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STATLINE
August 14, 2002
© 2002 College of American Pathologists
 

This month's stories:

College Mobilizes To Prepare Members, Labs
Bioterrorism Measures Win Quick Endorsements by CGPA
CAP Collaborates With Government, Other Organizations
CSA to Review Programs With Eye Toward Preparedness
CAP Assembles Bioterrorism Experts for Annual Meeting
College Talking Points on Bioterrorism Available Soon
CDC Utilizes SNOMED for Infectious Disease Reporting

College Mobilizes To Prepare Members, Labs

The College, at the request of the Centers for Disease Control and Prevention, has sent a CDC alert on anthrax protocols to all its members and thousands of clinical laboratories, and continues work internally and with other groups to respond to the growing threat of bioterrorism.

Last Friday, the College mobilized to distribute the alert to about 30,000 clinical laboratories and all 16,000 CAP members after receiving the CDC request for assistance only hours earlier.

College staff and CDC officials had been discussing possible CDC participation in a ASCP/CAP Joint Annual Meeting program on bioterrorism (see story below) when the agency asked for the College's help to distribute the alert. The request came about noon Friday, even as the CDC and other federal agencies were responding to reports of possible anthrax exposure at NBC headquarters in New York City. News of the NBC anthrax case added urgency to the CDC decision to notify laboratories of the anthrax protocols.

The College's Officers, who were attending a meeting of the CAP Finance Committee in New York at the time, quickly assembled for a conference call with staff and authorized the mass distribution of the alert. The College then worked with the CDC to craft the language of the alert, which asks labs to familiarize themselves with the protocols and the procedures to follow if they believe they have a case or isolate. After language for the alert was made final, College staff responded quickly to distribute it by e-mail and fax.

The College has in recent weeks discussed laboratory preparedness with federal officials, including Scott Lillibridge, MD, a special assistant to Health and Human Services Secretary Tommy Thompson and Stephen Morse, PhD, director of the CDC's Laboratory Response Network (LRN). The alert asks laboratories to use the LRN if they have a suspect agent. The LRN comprises more than 80 state and local public health and military laboratories with protocols and reagents that allow them to rapidly identify Bacillus anthracis.

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Bioterrorism Measures Win Quick Endorsements by CGPA

Last Friday, the College's Council on Government and Professional Affairs endorsed two legislative efforts in the U.S. Senate aimed at responding to the threat of bioterrorism.

The Council, meeting via conference call, agreed to support "The Biological and Chemical Weapons Preparedness Act of 2001" (S. 1468), introduced Oct. 3 by Sens. John Edwards, D-N.C., and Chuck Hagel, R-Neb., and an effort by Sens. Edward Kennedy, D-Mass., and Bill Frist, R-Tenn., to secure funding for the Public Health and Emergencies Act (PL 106-505), which became law last year.

The Edwards-Hagel bill includes provisions that specifically address laboratory readiness, hospital preparedness and health care workforce training. Rep. Richard Burr, R-N.C., has introduced a companion bill in the House, H.R. 4964. The legislation highlights the need to boost funding for "hospitals, laboratories, clinics, information networks, and other necessary elements to ensure the provision of public health services in the event of a bioterrorism attack." It earmarks $1.65 billion for various programs and directs the Secretary of Health and Human Services to allot funds to each state through block grants for various goals. Of specific interest to pathologists, are goals related to building a nationwide laboratory response system and the education and training of health care workers, which would include laboratory personnel.

The Kennedy-Frist effort would provide $1.4 million in fiscal 2002 funding for readiness and medical personnel training programs already established under the Public Health and Emergencies Act. Although the act became law in November 2000 and authorizes various programs to improve the nation’s overall preparedness against bioterrorist attacks, those programs can't start until Congress appropriates money for them.

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CAP Collaborates With Government, Other Organizations

Offering assistance and experience, the College is reaching out to both government policymakers and professional groups as the nation—and laboratories—respond to the growing threat of biological and chemical attacks.

This week, the College will provide testimony for a Senate hearing on bioterrorism. The hearing, scheduled for 10 a.m. Thursday, will be held by the Senate's Health, Education, Labor & Pensions (HELP) Committee, chaired by Sen. Kennedy, and will focus on how the federal government can fight against and prepare for terrorist attacks involving biological weapons.

The College also will continue working with the Centers for Disease Control and Prevention on laboratory preparedness and is expected to meet with Health and Human Services Secretary Tommy Thompson to discuss preparedness issues.

On the private-sector side, CAP staff met recently with a representative of the American Society for Microbiology (ASM) to address issues of common interest related to laboratory preparedness. Of particular interest is the College's ability to promptly disseminate Level A laboratory protocols now being revised by the CDC, the ASM and the Association of Public Health Laboratories. These protocols describe the specific tests the microbiology Level A laboratory should perform to rule out a suspected organism or refer it to another laboratory.

The protocols are designed to assist clinical microbiology laboratories with information and techniques for micro-organisms that might be suspected as bioterrorist agents. The protocols for level A clinical laboratories offer standardized, practical methods to aid laboratories in ruling out critical agents or referring specimens to level B and C public health laboratories for confirmation. The procedures focus on anthrax, tularemia, plague, brucellosis, botulism and unknown viruses. When the protocols are made final, they will replace the CDC Level A Protocols currently in place.

