Synthetic Cannabinoids in Drivers: Clinical and Psychophysical Indications of Intoxication

WSLH Toxicologist Kayla Neuman is presenting study data on the effect of synthetic cannabinoids on driving at the American Academy of Forensic Sciences annual conference on February 25, 2016.

Here’s an abstract of her presentation –

 

Synthetic Cannabinoids in Drivers: Clinical and Psychophysical Indications of Intoxication

Kayla M. Neuman, M.S., Wisconsin State Laboratory of Hygiene – Forensic Toxicology Section

Synthetic Cannabinoids, also known as “fake pot”, K2, and spice are growing in popularity amongst drivers in Wisconsin. Specialized evaluations performed by Drug Recognition Experts (DRE) to identify drugged driving impairment were examined. The data collected was used to determine the likely symptoms caused by these types of substances.

The Wisconsin State Laboratory of Hygiene (WSLH) with the cooperation of the WI Department of Transportation’s Bureau of Transportation Safety (BOTS), outsourced samples to other laboratories to test for synthetic cannabinoids. A total of 118 cases were sent out between March 2010 and May 2015, with 24 cases having all information required for the data collection. Of the 24 cases examined, 20 were male subject and 4 were female subjects. There were a total of 11 different types of synthetic cannabinoids found in these 24 blood specimens and negative results for the rest of the alcohol and drug testing. Examination of the police reports revealed that impaired drivers were commonly identified by poor driving and traffic crashes (71%).

Based on the DRE evaluations, the subjects consistently had poor balance and coordination (54%), bloodshot eyes (67%), droopy eyelids (54%), and were unable to cross their eyes (75%). These symptoms are also common with impairment seen by those who use cannabis. Impairment was also noticeable by the subjects speaking slowly and swaying while trying to balance during two of the tests used. However, the body’s responses (pulse rate, blood pressure, body temperature, pupil size, pupil reaction to light, and muscle tone) to synthetic cannabinoids were within normal DRE ranges for the majority of cases. There were a few cases that displayed specific indications of intoxication that were not within normal ranges including dilated pupils (46%), watery eyes (42%), uncontrollable shaking (21%), elevated pulse (42%), and elevated blood pressure (21%). This may be due to the specific type of synthetic cannabinoid used, the person’s body chemistry, or the amount of time between driving and the DRE evaluation. Overall, driver performance on DRE evaluations indicated that synthetic cannabinoids caused significant physical impairment and do impair a person’s ability to drive a car.

Abstract will be presented during the American Academy of Forensic Sciences annual conference in Las Vegas, NV, February 25, 2016.

Zika Virus Testing

(Information current as of 02/16/2017)

 

Aedes-aegypti-mosquito_CDC-Public-Health-Image-Library_WEB

For individuals that meet Centers for Disease Control and Prevention (CDC) travel or exposure criteria, fee-exempt testing Zika virus testing is available at the Wisconsin State Laboratory of Hygiene (WSLH) upon approval by a Wisconsin Division of Public Health (DPH) epidemiologist. The most common Zika virus tests approved are the Zika virus IgM antibody assay on serum, the Arbovirus PCR Panel (Zika, Dengue and Chikungunya viruses) on serum, and the Zika virus PCR on urine.

 

The following information is for Wisconsin clinical and hospital laboratories.

 

