness and response work together to determine if an unknown agent or infectious disease poses a health risk to Iowans. Teams include:
• State Hygienic Laboratory• Homeland Security and FBI• Fire Departments and HazMat Teams• 71st Civil Support Team• Iowa State Patrol• Local law enforcement agencies
PREPAREDNESS
The State Hygienic Laboratory provides highly specialized training for partners with
• Bioterrorism laboratory workshop• Full-scale exercises and drills• Packaging and shipping training• Specimen collection training• Field identification of threats training
EVENTS
Threats to public health and safety can happen anywhere including in the small towns and facilities in Iowa. Some recent events include:
• Castor beans – Osage• Unknown substance – Eastern Iowa Airport• Pesticide drift – Marion• Cyanide powder – Centerville • Credible threat letter – Oskaloosa
RESPONSE
The State Hygienic Laboratory is on-call around the clock, 365 days a year to identify biological, chemical and radiological threats to Iowans. It responds with
• Some of the most highly trained laboratory response staff in the state• Testing of highly infectious agents • Biosafety level 3 laboratories• Statewide courier for routine and urgent sample transport• Tier 1 select agent registration – extra physical security and personnel
reliability requirements
OUR IMPACTState
Hygienic Laboratory
www.shl.uiowa.edu
SAFEGUARDING HUMANAND ANIMAL HEALTH
PREVENTING HEALTHISSUES SUCH AS:
ECOSYSTEM DIVERSITYPROTECTION
WATER AND LANDPRESERVATION
· RESPIRATORY· NEUROLOGICAL· FOODBORNE ILLNESSES· CANCER· SKIN CONDITIONS
IOWA COUNTIES SERVED99
ENVIRONMENTAL HEALTH
SAFE WATER
CLEAN AIR NUCLEARPREPAREDNESS
FOOD EMERGENCYRESPONSE
783
16
23,24039,124
984
374
70
244
436
846
125
585
1,344 489
116
903
1,059
1,671
1,850
163
1,211
158
894
876
38347
2,147
12166
730
797
2,630
596
299
689433
44
444
135
3
793
167
2,640
278
348
1,499
669
33
6
860
255
28
845
1,046
618
476
3,209
5,306
780
340
44
833 99103
119
1,036
793
57
2234
3,265
2
137
155
189
31 5
1,582
224
370
0
1,807447
368
7,708 329
125
309
234
1,299
889 4,754
1
169
453524
822
280
474
Environmental Health Analyses Performed for Iowaby the State Hygienic Laboratory
Fiscal Year 2016 = 145,714*
*Includes numbers not assigned to counties
AIR QUALITYStatewide monitoring network at 29 sites
WATER QUALITYLakes, rivers, streams, impoundments
(more than 200 waterways), recreationalwater and private wells
FOOD SAFETYFood Emergency Response Network and
Rapid Response Team
TOXIN ASSESSMENT AND RISKMANAGEMENT
Contamination evaluation and quantification
NUCLEAR PREPAREDNESSState and regional service
MAKING ADIFFERENCE
IN IOWA
TOXIN DETECTION
SOIL QUALITY
OUR IMPACT - ENVIRONMENTAL HEALTH
AMBIENT AIR QUALITY
Collects data from more than 100 monitors at 29 sites in 16 Iowa counties to monitor air quality. Poor air quality may affect the health of those with respiratory conditions, the elderly and the very young.
LIMNOLOGY
Collects and analyzes samples of surface water, wastewater and groundwater throughout Iowa. Limnologists examine the physical, chemical and biological characteristics of aquatic systems and their watersheds. Among the many toxins that limnologists monitor are lead, mercury, pesticides and arsenic.
RADIOCHEMISTRY
Primarily performs analyses of water and soil to determine radioactivity concentrations, but also is capable of analyzing air, food, milk, urine and foliage. Radionuclides can be harmful to human health if inhaled or ingested. The section maintains preparedness for any radiation emergency response incidents.
ENVIRONMENTAL CONTAMINATION
Assesses for the toxic chemicals and elements in the environment that are threats to human and animal health. The Hygienic Laboratory analyzes air, soil, water, vegetation and food for potentially toxic organic compounds, such as plasticizers, pesticides, pharmaceuticals and industrial chemicals. It also measures minerals and metals in the occupational and natural environment, some of which are harmful to health even with minimal exposure.
