Community Garden Project 2017 2
Fire Safety 2
2017 Sentinel Laboratory Bioterrorism Exercise Results 3
Fish Contamination Monitoring Program—A Year in Review and The Future of Fish Analysis 5
Page 2
In 2011, the Bureau of Laboratories, “Healthy Living” Vision Priority Team 6 created a
volunteer-based annual community vegetable garden in order to provide healthy food
options for local individuals with limited access to fresh produce.
Since inception, our small community garden has been able to produce approximately
1000 pounds of a variety of vegetables for donation to the Greater Lansing and the
Holt Community Food Banks.
We thank our laboratory gardeners and the building facilities crew from the
Department of Management and Budget for their support toward this healthy initiative.
Thank you to Michigan State University Horticulture Department for the donation of
the vegetable plants for our 2017 garden.
The BOL Community Garden Project is one way the laboratory forms local community
partnerships in order to help strengthen public health efforts in Michigan.
Community Garden Project 2017
In preparation for National Fire Safety Week, the Bureau of Laboratories Health
and Safety Officer, Judy Smith, assembled laboratory employees to participate in
fire extinguisher refresher training.
DeLau Fire Services provided equipment, fire, and technical expertise about fire
safety and use of dry chemical extinguishers in the work environment.
While all employees were successful with extinguishing a small contained outdoor
fire, the employees gained respect for the importance of fire safety and
professional fire fighters.
Fire Safety
2017 Sentinel Laboratory Bioterrorism Exercise Results expected to perform notification to MDHHS BOL of a potential select agent.
Automated identification systems, including MALDI-TOF and Vitek, are not
recommended for identification of organisms where aerosol generation is
a safety concern. Additionally, rapid identification systems commonly misidentify
select agents. The American Society for Microbiology (ASM), “Recognize/ Rule
Out / Refer,” guidelines provide accurate and safe steps for identification of
isolates which cannot be ruled out as select agents.
ASM Sentinel Clinical Laboratory protocols for Suspected Biological Threat
Agents: http://www.asm.org/index.php/guidelines/sentinel-guidelines
Exercise Scenario/Clinical History:
A 67-year-old male with diabetes mellitus presented to the emergency department with
a leg wound that was not healing and appeared to be getting worse. He stated that the
antibiotics his family physician prescribed had run out. The patient had no recent travel
history, but during his work-up, it was discovered he had fought in the Vietnam War.
Swabs were collected from the leg wound and submitted to the laboratory for culture
testing.
Exercise Result:
Participants should not have been able to rule out Burkholderia pseudomallei. The
patient history was helpful by learning that the patient had fought in the Vietnam War.
Burkholderia pseudomallei is sometimes referred to as the “Vietnam time bomb”
because the disease can reactivate in returning Vietnam veterans after many years in
latency. The organism sent was Burkholderia thailandensis, that mimics Burkholderia
pseudomallei biochemically. The initial culture result worksheet sent with the sample
did not list Burkholderia pseudomallei as a rule out option, however, a new result
worksheet was emailed to participants and the due date was extended.
Important Note: Once a laboratory has isolated a suspected select agent, it is
Important for facilities to immediately contact their designated Laboratory Response
Network (LRN) reference laboratory. The LRN reference laboratory for Michigan
is the Michigan Department of Health & Human Services, Bureau of Laboratories
(MDHHS BOL). Do not attempt full identification and susceptibility testing in your
facility. The LRN provides guidance recommendations for retaining samples and
submission for confirmatory testing. As part of this exercise, laboratories were
Page 3
Test Name Expected Result for Burkholderia thailandensis
Colony Morphology
Creamy, Grey, Convex, non-hemolytic and may have non-violet pigment on blood agar
Many laboratories neglected to report their findings on Mac-Conkey agar
An important feature of this organism is the ability to grow on MacConkey agar in comparison to some other select agents that do not
Gram Stain Gram negative rods/bacilli, bipolar staining
Catalase Positive
Oxidase Positive
Indole Negative
Motility Motile or Positive
Additional tests
Growth at 42°; Resistant to Penicillin; Amoxicillin/Clavunate-susceptible; Polymixin B or colistin-no zone
Growth on B. cepacia selective agar; No pigment on Mueller Hinton agar
Continued on page 4
Page 4
Sentinel Lab Results:
The exercise sample was shipped to seventy three sentinel laboratories in Michigan.
Nine out of the seventy three laboratories no longer perform microbiology testing.
Laboratory Exercise Statistics
Number of Facilities
Percent Response
Laboratory Performance
62/64 97 Performs Microbiology testing and responded to the exercise.
48/62 77 Contacted the LRN laboratory
62/62 100 Reported results by the exercise due date, June 23, 2017.
61/64 95.3 Have at least 2 staff members trained and certified for Category A packaging and shipping.
48/62 77.4
Could not rule out Burkholderia pseudomallei, or ruled out all select agents using the initial worksheet that excluded Burkholderia pseudomallei. 37/66 Unable to rule out Burkholderia pseudomallei
11/66 Ruled out all select agents using initial worksheet that excluded Burkholderia pseudomallei
4/62 6.5 Incorrectly ruled out all select agents using the updated form that included Burkholderia pseudomallei.
6/62 9.7 Incorrectly identified the isolate as Yersinia pestis.
2/62 3.2 Incorrectly identified the isolate as Brucella species.
2/62 3.2 Incorrectly identified the isolate as Francisella tularensis.
2017 Sentinel Laboratory Bioterrorism Exercise Results
Continued from page 3 MDHHS BOL would like to thank all facilities who participated in the 2017 BT
Sentinel Laboratory Exercise. This preparedness exercise is one way to ensure
that Sentinel Laboratories are able to meet the ASM guidelines of, “Recognize /
Rule-out / Refer, Suspected Biological Threat Agent specimens. The Centers for
Disease Control and Prevention recommendation is to have at least two staff
members in your facility certified to package and ship Category A samples.
MDHHS BOL offers free packaging and shipping certification classes throughout
the State of Michigan. New classes will be offered in the spring and fall of 2018.
If you are interested in hosting a class at your facility, please contact Shannon
Sharp, BT Coordinator at [email protected] or (517)335-9653.
Burkholderia pseudomallei
After 48° on Blood Agar Plate After 48° on Chocolate Agar Plate
Gram Stain
Page 5
Fish Contamination Monitoring Program -
A Year in Review and the Future of Fish Analysis
Since the 1980s, the State of Michigan has collected and analyzed fish from our
state’s waterbodies. During the course of our involvement in the program, the
Analytical Chemistry section has provided analytical results to the Michigan
Department of Environmental Quality (DEQ) and the MDHHS Division of
Environmental Health from fish samples processed, extracted, and analyzed by
staff here at MDHHS BOL. In a typical year, fish analysis consists of the extraction
and analysis of 500-700 samples, predominantly for persistent organic pollutants
(POPs) including polychlorinated biphenyls (PCBs), chlorinated pesticides, and
mercury. The data provided by the laboratory is used at the DEQ for temporal trend
studies and ecological site assessments. The edible fillet results are used by the
Division of Environmental Health for the public “Eat Safe Fish Guides.”
In the past year, the Analytical Chemistry section (AC section) analyzed
approximately 520 samples as part of the 2017 advisory year. Several things
transpired this past year that set 2017 apart from years past. In 2017, the laboratory
offered more analytical tests with more targeted analytes than ever before. In
addition to PCBs, pesticides, and mercury, the AC section reported results for
Perfluorinated Compounds/Perfluoroalkylated Substances (PFCs/PFAS), Dioxins,
Furans, coplanar PCBs, Polycyclic Aromatic Hydrocarbons (PAHs), Toxaphenes,
lead, nickel, vanadium, arsenic, and chromium. In total, the AC section reported
results for 187 analytes across more than 11 methods which amounted to over
1600 analyzed samples, totaling over 72,000 individual test results. This year also
marked a transition in technology being used by the laboratory. Traditionally, the
bulk of the fish analyses were performed using gas chromatographs with electron
capture detectors (GC-ECD), and direct mercury analyzers. Over the past few
years and especially in 2017, the AC section has incorporated newer and more
sophisticated technologies for fish analysis including: Liquid Chromatograph
Tandem Mass Spectrometry (LC-MS/MS), Gas Chromatograph Mass Spectrometry
(GC-MS), Gas Chromatograph Tandem Mass Spectrometry (GC-MS/MS), Gas
Chromatograph High Resolution Mass Spectrometry (GC-HR-MS), Inductively
Coupled Plasma Mass Spectrometry (ICP-MS), and Inductively Coupled Plasma
Atomic Emission Systems (ICP-AES), in addition to our traditional analytical
techniques.
Bureau of Laboratories, Analytical Chemistry Section, UPLC MS/MS
Continued on page 6
The AC section has invested heavily in embracing technological advancements to
improve the accuracy and efficiency of fish testing. Over the past several years this
section has increased testing capacities with the addition of one GC-MS/MS, three
Ultra Pressure Liquid Chromatograph Tandem Mass Spectrometers (UPLC-MS/MS)
instruments,
several ICP-MS instruments, and a new mercury analyzer. The laboratory intends to
expand on the advances made in 2017 to further utilize modern technologies including
GC-MS/MS and LC-MS/MS instrumentation and improve sample preparation
techniques to keep pace with the ever changing landscape of trace analytical testing. It
is our goal to be prepared for whatever emerging contaminant issues our partners wish
to address. 2017 was an exciting year for the fish program and it is expected that a
busy 2018 will bring even more new challenges. The lab is currently developing
methods for PFC analysis in additional matrices such as venison, serum, and water. In
addition, we have already received, analyzed, and reported priority samples for the
analysis of PFCs and mercury in fish from water bodies affected by the ever growing
PFC contamination concern that has made news not only in Michigan, but nationally as
well. In the next couple of years, the annual sample volume for PFC analysis in fish
could potentially increase to approximately 800 samples for PFCs alone.
Page 6
LabLink is published quarterly by the Michigan Department of Health and Human Services, Bureau of Laboratories, to provide laboratory information to Michigan health professionals
and the public health community.
MDHHS is an Equal Opportunity Employer, Services and Programs Provider.
Editor: Teresa Miller
Fish Contamination Monitoring Program -
A Year in Review and the Future of Fish Analysis
Continued from page 5
Thermo Triple Quadrupole
Mass Spectrometer
Bureau of Laboratories
Analytical Chemistry Section
Inductively Coupled Plasma
Mass Spectrometry
Bureau of Laboratories
Analytical Chemistry Section