Diagnostic Testing:
  • If a physician suspects a case of Zika virus and would like testing performed, please contact the WI Department of Health Services (WDHS) Communicable Disease Epidemiology Section (phone: 608-267-9003). Once WDHS approves testing, they will provide your laboratory with a form that must be completed and accompany the specimen. For more information – https://www.dhs.wisconsin.gov/zika/lab-testing.htm
  • For individuals that meet Centers for Disease Control and Prevention (CDC) travel or exposure criteria, fee-exempt testing Zika virus testing is available at the Wisconsin State Laboratory of Hygiene (WSLH) upon approval by a Wisconsin Division of Public Health (DPH) epidemiologist. The most common Zika virus tests approved are the Zika virus IgM antibody assay on serum, the Arbovirus PCR Panel (Zika, Dengue and Chikungunya viruses) on serum, and the Zika virus PCR on urine. NOTE: Specimens testing positive or equivocal for Zika virus IgM will still need to be forwarded to the CDC for confirmatory plaque-reduction neutralization (PRNT) testing because of the significant cross-reactivity between Zika and other Flaviviruses in the MAC ELISA assay. Also, requests for IgM testing for dengue and chikungunya viruses will continue to be sent to CDC.
  • Transport – Specimens approved for testing by WDHS may be transported to the WSLH by calling Statmedex for pick-up. Specimens should be triple packaged as a Category B Biological Substance.
  • Fee for Service Testing – No fee-for-service testing is being offered at this time. ALL Zika virus test requests must be approved by WDHS by calling 608-267-9003.
Reporting:

Zika virus has been added to the list of notifiable diseases/conditions. The WSLH will report any confirmed cases of Zika virus to WDHS.

 

Resources:

For information on Zika virus infection:

WI Department of Health Services: https://www.dhs.wisconsin.gov/zika/index.htm

CDC: http://www.cdc.gov/zika/index.html

Pan American Health Organization (PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688&lang=en

 

How Dangerous are Harmful Algal Blooms?

It sounds like something out of a late-night horror movie — thick green muck spreading across a lake and disrupting the drinking water supply for 400,000+ people. But it wasn’t Hollywood — it was Lake Erie and Toledo, OH in summer 2014.

blue-green-algae-bloomThat harmful algal bloom (HAB) and others are discussed in the ET&C Focus article “Are harmful algal blooms becoming the greatest inland water quality threat to public health and aquatic ecosystems?” published in the January 2016 issue of Environmental Toxicology and Chemistry. The article is co-authored by Wisconsin State Laboratory of Hygiene Environmental Toxicologist Dawn Perkins.

While the authors don’t have an exact answer to their question yet, they do outline the challenges ahead and the information that is still needed to ensure the story has a happy Hollywood ending.

From the article –

HABS … in Focus

  • Harmful algal blooms (HABs) represent a transformational threat to inland water quality.
  • Formal monitoring and surveillance programs for HABs are limited in developed and developing nations.
  • Site-specific HAB events degrade water quality to a greater extent than many chemicals.
  • Harmful algal blooms confound routine surface water quality assessment and management practices.
  • Strategic engagement by environmental toxicology, chemistry, and risk assessment is necessary.

“Are harmful algal blooms becoming the greatest inland water quality threat to public health and aquatic ecosystems?” Environmental Toxicology and Chemistry, vol. 35. no. 1, January 2016

 

Influenza Genome Sequencing Project Wins CDC Award

WSLH Microbiologists Rich Griesser and Tonya Danz performing Whole Genome Sequencing testing on influenza viruses.

WSLH Microbiologists Rich Griesser and Tonya Danz performing Whole Genome Sequencing testing on influenza viruses.

A pilot project at the Wisconsin State Laboratory of Hygiene (WSLH) to perform Whole Genome Sequencing on influenza viruses received the Excellence in Domestic Partnering Award from the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention (CDC).

The WSLH is in the first year of a 3-year project funded by the CDC to pilot Next Generation Whole Genome Sequencing of influenza viruses submitted for surveillance from Wisconsin and other states.

The WSLH is the first state public health laboratory in the country to collaborate with the CDC on this cutting-edge technology. The WSLH has been 1 of 3 CDC-designated National  Influenza Surveillance Reference Centers since 2009.

Genetic characterization of influenza viruses is important both for monitoring genetic drift (how the virus may be changing) and for selecting the virus strains to include in influenza vaccines. Next Generation Sequencing (NGS) in state public health laboratories could potentially shave months off the vaccine development process.

“This is a big recognition at CDC,” said Dr. Peter Shult, director of the WSLH Communicable Disease Division and Emergency Response. “I am very  proud of the hard work of our staff, especially (microbiologists) Tonya Danz and Rich Griesser, (electronic laboratory reporting coordinator) Mary Wedig, and our WSLH IT staff. This type of public health work is what the WSLH is all about.”

 

Previous Stories about the Project

Building a Better Flu Vaccine
Getting CLARITY on Whole Genome Sequencing

Nonfatal Worker Injuries Remain Stable in Wisconsin for 2014

According to estimates from the U.S Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses (SOII), Wisconsin’s overall incidence rate of nonfatal occupational injuries and illnesses remained unchanged, at 4.0 cases per 100 equivalent full-time workers in 2014.

Nationally, the total injury and illness case rate per 100 full-time workers fell from 3.5 in 2013 to 3.4 in 2014. In surrounding Midwestern states (IA, IL, IN, MI, MN, NE, OH), Iowa had the highest total recordable case rate of 4.4 cases per 100 full-time workers while Ohio had the lowest rate of 2.9 cases.

SOII is the largest work injury data collection conducted nationwide. The Wisconsin SOII program collects data from a representative sample of 6,000 establishments in both the private and public sector.

JPEG INFOGRAPHIC SOII 2014Key Findings for Wisconsin:

  • Private industry total incident rates fell slightly from 4.0 in 2013 down to 3.9 cases per 100 workers in 2014, while state and local government rates rose from 4.5 in 2013 to 4.7 in 2014.
  • There were an estimated 86,300 total injuries and illnesses in Wisconsin workers with 25,300 (29%) requiring time off due to injury.  The number of cases with time off due to injury is up from the estimated 23,200 in 2013.
  • Across all industries, Wisconsin workers averaged 7 days off due to injury.
  • The leading nature of injury that required time off work in the private sector was sprains, strains and tears at 37.8% of lost time injuries. Soreness and pain was the second leading cause, at 16.3% of lost time cases.
  • Establishments with between 50 to 249 employees had the highest rate of workers who had time off due to injury at 4.7 cases per 100 full-time workers. Employers with between 11 to 49 employees were second-highest, with a rate of 4.1 cases per 100 full-time workers.

The Wisconsin State Laboratory of Hygiene, a part of the University of Wisconsin-Madison, is the state’s public, environmental and occupational health laboratory. The WSLH’s Bureau of Labor Statistics/Occupational Safety and Health Statistics Unit have a cooperative agreement with the U.S. Bureau of Labor Statistics to conduct their annual Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries in Wisconsin.

For more information about nonfatal work injuries in Wisconsin, go to www.slh.wisc.edu/bls.

2015 Mycobacteriology Conference Highlights

The Wisconsin Mycobacteriology Laboratory Network (WMLN) held its annual meeting on November 4, 2015.

The WMLN is an ongoing collaboration of all 31 laboratories in Wisconsin that perform some level of testing for TB, to share expertise and data critical to the state’s TB control efforts, and to improve TB testing quality overall in Wisconsin.

WMLN activities are coordinated by the Wisconsin State Laboratory of Hygiene and support statewide TB control efforts by the Wisconsin Department of Health Services’ Wisconsin Tuberculosis Program.

 

2015 WMLN Conference presentations

Tracking Viruses and Bacteria for Wisconsin and Nationally

flu_virus_illustration_CDCThe Wisconsin State Laboratory of Hygiene (WSLH) has been chosen by the Centers for Disease Control and Prevention (CDC) to be 1 of 3 National Influenza Surveillance Reference Centers for the next 5 years (2015 – 2020).

The WSLH, along with the state public health laboratories in California and New York, will provide influenza virus isolation, neuraminidase inhibition (i.e. anti-viral medication resistance) and whole genome sequencing testing services.

Test result data will be used by CDC to speed influenza vaccine development and better understand what influenza viruses are circulating and how they may be changing.

The WSLH will provide testing for Wisconsin and 21 other states.

Since 2009, the WSLH has served as a CDC virus isolation project partner looking for antigenic shift and drift in influenza viruses. This latest project builds upon that partnership.

