The primary mission of the Disease Control Division is to test human specimens, food and water for diseases of public health significance to protect the citizens of Iowa. The Hygienic Laboratory supports numerous programs to prevent and control communicable disease, participates in epidemiologic investigations of disease outbreaks, and serves as a reference laboratory for clinical testing. Testing services help prevent the spread of disease in Iowa through the detection of infectious organisms, and help families through newborn screening for genetic disorders and maternal screening.
The testing services focus on the diagnostic tests needed to identify Iowans stricken with a disease and environmental testing of food and water for microbial pathogens. The diagnostic testing includes detection of infectious germs, new born screening for genetic disorders and maternal screening. For newborn screening, the laboratory performs tests for more than 29 genetic disorders.
In the area of infectious diseases, the Laboratory is divided into the classic microbiology sections of virology, bacteriology, parasitology, mycology, and environmental microbiology. Both traditional culture methods and molecular test methods are employed. In outbreak situations in Iowa, it is Hygienic Lab that is called upon to test samples for the physicians and epidemiologists. The Laboratory works in partnership with all of the clinical labs in Iowa where many of the pathogens are first detected. These labs then send samples to the Hygienic Laboratory for further characterization.
An example of the Laboratory’s role is in a foodborne outbreak. Typically, a physician sees a patient with a gastrointestinal illness, and orders laboratory testing such as a stool for culture. The culture is usually performed in a local clinical laboratory. When the local clinical lab detects the pathogen in the stool, they forward it to the Hygienic Lab to further characterize the pathogen. In the process of further characterization, the Hygienic Lab determines the DNA finger print of the pathogen.
Like detectives, based on the finger print, the Laboratory searches for other pathogens reported from other public health laboratories. The database used to search for the pathogen with the same fingerprint is the CDC PulseNet database. When the detective work finds similar pathogens, the information is given to the epidemiologists who determine if there is a common food source in patients who have a pathogen with matching DNA fingerprints.
When available, the Hygienic Laboratory cultures the food to search for the pathogen that was found in the patient. If the same germ is in the food and in the patient, the “smoking gun” has been found. At this point, the epidemiologists from the state and CDC work with FDA to remove the food from the marketplace. This all takes time, but it starts with a physician ordering a laboratory test.