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Nebraska
- Stephen Hinrichs, M.D.
- Tony Sambol
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In Nebraska, the Laboratory Program
Advisor, Tony Sambol, working with the direction of the State Public Health
Laboratory Director, Dr. Stephen Hinrichs, improved - and continues to
improve - communication with private clinical laboratories through site
visits. The events after September 11, 2001 changed the traditional focus of
the Nebraska public health laboratory from rapid testing, laboratory
improvement, applied research, and support of surveillance and epidemiology
investigations to an immediate need to improve awareness and testing for
specimens associated with bioterrorism.
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Enlisting
laboratories:
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Improving testing
for bioterrorism:
- State-wide assessment was based on information in the CLIA database
and allowed a chance to implement a state epidemiologic survey. Based
upon examination of referral patterns gathered during site visits, the
state was partitioned into 6 regions so that each region had a
laboratory system with an anti-bioterrorism Level B laboratory to
which clinical isolates suspected of bioterrorism could be referred from
Level A laboratories for more thorough testing. The status of these
laboratories as Level B or the newer reference laboratories has not
been confirmed by HHS; nevertheless, these laboratories serve as
reference centers and information sources for their constituents.
- During his site visits to sentinel laboratories, Mr. Sambol assessed
each laboratorys knowledge of approved testing practices for agents
suspected of bioterrorism, including when and how to refer specimens to
more sophisticated, reference laboratories.
- Based upon his on site assessments, Mr. Sambol has created and begun
to disseminate to clinical laboratories a CD ROM with CDC-approved
Level-A bioterrorism training materials, including specific protocols
for testing.
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Finding incentives
for physicians and clinical laboratory professionals:
- Laboratories will be provided protocols for testing and referral of
various public health threats, including threats to food safety such as
E. coli and salmonella.
- Dr. Hinrichs is investigating the possibility for a geographic
information system (GIS) to provide surveillance feedback to clinical
laboratories and physicians so the incidence of new cases of infectious
diseases such as Influenza. Because many Level A clinical laboratories
do not yet have the hardware necessary to use a GIS, this would likely
be a staged process, depending upon funding, and beginning with the 6
Level B laboratories.
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Improving
communications between the Nebraska public health laboratory and clinical
settings:
- Nebraska has been conducting an extensive survey of hospitals to
determine their needs for rapid communication between the state public
health laboratory and hospital laboratories, emergency rooms, and
infection control committees.
- In addition to existing telecommunication capacity, Nebraska is also
examining possible expansions of satellite communications.
- Linkages will benefit hospital communities in various ways,
including distance learning, real-time consultation, electronic billing
and more rapid epidemiological investigations and reporting.
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Interfacing with the
U.S. postal system to coordinate testing of postal facilities:
- Acting as the APHL Liaison to the U.S. Postal Service to coordinate
environmental testing of postal facilities at State Public Health
Laboratories, Tony Sambol, interacted with either the SPHL Director
and/or the BT Laboratory Testing Coordinator for nearly every state.
- Assured capacity by teaching other NLS liaisons (Snippes and Dyke)
how to coordinate activities.
- Accurate, timely and secure testing of postal facilities was
assured.
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This page last reviewed: 7/12/2004
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