The WSLH’s contract with CDC to serve as a national Vaccine Preventable Disease (VPD) Reference Center also has been renewed for another 5 years. The WSLH provides routine testing capacity for measles, mumps, rubella and other vaccine-preventable diseases for other public health laboratories as well as surge capacity for CDC in case of a large-scale outbreak.

The WSLH is not only performing viral and bacterial VPD testing for Wisconsin and 17 other state and local public health laboratories across the country, it is also the only VPD Reference Center providing test performance evaluation panels to public health laboratories so that they can assure the quality of their testing.

The work WSLH scientists perform with both reference centers enhances our surveillance and outbreak response capabilities to support Wisconsin’s public health system and the health of Wisconsinites.

Babies in the Lab and Living with PKU

About 7:00 AM Monday through Saturday, chemists and support staff working in the Wisconsin State Laboratory of Hygiene (WSLH) Newborn Screening Laboratory gather round a table and open envelopes containing precious samples from the state’s newest residents – dried blood spot specimens collected from babies born within the previous couple of days.

The blood spots are sent to multiple stations in the laboratory where they are tested for 44 rare, serious disorders that, if not treated quickly, can lead to severe health problems and sometimes even death. Out of the 65,000 babies born in Wisconsin annually, about 135 will have one of the disorders.

For lab staff, these blood spots represent real-life babies. But rarely do they get to meet the actual people whose lives they have so profoundly affected.

Earlier this month they got their chance.

David, Kristi and Logan Schrimpf and Joelle Odor in the Wisconsin Newborn Screening Laboratory. Joelle was the first baby to test positive for PKU after newborn screening was consolidated at the WSLH in 1978. Logan is one of the most recent babies to test positive for PKU.

David, Kristi and Logan Schrimpf and Joelle Odor in the Wisconsin Newborn Screening Laboratory. Joelle was the first baby to test positive for PKU after newborn screening was consolidated at the WSLH in 1978. Logan is one of the most recent babies to test positive for PKU.

In celebration of Newborn Screening Awareness Month, two people living with PKU – one of the 44 disorders on the newborn screening panel – visited the WSLH Newborn Screening Laboratory.

PKU is a metabolic disorder that requires a lifelong, low-protein, low-phenylalanine diet to avert irreversible brain damage from the accumulation of phenylalanine in the body. People living with PKU drink liquid supplements and/or take pills to obtain needed nutrients for proper growth and development.

Joelle Odor was the first baby to test positive for PKU after newborn screening was consolidated at the WSLH in 1978. She told staff of her challenges staying on the restrictive PKU diet when she reached her teens and how changes in the formulation of supplements have allowed her to get back “on diet”.

Logan Schrimpf is only 3 months old so his parents Kristi and David did the talking for him.

Logan is the Schrimpf’s first baby and his PKU diagnosis has required some additional adjustments for the new parents. David recounted the emotional roller coaster he and Kristi were on the first few weeks of Logan’s life, including how important it was to learn the results of follow-up tests that monitored whether dietary changes were lowering Logan’s phenylalanine levels.

At 3 months, Logan is doing great and the Schrimpf’s are adapting to life with a child who has PKU.

Because diet and supplemental formula are crucial to managing PKU, two dietitians from the University of Wisconsin-Madison’s Waisman Center metabolic disorders clinic also spoke to the lab staff. Nikki Drilias and Therese Breunig brought along samples of some of the different formula options for staff to taste.

Joelle, Kristi, David and Logan also toured the newborn screening lab learning how the chemists detect the disorders in the dried blood spots.

For everyone involved the event was a chance to learn more about the people behind the lab results.

Wisconsin Newborn Screening Laboratory staff taste samples of the different formulas people living with PKU drink daily to supplement their low-protein diet.

Wisconsin Newborn Screening Laboratory staff sample the different formulas people living with PKU drink daily to supplement their low-protein diet.

 

 

 

 

 

 

 

 

 

 

 

Wisconsin Newborn Screening Laboratory Co-Director Dr. Patrice Held (right) explains what happens in the lab to Kristi Schrimpf holding son Logan, Waisman Center dietitian Therese Breunig, David Schrimpf and Joelle Odor.