OUR IMPACTState
Hygienic Laboratory
www.shl.uiowa.edu
Timeline of Events
COMPONENTS OFNEWBORN SCREENING
BABIES SCREENED - FY2016
BabiesScreenedby CountyFY2016
0-100
100-500
500-1,000
1,000-3,000
>3,000
1966IOWA BEGINS
NEWBORNSCREENING
71
24
1,7696,586
143
138
55
281
1,054
257
256
171
287 105
106
238
120
172
411
117
115
119
170
144
550203
1,332
11989
167
167
159
1,119
96
154171
123
32
109
82
100
195
107
161
35
167
82
117
74
183
250
373
170
234
107
154
322
2,778
99
94
180
176 275352
500
59
86
80
9067
514
180
53
106
105
278 64
572
162
54
82
2,07988
483
882 180
42
120
62
425
534 327
70
423
82137
1,491
52
151
*Includes 2 that are not assigned to a county.Based on mother’s zip code
2005SHL PROVIDES
SCREENING FORLOUISIANA AFTER
HURRICANE
1992SHL BEGINS
SCREENING FORNORTH DAKOTA
NEWBORNS
2006COURIER PROGRAMBEGINS FOR DAILY
COLLECTION OFSPECIMENS2007
SHL BEGINSSCREENING FORSOUTH DAKOTA
NEWBORNS2013
NATIONAL 50TH
ANNIVERSARY OFNEWBORNSCREENING2013
MILWAUKEE JOURNALSENTINEL IDENTIFIESIOWA & DELAWARE
AS MODELPROGRAMS
2016IOWA NEWBORN
SCREENING PROGRAMCELEBRATES ITS 50TH
ANNIVERSARY
IOWA NEWBORNSCREENING PROGRAM
NEWBORN SCREENINGBY THE NUMBERS*
Babies born in U.S. who are saved orhave health improved
Conditions detected
Iowa babies screened
North Dakota babies screened
South Dakota babies screened
Analyses performed for Iowa
12,000
50+
41,509
13,734
13,695
331,660
*Based on fiscal year 2016 numbers
STATEWIDECOURIER
SAVING LIVES 7 DAYS A WEEK
SCREEN FROM 5DROPS OF BLOOD
BIRTHING FACILITIESAND MIDWIVES
OUR IMPACT - NEWBORN SCREENINGSince 1966, hundreds of Iowa babies have been helped through early detection of inherited conditions that, if left undetected and untreated, can have devastating health effects. The Iowa Newborn Screening Program works 365 days a year, to ensure that these conditions are identified so lifesaving treatments can be provided and babies can thrive. In their own words, parents describe the impact of the Iowa Newborn Screening Program.
THE FAMILY CIRCLE
Brody (top, left) and Brooke were born with biotinidase deficiency. Biotin is used in the body to breakdown fats, proteins and carbohydrates. If left untreated, this serious condition can cause coma or death.
”We feel fortunate that our children are healthy, active and can live a normal life like any other child. We are grateful we know how to keep our children healthy.“
JUST IN TIME
Zach was the first baby in Iowa identified through the Newborn Screening Program with MCAD (medium chain acyl-CoA dehydrogenase) deficiency just one month after screening for the rare genetic disorder was added to the program.
”There are no words to express how grateful I am [for newborn screening]. My son probably wouldn’t be with us today without it.“
YAY! FOR NEWBORN SCREENING
Payton (left), Max and Garrett were diagnosed with classic galactosemia in which the body is unable to properly digest galactose, a sugar found in all foods that contain milk. Babies who do not receive prompt treatment may die within the first few weeks of life.
”All are doing an outstanding job in school and are happy,healthy kids.“
FOUR IOWA
As infants, these four brothers (circling the group) were diagnosed with Phenylketonuria or PKU. It was the first condition in the nation that was detected when newborn screening began in the 1960s. If left untreated, PKU can cause permanent brain damage.
”Everyone is doing great. We are blessed!“