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!“