Wisconsin Newborn Screening Laboratory Co-Director Dr. Patrice Held (right) explains what happens in the lab to Kristi Schrimpf holding son Logan, Waisman Center dietitian Therese Breunig, David Schrimpf and Joelle Odor.

Worker Fatalities Remain Stable in Wisconsin for 2014

2014 CFOI Infographic ImageIn 2014, there were 97 Wisconsin workers who died due to injury. This number remains unchanged from the final count published in Wisconsin for 2013. The number of workplace deaths in Wisconsin the past decade range from 77 to 125, and average 98 fatalities annually.

The preliminary count of occupational fatalities in the U.S. in 2014 is 4,679, a 2% increase from the revised total of 4,585 in 2013.

The Census of Fatal Occupational Injuries is conducted annually nationwide by the U.S. Bureau of Labor Statistics (BLS), and compiles a count of all work-related deaths.

Key findings for Wisconsin in 2014:

  • Falls decreased by nearly half, while contact events increased 47%.
  • Self-employed workers sustained 39 fatalities, a 44% increase from 2013.
  • Employees age 65 and older sustained highest number of fatalities.
  • Transportation incidents caused the most fatalities.
  • Public sector fatalities decreased by half.

Worker Characteristics and Occupation

Of the 97 fatalities, 12 were in contractor status at the time of their death, which is an increase from 7 in 2013. Self-employed workers sustained 39 fatalities, a 44% increase from 2013.

The highest number of fatal work injuries occurred among age group 65 years and older with 25 deaths, followed by age 45 to 54 with 21, and age 55 to 64 with 19. These same age groups saw an increase in fatalities nationwide. Most fatal work incidents in Wisconsin occurred in the month of August.

Wisconsin transportation and material moving occupations sustained the greatest number of fatal injuries in 2014 at 22 incidents, followed by management occupations with 16 deaths. Construction and extraction occupations sustained 15 fatalities, and 14 deaths occurred among farming, fishing, and forestry workers.

Event

Transportation incidents comprised the highest number of fatal work injuries at 38, followed by contact with objects and equipment with 22, falls, slips, and trips with 16, and violence due to persons or animals with 15. Falls, slips, and trips declined 47% from 2013 while fatal contact injuries increased 47% from 15 to 22. Violent events increased from 11 in 2013 to 15 in 2014. Homicides declined by half from 2013, while suicides increased from 3 to 9 in 2014. Nationally, transportation incidents accounted for 40% of total fatal injuries, followed by falls (17%), violence (16%), and contact injuries (15%).

Industry

In 2014, 92 of the 97 work-related deaths in Wisconsin occurred within private industry. Public sector worker deaths decreased by more than half from the prior year. Agriculture, fishing, forestry, and hunting saw a 30% increase in fatalities from 2013 with 26. Fatalities in the professional and business services industry nearly tripled from 2013 to 2014, while the trade, transportation, and utilities decreased to 17. Fatalities in the construction industry increased slightly to 13. Manufacturing industry deaths rose slightly from 9 in 2013 to 11. Nationally, fatal injuries increased in agriculture, mining, manufacturing, and construction industries.

Background of Census of Fatal Occupational Injuries

The Census of Fatal Occupational Injuries, part of the BLS occupational safety and health statistics program, compiles a count of all fatal work injuries occurring in the United States during the calendar year. The program uses diverse state, federal, and independent data sources to identify, verify, and describe fatal work injuries. For more about the Census of Fatal Occupational Injuries, go to www.bls.gov/iif.

The Wisconsin State Laboratory of Hygiene (WSLH), a part of the University of Wisconsin-Madison, is the state’s public, environmental and occupational health laboratory. The WSLH’s Bureau of Labor Statistics/Occupational Safety and Health Statistics Program has a cooperative agreement with the U.S. Bureau of Labor Statistics to conduct the Census of Fatal Occupational Injuries in Wisconsin.

For more about occupational fatalities in Wisconsin, go to: www.slh.wisc.edu/bls.