In another collaborative effort, the College is coordinating a December audioconference on bioterrorism with the American Association for Clinical Chemistry and the American Society for Clinical Laboratory Science. The conference, titled "What Every Laboratory Needs to Know About Chemical and Bioterrorism," is scheduled from 1 to 2:30 p.m., Dec. 12, and will be moderated by K. Michael Park, PhD, director of Core Laboratory Operations, the University Hospitals, Oklahoma City, Okla. Scheduled speakers include Jane R. Willis, PhD, with the CDC's National Laboratory Training Network; and Jimmie L. Valentine, PhD, professor of pediatrics and pharmacology at the University of Arkansas for Medical Sciences, Little Rock.

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CSA to Review Programs With Eye Toward Preparedness

The CAP Council on Scientific Affairs has indicated its commitment to review the College's laboratory accreditation and proficiency testing programs in the context of preparedness for biological or chemical attacks.

CAP leaders believe the College's long-standing role as a leader in ensuring high-quality laboratory services now carries over to the effort to prepare laboratories for handling possible cases of anthrax and other biological agents terrorists might use here and abroad.

To that end, CSA and Commission on Laboratory Accreditation members, in a special conference call last week, committed to review how the Laboratory Accreditation Program can educate pathologists and laboratories about the Centers for Disease Control and Prevention's Laboratory Response Network and ensure laboratories have systems to protect personnel from exposure to biological agents. They also discussed whether CAP checklists should be modified to address bioterrorism preparedness and the feasibility of proficiency testing for biological or chemical agents likely to be used in a terrorist attack.

No decisions have been made to modify existing programs; the CSA will continue to assess the situation.

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CAP Assembles Bioterrorism Experts for Annual Meeting

The College, through programs at the upcoming ASCP/CAP Joint Annual Meeting and later this year, is placing a high priority on educating pathologists and laboratories about how to prepare for biological and chemical attacks.

The College has arranged to have leading authorities on responding to biological and chemical threats speak during a special program at the Joint Annual Meeting in Philadelphia. The program, "Government Affairs: Issues and Answers—Bioterrorism," will be Saturday, Oct. 20, from 8:30 a.m. to noon, at the Pennsylvania Convention Center, Room 113BC, Level 100. CAP Secretary-Treasurer Jared N. Schwartz, MD, PhD, will moderate the program and speak about his experience working with samples from the recent anthrax contamination incident in Florida.

Also scheduled to speak at the program are:

  • Stephen Morse, PhD, director of the CDC's Laboratory Response Network (LRN). Dr. Morse, who will deliver his remarks by way of a video link, has been working with the College over the past several weeks to alert laboratories to CDC anthrax protocols and take other measures to prepare laboratories for biological threats.
  • Amy E. Smithson, PhD, a senior associate at the Henry L. Stimson Center. Smithson directs the 8-year-old center's Chemical and Biological Weapons Nonproliferation Project, which serves as an information clearinghouse, watchdog and problem-solver regarding chemical and biological weapons issues.
  • Judith F. English, president of the Association for Professionals in Infection Control and Epidemiology (APIC). English, who chaired the APIC's Bioterrorism Task Force, co-authored a 1999 report titled "Bioterrorism Readiness Plan: A Template for Healthcare Facilities."

Also Saturday: A special free program, "Responding to Disaster—Lessons Learned," will be presented from 8 to 9:30 p.m. in Room 201 of the convention center. Scheduled speakers include Susan D. Roseff, MD, of Virginia Commonwealth University, Richmond, Va.; Kim A. Collins, MD, of the Medical University of South Carolina, Charleston; and Capt. Glenn N. Wagner, DO, Armed Forces Institute of Pathology, Washington, D.C. Lee H. Hilborne, MD, of the UCLA Medical Center, Los Angeles, will moderate. The program will focus on how laboratories, pathologists and technologists can respond to media inquiries and how they can prepare for potential future terrorist assaults and similar events.

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College Talking Points on Bioterrorism Available Soon

The College soon will make available Talking Points on bioterrorism to help members respond to inquiries by the media and others.

The CAP Council on Public Affairs and College staff are now developing the Talking Points document, which is expected to be available soon on the College's Web site, in an area set aside for CAP Spokesperson information. Existing CAP documents that can help pathologists work with the media include "Presenting Yourself on Television" and "Tips on Successful Interviews." A question-and-answer document on anthrax also is in the works.

Further help for pathologists will be available this weekend at the ASCP/CAP Joint Annual Meeting in Philadelphia, during a program on responding to media inquiries (see story above). And members may use the College's "Hometown Interviews" program at the meeting to serve as expert sources of information for their local media.

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CDC Utilizes SNOMED for Infectious Disease Reporting

College review of SNOMED® International, used for the electronic reporting of infectious diseases to the Centers for Disease Control and Prevention, shows that the latest release includes coverage of bioterrorism events.

In relation to the recent outbreaks, SNOMED® can be used for bioterrorism preparedness. Early detection can be enhanced if the laboratory continually tracks and monitors infectious organisms, diseases, signs and symptoms. A SNOMED-enabled system can make this process more efficient.

The reporting to CDC of more than 50 infectious illnesses, including anthrax, is required. All of these reportable conditions are coded in SNOMED® 3.5 and SNOMED® RT (Reference Terminology). SNOMED-encoded data captured by pathologists through laboratory information systems provides a timely and reliable source of records that can be quickly forwarded to the CDC or other health care agencies. The CDC offers prepaid SNOMED® RT licenses for laboratories willing to electronically report infectious diseases. For more details, call Peggy LaJoie at (847) 832-7248.

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Editor: Carl Graziano
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