I'm really excited about
of time with you this evening beto talk about the Wisconsinbit
State Lab of Hygiene. It really is your public health
and environmental lab here in Wisconsin.
We do a lot more than bioterrorism and emerging
infections. But as I go through,
I'll emphasize a few of those areas, as well.
I'd like to share with you
the State Lab of Hygiene. We'll do almost a virtual tour
of some of our areas, and then
roles that the State Lab discuss some of the current
the University and in Wisconsin. of Hygiene fulfills here at
beginnings here at We had some very early
Back in 1903, the legislature passed a law and appropriated
the big sum of $1,500 to establish a laboratory
known as the Hygienic Laboratory
of Wisconsin. The laboratory was first opened
in October of 1903, in the
just up the street basement of what is now Ag Hall
It was a very modest one-room laboratory that primarily
focused on bacteriological
a little later on, some bacteriological testing for
a number of infectious diseases.
what's often being referred to The laboratory was founded on
Back around 1902, Governor as the "Wisconsin Idea."
the UW President, President Van Hise, got together
and they came up with something known as the "Wisconsin Idea."
And in short, what the
take the resources, the Wknowledge of the University ofo
Wisconsin to the corners of the state, to benefit state
government, local government, and really all the citizens of
our state.
the year when the School of Medicine at this University is
celebrating their 100th anniversary, and not to be
outdone, but the State Lab of Hygiene has actually been
around a little bit longer than the School of Medicine.
The State Lab of Hygiene
University, which is somewhat unique for laboratories like
ours, many of the public health and environmental laboratories
are really attached to a state
of Health or the Department execuof Natural Resourcesment
or Environment. But in Wisconsin, the decision
was made very early on to place this laboratory at the
University of Wisconsin and give it the challenge of meeting
part of a scientific mission of the university, participate in
teaching, participate in
promote public health throughout research, and above all, to
Some early shots from our laboratory.
This is the first laboratory. The second laboratory
was actually moved from the Agriculture building over to
South Hall, which is
That laboratory actually up on Bascom Hill.
They hired a few more people. They expanded the scope of
testing.
quality, a little bit of air They primarily focus on water
really began testing quality, and that's where they
diseases, shortly after for the turn of the century.ble
From there, in 1928, the lab
then called Wisconsin General Hospital, which is the old
University Hospital,
And again the mission of the right behind where we are.
became the laboratory to support laboratory expanded, and we
and Family Services, and the the Department of Health
Department of Natural Resources labohere in Wisconsin.the
We're actually established
The Wisconsin Statutes, among other things, indicate that the
Wisconsin State Lab of Hygiene
teaching in the fields should be a facility for
and environmental protection. And I think today, as I look at
laboratories like ours around the country, I'm one of the few
people who have actually
laboratories similar to ours. I can honestly say that here
in Wisconsin, we've taken that
have done a lot more with that mission very seriously and
states have. than what many of the other
back in 1914, the Dean of the Medical School, he had a
joint appointment as Director of the State Lab of Hygiene.
Later on, Dr. Al Evans was named
At the time, he was also director the laboratory.
Preventative Medicine. chair of the Department of
and in fact I might mention that I started my public health
career in the building and
And Dr. Stan Inhorn was instrumental in convincing me
that I really ought to go back to graduate school.
And little did I think after
and going to the CDC, and out west for a number of years
that I would have this
to the University of Wisconsin. But Dr. Inhorn was chair of
the Department of Pathology and also director of the laboratory.
More recently, up until 2006, Dr. Ronald Laessig was director
of the lab and also a professor of Pathology and in
Population Health Sciences. The statutes that created
the State Laboratory of Hygiene also indicated that there
would be an autonomous
direction to the laboratory. or independent board to provide
Chancellor of the University That board consists of the
secretaries of the three or his designee and the
And those are the Department agencies that we support.
the DNR and the Department of Heath and Family Services,
and Consumer Protection. of Ag, Trade
can identify an individual Each of those secretaries
In addition to that, the to sit on our board.
represent clinical laboratories, Governor appoints a physician to
laboratory industry, a person from the environmental
health lab industry, someone from the occupational
the health department, a person from local
one of whom must be a coroner and tor medical examinermbers,
here in Wisconsin.
of people throughout Wisconsin We support and serve a lot
and environmental testing. by providing clinical
our laboratory to provide occupational health testing
and industrial hygiene testing. I'll say a little bit more
about that a little later.
laboratories are physicians, But the people who use our
as well as a number of federal hospitals and clinics,
that we do next door. We work very closely with thek
Center for Disease Control, the EPA, with OSHA,
with the USGS, and a number of public health environmental
projects that impact many of us here in Wisconsin.
We also like to think that we are the laboratory that
supports the local health department infrastructure
throughout the state. We support them, as well as the
Tribal Health Centers here in Wisconsin.
We also have an academic
And we are always looking out for other places on campus
where we could link up
to provide laboratory support witto projects thaters
they are already undertaking. Our staff are actively involved
in a number of professional and research associations
such as the American Waterworks Association,
the American Professional Hygiene Association, and the
Association of Public Health
Although we are not a private laboratory like you would see
elsewhere in the state, we do do some work directly
for the citizens upon request.
are funneled through the Usually these requests
or through the Department of Natural Resources.
And one of the other things that we have become since the
late 1980s, has been the primary
laboratory to support bioemergency responsesrism
here in Wisconsin.
of the National Environmental And weResponse Network. a part
So what do we do? If we look at the scope
of everything that we do in our laboratory, we're primarily
a reference testing laboratory
We're involved in the teaching for clinical specimens.
We have an active research mission at the university.
outreach program, looking for ways to take our services
throughout the entire state.
locations here in Madison. We do that from two main
next door, 465 Henry Mall. The first is the building
was built specifically That's the building that
in 1953. for the State Lab of Hygiene
houses our communicable disease And thadivision,g today
the disease prevention division,
improvement division, and the management offices
for our laboratory. That's about
a 100 square foot building. In addition to that, in 1999,
we dedicated a building out on the East Side of Madison
out near the Department of Agriculture.
And that's where we house our environmental health division,
where we have a large environmental sciences
laboratory, an occupational or industrial
hygiene laboratory, as well as our forensic
toxicology laboratory is
is about 72,000 square feet. housed in that building, which
shrank down. That, for some reason,
lot better on your handout. You cI apologize for that.whole
This is sort of the organizational structure of
our laboratory. And I don't want to really
go into that, in much detail. I guess I would rather talk
about the staff that we have
We currently have about 340-350 staff.
About 25 of those are either
We've got a little over 300 classified staff, mostly
microbiologists, chemists,
in the laboratory. medical technologists
of students who are coming in Afor various types of traininger
at the lab. If you look at kind of
the budget of our operation,
laboratory. we'And of that amount, we areear
required to raise funding for three-quarters,
or about $30 million. We do that by charging fees
for some of the testing,
with other governmental agencies by entering in to agreements
and by soliciting research to do special work for them,
to support our operation. prOnly about a quarter of thets
resources that we use in the laboratory come from
the state GPR and state tax dollars.
Of that one-quarter,
basically providing laboratory we spend two-thirds of that
Health and Family Services services to the Department of
Only about a third and to DNR.
less than $2 million of that amount, or something
of our laboratory. to support the academic mission
well defined strategic goals. I won't go into those in a lot
of detail, but I just want to highlight a couple key areas.
We believe that the future, for us to be successful
in the future, we really need to network with a number of
laboratories around the state.
sophisticated networks of these laboratories, both clinical
laboratories and environmental
in the event we ever encountered laboratories, that could help us
public health or environmental some type of a severe
like biochemical, or biological, disaster, including things
One of our other goals or radiological emergencies.
new technologies is to implement and integrate
Some of these are emerging throughout the laboratory.
mostly with others on campus technologies that we work
And we're constantly looking to develop.
for example, molecular assays not just in a clinical
laboratory, but in our
our newborn screening lab, environmental laboratory,
lab services. aOne of the most difficultic
things, I think, today
is finding qualified people aboto fill the positionstory
that we have. It's getting more and more
difficult all the time
and then also to keep people to attract people to your lab
We see people come in, in our laboratory.
They retrain them. and they spend a couple years.
they're going across town or they're doing what I did,
and get out of the state
professional opportunities. One of our major goals is to
focus on workforce development
and keep the rest. in an effort to hire the best
builds upon what we see Oas one of those key goalst
of the laboratory.
and distributor of laboratory information.
We're actively involved in collecting information from
clinical labs and we're working on the environmental laboratory
sector as well, so we can collect that information
as part of a statewide
And we can report that to either surveillance network.
of Health to support the DNR or to the Department
The next few slides thdeal with our communicables.
disease division. We have a very highly respected
and well-equipped,
laboratory next door. This laboratory is registered
as a select agent laboratory
Control, which basically means with the Center for Disease
some of the most dangerous they're registered to handle
We have BSL-3 laboratory biological pathogens.
many of these pathogens, capability, which means that
that cause Anthrax, Tularemia, things like the organisms
handled within our laboratory. and others, can be safely
supports outbreak responses throughout the state by working
closely with local
and the Department of Health. And we've really become
quite good at being, or priding ourselves on the fact
that we, on several occasions,
in the country to identify have been the first lab
of a disease, and to a multi-state outbreak
the cause of the disease, and to submit that and share that
information with CDC
We're actively involved in and other states.
which is a technology that a program called pulse-net,
that might be isolated from alfood, and an organism thatm
comes from somebody who might have been ill,
or some other source; and can not only identify them
as the same genus and species,
they are identical strains. And that capability has been
a real boon to us in public health, because we now have
a tool that allows us to track definitively
associations, where before
"Well it's the same organism, webut so what?"t.
There's a lot of people in
the same organism. the community that may have
level and identify whether it's Noactually the same strain.es
That's been very helpful
of E. coli 0157 on spinach in these multi-state outbreaks
of Salmonella in various types and lettuce, and outbreaks
The communicable disease lab of food recently.
for a whole host provides reference testing
We do very little primary testing, meaning we don't look
at a lot of clinical specimens. They go to a clinical
laboratory first. The clinical lab identifies
something that needs further
comes into our lab, so we can do the definitive testingm
on diseases like Tuberculosis,
and a whole host of other Rinfectious diseases.
( inaudible ) >> In the case of bioterrorism,
if there was a powder that somebody really thought
contained a bioterrorism agent, that would come to us directly
from law enforcement. We've set up very good
working relationships with
who would be on-scene to law enforcement and those
They would bring those types initiate those investigations.
But in a clinical sense, of samples directly to our lab.
one of these agents, and if someone was exposed to
they developed Tularemia, or they developed Anthrax,
and the clinical lab
from blood culture, or from another clinical specimen--
When they have worked that up sufficiently to suspect that
this could possibly be Anthrax, at that point, they will
package that and get it in
definitive testing on those torganisms to support any kindal
of an outbreak. >> Is it safe that they bring
samples to you, instead of you
and holding them going and picking up the samples
It's probably safer to have people bring that sample to us.
Now the people who would be bringing that sample to us,
we have actually trained on the safe handling practices,
how to safely collect the sample, how to package that,
how to ensure that nothing
not going to be any hazard is going to leak, and there's
a sample into our lab. associated with them bringing
we put it into containment Once it gets into our lab, then
of our people would be exposed. and ( inaudible )o that none
We have a network of people primarily in law enforcement
and emergency responders
maybe be out on the scene. who would likely
We've also trained laboratorians We have those people trained.
state, so if they see a specimen in about 135 labs around the
these organisms, that they will thathen safely package thatof
and ship that in to us
( inaudible ) inThat's a little bit hard.
to define but we are--
the question? >> Yes, how many cases
do we get in a year?
how I can answer that. I'm really not sure
to give you an exact number. I'm just not sure how
something like tuberculosis, If you were talking about
would we get to support that? you( inaudible )ny samples
Most of the things that come into our lab come in
by courier or they are shipped
On any given day, we probably receive in the neighborhood
of five to 500 or 1,000 samples to be worked up.
Does that give you some idea? I mentioned earlier this ability
to differentiate between
We do that by a technology organisms of the same strain.
Postfield Gel Electrophoresis. known as PFGE or
typing assay. BOur laboratory is probablyr
one of the more advanced
in developing and using these types of tools.
We also have
One of our main focuses there a diagis influenza.gy lab.
And the laboratory is also
for rabies. Whenever there is a potential
rabies exposure, someone gets bit by a bat, and the bat is
captured, that comes in and we'll test the animal for rabies
in an effort to minimize
of people who may be exposed. I mentioned tuberculosis.
Yes?
Everything gets autoclaved. Then we have a commercial
company that will come by and pick up all of that material.
Then I believe it's either
( inaudible ) iWhat do we use that for?.
( inaudible ) We use Postfield Gel to take
DNA, make the fragments, and
from one organism to the then compare the fragments
organism from another source. Basically, if we get a similar
distribution of the fragments,
they are the same strain. ( inaudible )ay
Yes.
Do you do anything that would be resistant to autoclaving...?
( inaudible ) >> We do not in our laboratory.
I think there's maybe another lab on campus that may
handle something like that. Yes?
Do you do anything with all of the hospitals
in the United States and the
MRSA, or others like it? incidence of Staph infections,
anything with the hospitals and >look for unusual or maybedo
drug resistant organisms. And we do.
We work with the hospitals, not in the United States
so much, but particularly here. >> Where's here?
On campus.
but we work with the hospitals It is a nationwide problem,
If we isolate an organism like MRSA, VRSA or a highly
drug-resistant organism,
We will then share that organism with colleagues at
the Center for Disease Control
then do additional typing and susceptibility on that
organism. But in most cases, the clinical
labs would refer that organism
I mentioned tuberculosis to us initially.
that we thought we would is a disease here in Wisconsin
hasn't quite happened. get rid of, but it just
tuberculosis lab for the state. In We not only isolate the the
organism, but we determine
to that. the drug susceptibilities
it no longer takes six And with newer technology,
the organism. toWe can actually do itify
in about 24-48 hours. We've got new technologies for
working with influenza virus. Primarily, this will
allow us to determine drug susceptibilities of some
of the newer anti-viral agents. And this is very important,
because some of the more common strains of influenza,
about 80% of them have recently been shown to be resistant
to some of the drugs
for a number of years. that we have been using
a variety of influenza testing We've got the ability to do
of surveillance. to support any kind
and Carol Kirk in our lab have developed a national
reputation, a national leader in providing that information
to other labs around the country
They've established a network of hospital laboratories
to submit clinical specimens
several hundred positions to in clinics that are usingied
rapid tests with influenza. So when they get a positive
with that, they send
but the clinical specimen in not only that positive in,
to isolate that virus. for us to attempt
things that we have done in our Oncommunicable disease labl
is to participate in the
Response Network. The Lab Response Network
is a large group of diverse laboratories that have agreed
to standardize procedures for how we would respond
to a bioterrorism attack
public health event. or other significant
laboratories, which is a kind Thof clinical labs,nel
reference laboratories, which we are a state reference
and kind of a national
those few laboratories reference lab, and then
laboratories like the CDC atin Atlanta, and others,d,
that have the ultimate
capabilities, serve as the definitive lab
for this network. This is a network that
has evolved since about 1990, when CDC, the FBI
and the Association of Public Health Laboratories
formed a partnership and have been working on this ever since.
We often criticize government,
for not doing things correctly, partior not doing it right.ment
But I've got to say that this was a true partnership that
took some very enlightened
to bring CDC, the FBI, and leadership at the federal level
labs together to sit down and identify what do we really
need to have as a nation
to a bioterrorism attack. Not only did they work out
the methods and the details,
but the Department of Health standardize a lot of that,
to Congress to obtain funding that funded not only the federal
component of this, but
to have these labs established they recognized the need
So they put money in there around the country.
in all 50 states to develop to sthis capabilityries
and to support this network.
the laboratories that have been The established.hows
I think there are about 170 or so, now.
Every state has at least one
We followed that national model here in Wisconsin.
Dr. Pete Shult and others were instrumental to developing
what we refer to as the Wisconsin Lab Response Network.
We've got about 135 hospitals and clinical labs that
participate in this network.
training, consultation, and reference testing to support
their local activities. If it wasn't for this network,
we would never identify a number of the outbreaks
that you read about in the newspaper.
Outbreaks like
occurred in the Fall of '06. the contaminated spinach that
to be the first in the nation Tto identify there was thise
outbreak, was the fact that some of these local labs
identified the organism,
And all of a sudden, we're shipped it in to us.
from three different areas getting the same organism
And something like that should of the state.
there is a common source. Why are we seeing this?
Is it a new strain? Is there something unusual
about it? Because of the way that we have
established this network
well-primed to quickly ship of lthese specimens to usy're
so that we can follow up
Yes? and make those associations.
What do they do? ( inaudible)
from the patient? DoHow do they know that whats
they're isolating is something
Well, the microtechnologists that's important?
in the hospital laboratory, they have been trained.
And most of them understand that they can work up a sample
to identify an organism.
that causes a recordable disease And if that organism is one
a Shagella, you know, hsomething like that, then that,
organism would be sent to us. Now for clinical management
purposes, simply knowing what the organism is, and probably
more importantly, knowing what
that testing can be done drugs it's susceptible to,
But when it comes time at the local level.
a person who is sick in Monroe, to mand one in Deerfield,tween
and three in Madison, someone on a larger scale
needs to get those organisms, bring them into the lab and
do that epidemiological typing
in Public Health. >> They have a clinical sample.
They identify it. They type it
so they know what it is?
What are their requirements? >> They could do that, yes.
With laboratories, there is >a strong recommendation.
that those isolates be submitted
There is not a hard and fast to the State Lab of Hygiene.
be sent. requirement that the organism
Samples like that from In some states there is.
have staff of epidemiologists or people who do the quick work
to rule out and find out
that produced...? >> We have two epidemiologists
on staff. But we refer that information
to the Department of Health,
They then work closely with tthe local health departments.
to track down possible sources, to go out and bring in
additional samples that will help us further track
these things down.
area of our lab. I'd like to move on to another
our disease prevention area. And that's
of newborn screening. MaI want to highlight this oned
because in my mind, this is the most effective
public health program that I can think of.
Every child born in Wisconsin,
somebody prick them in the heel and take five drops of blood
and put in on a piece of filter paper.
That filter paper is then sent
test it for about 47 different into our laboratory, where we
or immunologic diseases. metabolic, endocrine,
newborns in Wisconsin every year, and we test them
for things like PKU, which is a metabolic disease that results
when the body cannot break down an amino acid, and so it builds
up in the body and then has some
effects on the child at a very very serious developmental
All states perform early age if it's not detected.
Some states only test for about 12 of these conditions.
Other states test for 60-65 of these conditions.
We're currently testing for about 47 of them
here in Wisconsin.
are quite rare, depending on And even though these children
20 children a year, we may find five, or we may not
find any in any given year. They're that rare.
But the things that we screen for, are things that
if identified, there is an intervention,
or there is a treatment,
that will result in that child or there is a special diet
Without screening, many of these children would end up
in state institutions,
their first year of life. mSo this is really a veryd
successful public health program
I want to mention just one of thathese you'll probably bes.
reading more about in the next
And that's Severe Combined Immunodeficiency.
This is the "bubble baby syndrome"
where a child is born without any immune system.
They don't have the cells to produce an immune response.
We're not sure how frequent that is in Wisconsin.
Some of our early studies have shown that maybe
we might see one a year.
at the present time We'rewho are from Wisconsinldren
who have had that condition.
begin screening for that, Tone is we have developed
a technology in the last year that we are
very comfortable with.
children shortly after birth, these children can undergo
a bone marrow transplant and
So by having this transplant completely turn this around.
fairly normal immune system. they can develop a
a normal life. And we believe they'll live
maybe a year, Wand that would be all.
We're quite excited about this. It's been one of the major
research efforts this past year.
working with the Department Aof Health to put in placen
an emergency rule to actually add this
to the newborn screening panel
We also have, in our laboratory a school of cytotechnology
that trains people primarily
We have a laboratory to do pap smears and others.
Some of the people in our lab thahave been pioneerss.
in the development
They're rapidly involved of some of these assays.
genetics and in research in teaching both the medical
identifying, at the molecular to dlevel, a number of for
these types of diseases.
What cytogenetics is? (Oh, what that is.
What those are, that's chromosomes.
And I've got one--
abnormal. And I don't see exactly--
It's chromosome 11. I'll do this.
It's chromosome 11. You see?
They should be identical
Now the fact that they're curved is just the way
that they're isolated from the cell itself.
But if you look at 11 and 13, what's actually happened here
is a piece of 13 is missing.
We do that type of chromosome analysis
in our cytogenetics lab.
rearrangement, the abnormality And depending on the
things are associated of with clinical conditions.hose
So we do this looking at, in some cases, prenatal tests.
In some cases, we'll run this on infants that may be born
with a condition that might be
( inaudible ) of chroThere are 21 pair origin.
of chromosomes here.
from a single cell And these would be chromosomes
We basically process and a single person.
the chromosomes and then the specimen and isolate
( inaudible ) analBone marrow donors are,cope.
in many cases, a sibling, another child if there is one.
It could be a parent, would be a pretty close match.
And the fact that there's a transfusion that
occurs early in life, there are fewer rejection problems
in the child themselves.
very successful in most cases. The treatment has been
With all this information we have, has anyone looked at...
( inaudible ) >> We are beginning to do some
of that in our cytogenetics lab where we know certain types
of cancers are associated with certain abnormalities
in chromosomes. And probably about a third
of the work in cytogenetics is cancer patients.
We're trying to associate abnormalities in the
chromosomes with the type of cancer that they have.
Yes?
There are requirements ( inaudible )
If they have some type about who can be a donor.
if they have various types of known genetic condition,
use them for a donor. oWe're running low on time.
I would like to just mention
our environmental health lab. We analyze local drinking water
to determine if there are contaminates in drinking water,
either microorganisms or various chemicals that
might be present in the water.
that the public health lab That's been one of the things
for over 100 years. An example of someone in
our radiochemistry laboratory looking for radioactive material
that might be present in primarily surface water.
Our laboratory does a lot of outdoor air quality
measurement to support DNR. A lot of this is research
testing, looking for very,
in the air. very loWe do some of thisinants
in cooperation with colleagues
engineering who have a number of research projects underway.
In order to test air samples
a very low level, you have to and lodo that at a labls at
that is virtually metal free. This is an example of our
ultra-low trace element laboratory.
If you look in there, the hoods here,
a lot of the counterwork, wherever we can, we've taken
the metal out of the lab
and other types of materials, andso we're not contaminatingcs
the testing that we do. In our OSHA laboratory,
industrial hygiene lab. That's a fairly large operation,
it's about $3.5 million a year, that we get from OSHA
to be one of only two labs
regulatory testing for OSHA. in the country that provide
in place with 40 states that will send their work to us
here in Madison.
to identify sources of pollution We do a lot of work with DNR
the environment. and monitor on an ongoing basis
a whole host of things that we can test the samples for,
anything from endocrine disrupters, or we'll look for
non-specific things or chemicals in water samples
that might impact organisms or fish.
And then we can actually
for a number of things. This is an example of ones
of our chemists in our
We actually have little fish, envlittle flathead minnowsab.
in these tanks. Then we put the sample in there
and we look to see if they have a negative impact
on the fish themselves. It doesn't tell us what's
causing the toxic effect, but it will say there's
something there, keep looking.
are forensic toxicology. Other important areas
Wisconsin for a DUI or OWI, we'll probably get a blood
into our lab, we'll test it to see how much alcohol
you have on board,
drugs or prescription drugs if at a very high levelal
that might cause impairment in your ability to drive
an automobile, snowmobile,
If you're ever arrested on those charges, that work
will come into our laboratory.
a month to work up in our lab. We receive about 2,000 OWI cases
includes the laboratory analysis Part of that work up not only
often have to go to court and testify on the lab findings.
This laboratory also supports work for the coroners and
medical examiners around the state.
We're not quite CSI,
We've got capability here to identify several hundred
prescription drugs. And in some cases, the person
may have a prescription drug
only have this much, but when we get a sample from them
on part of an autopsy they've got this much.
There's a problem.
to help the coroners and In many cases, we've been able
a possible cause of death by doing this type of analysis.
We have a lab improvement division.
I credit this to my predecessor,
to send out unknown samples to other labs, have
the other labs do the test, and send the results back to us.
It's called proficiency testing.
programs, there's a requirement to participate in some kindy
of proficiency testing. Where do you
get those samples?
there's an opportunity We saw that here in Wisconsin,
About $3.5 million a year. to make a little money.
We package them. So we prepare these samples.
We sell that to, right now, about 5,000 laboratories
around the country, and about 100 or so laboratories overseas.
We're providing a very
capitalizing on the expertise vthat the staff in the labnd
have developed over the years.
the samples look like. This is what some of
200 different proficiency Antesting challengest
that we make available. These go out maybe once a year,
four times a year.
gets sent one of these. TheThen they do the test,lly
report the results to us, electronically now,
to save us from paperwork.
on to the regulatory agency, Then we report that
it's CMS, the Center for if that's on the clinical side,
On the environmental side, Medicaid Services.
( inaudible ) We're very cautious and careful
about what organism we put in that unknown vial.
There have been some problems with proficiency testing
programs that have sent a virulent, but a pathogenic
sample, pathogenic to humans, and there have been
a few accidents with that.
about one of those And you'll probably be hearing
But fortunately, within a week.
we send out very carefully. They're generally the ones
that are not as highly
would be the type of organism patthat might be foundbut
in a clinical specimen. We send very, very small
quantities of these things. On the chemistry side,
we end up sending,
or cow serum that's been it's either a horse serum
of a chemical. spiked with a certain amount
there is something in there Sothat could be bad,h
quantities are minimal
that there really andhave not been accidentsate
as a result of that.
Informatics and Surveillance. This is where we are developing
the capability
of laboratory information. to electronically share a lot
so this can all be done We'securely over the Web.als
I'd like to end by saying that we are YOUR
Wisconsin State Lab of Hygiene. We take pride in the fact
that we support not only
we support state agencies, the university,
but we really support wthe people of Wisconsins,
in all that we do.
no effective way to respond Wto disease outbreaks ande
other public health emergencies.
I tell them frequently that they When I look at our staff,
of protecting you and protecting are really on the front lines
and environmental health our state's public health
That's all we've got up there. throughout the state.
I'll be happy to take them. But if you haYes?ny questions,
( inaudible ) Very good question.
I've had the pleasure or what,
in Idaho, of closing the last whTB Sanitarium that they hadst
in Idaho. We no longer isolate TB patients
like we did 50 years ago. We now can effectively treat
these patients
over a long period of time. It may be three months,
six months, 12 months or more.
non-infectious, so that they We can basically render them
in the community. And we do not need to put them
in a facility like they did in the '30s, and I think
into the early '40s,
in some states. My understanding is that
Wisconsin had a TB Sanitarium on
Now it's converted into another, the north side of Lake Mendota.
or Madison Health Department I think, Dane County
I remember those days well. But with today's therapy, and.
the incidence of TB going down, we can find other effective ways
of dealing with that. Any other questions?
Yes.
various lines of work, >> The lab has a lot going on,
with large quantities somof material for 340 staff.le,
How does the staffing level compare with other labs
that you've run?
the scope of the program here, >> Given the amount and
that's performed, the I think we're probablyork
a little bit on the low side. I think other labs that
don't have quite the scope
certainly have more people that we have here
We sort of pride ourselves in it than we do.
quicker and more automated on doing it a little better,
But from time to time, we find than other places.
to fill important key positions, ourselves still struggling
just are not enough laboratory scientists coming
out of our training programs
We have recognized that. around the country.
participating in a couple fellowship programs, jointly
with CDC, where they have emerging infectious disease
fellows that will come in for two years.
We train them and do our best to keep them.
We have a fellowship in our lab to train cytogeneticists.
They go through our training program.
We do everything we can to make sure they stay with us
once they complete the
So it's difficult, fellowship.
Yes? but we're hanging in there.
In most areas of the lab >> Do you have a backlog?
a significant backlog. we do not have
where we have a backlog that I can think of one area
And that was in I wishour toxicology area.orter.
But generally there is not
throughout our laboratory. that much of a backlog
Politically, have there been Yes?
Did any people at the State Capitol decide that they want
to cut down on the budget and you're strapped for funds?
Is that a problem?
I've only been here a year. And I guess I want to say that
we had a very successful budget this last round, even though
the state budget was laid way out there much longer
than it should have been, that only impacts
about 25% of our budget.
was passed and we were able to obtain the state supportt
for our lab.
what we bring in to run the lab does not come from the state.
So it's one of the things I tell people that's one
of the great things about being in Wisconsin and being director
of this lab, versus a lab associated with the Health
Department in another state where you are really at
the mercy of the legislature. There are some risks that
can be associated with that.
I understand that a lot of Yes?
and decide not to use them. It goes into the water supply
eventually. And a lot of us older people
aren't taking benefit of the drugs, in other words,
it goes into urine and gets back into the water supply.
Are you testing for that? >> We are, but some of these
drugs, when they break down,
endocrine disrupters. We've done an active research
program in that area. We're also working with some of
the sewer treatment facilities
they can maybe change tsome of their processesat
that would do a better job
materials that may end up oin the sludge, before it can
get back into the water supply. That is an area that we're
actively conducting research in.
Where can we take leftover drugs?
I don't know. >> I have a sister who died.
I have a house full of drugs. I don't know
what to do with them. >> We do not take drugs.
But I understand that here
there is a program. I'm not exactly sure who
runs that, but if you've got
send me a note. I'll look that up for you.
I think it may be the Madison Dane County Health
Department. Does anybody else know
who that is?
unused medications to your >> I was told to bring all
how to take care of them. >> Some pharmacists, I think,
would do that,
( no audio ) others might not.
ago, had a drug collection day >> The county, a couple months
your unused drugs, and other where you could bring in
for disposal by them. coSo probably, the Dane Countyt
Health Department or the City of Madison.
Yes, I remember something just recently.
I think they do this
where they will take those a couple of times a year,
Yes? and properly dispose of them.
throw them down the toilet. >> Right, you're not supposed to
throw them down the toilet. Anything that goes down
the toilet goes into
And all that stuff may actually go all the way through.
Yes?
and hold scientists >> Tis a sorry reflectiont get
about our own country.
But I will ask you, do you seek scientists from overseas
to fill those positions?
is yes, we do. >> The short answer to that
to find the scientific expertise We look wherever we can
We have a very diverse staff that we really need.
Prior to coming back to Wisconsin, I was at CDC
in Atlanta, and they are having a serious time identifying
scientists for their
And so they are actively key positions.
around the world. recruiting in Yes?ous countries
Is it salary or benefits? If you go into high schools
or middle schools for outreach
it's the most fascinating thing there is these days.
I think it's a little bit of both, you know,
sometimes we have salary issues.
when we're compared locally. We seem to do fairly well
get out and the more we can engage people in high school
to think about science. It's an exciting career,
There are a lot of things you can do.
I started out as a med-tech right next door.
I became an epidemiologist. I could share stories for hours
about some of the neat
the opportunities that I've had invehere in this country of
and overseas, because of
And I think that's a message the science background.
to young people today. that we need to get out
In our lab, I would say about half of the people
who leave our lab probably go to an industrial setting.
In those cases, it's generally
( inaudible ) fWe have an employee health
monitoring program in place,
say, developed a fever, wheif they develop any kindes
of symptoms, one of the things
is to, if they become ill, that they are trained to do
they say you know, and they see a physician,
of Hygiene. "I work with Tularemia.b
And maybe you ought to
We really have a very, check that out."
not having accidents in the lab vwhere exposures occur, andf
somebody actually becomes infected with something.
But we do have kind of
watch the employees for things a monitoring program where we
You're in a building that they may be exposed to.
( inaudible ) Will the new building
be on this campus?
over 50 years old >> We'rright next door.that's
Mechanical systems in the building after 50 years
have never been upgraded. They're failing.
In fact, some of
the ducts in there the ventilation systems,
They're held together are stwith duct tape.apart.
( inaudible ) We've engaged an architectural
firm to develop a plan
As part of that, one of the sites that is being considered
is out by the other lab on the east side of Madison.
I think this will benefit the state in the heart of campus,
to stay here on campus
In order to interact with that laboratory.
our research mission, witour teaching missionll
I think it's important
So there are other options that we have that presence.
One may be to move off, renovate the building
and then move back. That's about
a $20 million project.
But we're actively exploring A new building is way up here.
to address the facilities a numberthat we have. options
( inaudible ) For some of you, the Wisconsin
Vet Diagnostic Lab is a lab that's similar to ours.
It's a little bit smaller,
very nice facility but it's a brand new,
It used to be out on just down the road.
but was recently moved back Mion campus when they builte,
a dedicated a new lab.
about a year. That lab actually came back
onto campus.
very similar to our lab. And is administratively
the same statutory basis. They have a board
that's operated very similarly
But there focus is primarily to our lab.
That lab was funded primarily by the state, a little
bit of University money, and
went into that building. a little bit of revenue money
about a third of the size of our operation.
One more. >> Do you have anything
to do with Radon? >> Our laboratory
can test for Radon. And for those of you who
may not be familiar,
that is naturally released Radon is a radioactive gas
of geological formations. I think granite is one of them.
And in some locations,
the floors of the homes and buildings, and accumulate
to levels that are thought
We can do Radon testing, to be harmful.
Radon testing here goes to although I think most of the
Another one. private labs in the area.
That's a difficult question (for me to answer,
because I'm really not
But the one area that I can think of where some of our work
butts up against that is where I was talking about
newborn screening.
that we screen for, for example PKU, could cause
very severe mental illness
If you can identify the child, in a child at a very early age.
with a restrictive diet. you can provide them
can lead a fairly normal, They comehealthy life. and they
That's the only one area
really bumps against that. where our work
is there anything that's >> For the state of Wisconsin,
to what you describe even a little bit comparable
( inaudible) for physical...
But I know there is something >> Not tlike that.are of.
The Department of Health
mental health capabilities and Family Services have some
I just really don't know and facilities.
Okay? Thank you very much.
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