Michigan Dept of Community Health

Aug 11 at 8:01 AM




News and Articles
White House Innovation
Day Highlights Disaster
Response, Recovery
Emergency managers
converged with the tech
community in Washington,
D.C., to discuss tools that can
create more resilient
communities and also
positively impact disaster
preparedness, response and
recovery. The White House
Innovation for Disaster
Response and Recovery
Initiative Demo Day on July
29 showcased new
innovations in both
government and the private
sector that aim to aid the
survivors of large-scale
emergencies.
Read More>>
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News and Articles
Training & Events
Tools & Resources
The Michigan Update
Research

About the Guardian
The Guardian of Public Health is a monthly newsletter from the
Office of Public Health Preparedness (OPHP), an office from within
the Michigan Department of Community Health (MDCH). The
Guardian aims to provide its readers with relevant content on topics
that affect the public health of citizens and communities in
Michigan. For questions or comments please contact Rachel
Ruddock at ruddockr@michigan.gov.
Click here to subscribe to the Guardian

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Training & Events
Fundamentals of Disaster
Mental Health Webinar
American Red Cross
September 10, 2014; 6:00pm
10:00pm
Register here: Search for
disaster mental health
Participants should register
one week in advance and
must be a licensed
independent practitioner with
their license number
available.
Emergency Responder
Health Monitoring and
Surveillance (ERHMS)
System Training Course
WB2254
ERHMS training is now
available online. The training
is free and provides the
necessary tools for
implementing health
monitoring and surveillance of
emergency response workers.
Important procedures for pre-
deployment, deployment, and
post-deployment are outlined
Continuing education credits
can be obtained for those who
register and successfully
complete the course. