North Carolina’s

Role in

Preparedness

Objectives

• How you fit into the LRN• Describe critical aspects of lab

preparedness, surveillance and reporting, and response for bioterrorism

• Explain how clinical labs can access State PH Lab

• Access resources and training about response to bioterrorism

Laboratory Response Network

• Established in 1999 in response to Presidential Directive 39 which outlined national anti-terrorism policies and specific missions to federal agencies

– CDC, FBI & APHL

• Mission

– Enhance public health infrastructure

– Integrate labs to create national & international network equipped to respond to acts of biological or chemical terrorism, emerging pathogens, etc.

Laboratory Response Network

• Sentinel Lab – Level A– Hospital, Health

Departments, private and commercial labs

• Reference Labs – Level B/C– State, Local, Military,

Federal and international labs

• National Labs – Level D– CDC, USARMIID,

NMRC

Roles of the LRN Lab

• Reference service• Specialized testing• Direct services• Environmental

testing• Rapid Testing• Laboratory

Improvement• Applied research

• Disease identification and outbreak investigation

• Support of Surveillance and Epidemiology Investigations

• Emergency Preparedness and Response

All Laboratory Levels:

• Work Together As Members Of The National Laboratory Response Network for Bioterrorism

• Also Includes Department Of Defense, The Federal Bureau of Investigation, And Other Law Enforcement And Public Safety Agencies

Network Development• Lab Assessment

– Detailed Lab information via Sentinel Survey– Current Biosafety level and Clinical Scope

• Education– Online Training Resources (aphl.org)– Sentinel Lab Procedures (ASM)

• Training– Preparedness Workshop – 3x/year– Packaging and Shipping – 3x/year

• Proficiency– Sentinel Laboratory Drills– CAP-LPX – Laboratory Exercise

CAP LPX Preparedness Exercise

• Developed by CAP, CDC, and APHL• Provide laboratories with opportunity to

assess capabilities to detect pathogens of epidemiologic importance– Rule out and refer– Correct plan for notification– Packaging and Shipping– Handling of organisms

Current NC State Laboratory of Public Health

Anthrax in the US Mail - 2001

www.webofhope.com

Why is the Public Health Lab involved?

• Mandated by Congress• Experience with Biological agents of

concern and outbreak investigations• Link between local lab level and

CDC/federal agencies

The Role of NC State PH LabPreparedness Unit

• Represent national Laboratory Response Network in state jurisdiction

• Conduct standardized LRN/CDC protocols• Rule in or rule out presence of biologic

agent• Preserve forensic evidence for criminal

investigation

Preparedness Contact Information

• SLPH Main # – 919 733-7834

• BTEP Unit– Main Line- 919-807-8765– BT Pager (24/7)- 919-310-4243 – BT Duty Phone (24/7)- 919-807-8600

• CT Unit– Main Line- 919-807-8771– William Parks (cell) 919-602-2481 – Bernard Barrameda (cell) 919-710-5104

Clinical Laboratory Bioterrorism Readiness Plan

• http://www.asm.org/images/PSAB/BT_Readiness.pdf

• American Society For Microbiology (ASM) provides a model for laboratories to use for developing a bioterrorism (BT) preparedness plan.

• Serves as an aid in the process of developing a specific plan for each institution.

Have A Plan• Purpose• Contact Protocol and Chain of Communication• Laboratory Response Network• Responsibilities of the Clinical Laboratory• Sentinel Level Laboratory Guidelines• Packaging and Shipping Instructions• Information Checklist• Handling of Possible BT agents• Policy Sign-off List• Training Sign-off List• Therapy of BT agents• Appendix

Questions to Answer When Creating Your Plan

• What is the biosafety level of my lab?• Is my lab active in the LRN?• Where is the nearest higher level lab?• What guidelines should be followed to

package and ship biological agents?• Whom should I call?

Test Your Plan Annually

• Have a plan, test your plan, and keep it updated

• Provide training/in-service to your staff.• Know whom to call• Know chain of custody requirements• Know shipping requirements

Bioterrorism Web Sites• CDC: Laboratory Information for BT Emergencies

– http://emergency.cdc.gov/bioterrorism/lab.asp

• CDC: Main BT homepage– http://www.bt.cdc.gov/

• FDA: Main BT page– http://www.fda.gov/Drugs/EmergencyPreparedness/

default.htm

• SLPH Web Site:– http://slph.state.nc.us/default.asp

Conclusion

• The use of a biological or chemical agent for terrorism is a low probability event with very large, potentially devastating consequences

• BE PREPARED!

Course Pre-test

• Thank you for participating in North Carolina’s Role in Preparedness.

• The pre-test for the course is available at: http://www.quia.com/quiz/3062810.html

Questions or comments?

Contact:Barbie Page, MS, MT(ASCP)

Bioterrorism and Emerging Pathogens Unit

Barbie.page@dhhs.nc.gov

252-714-0184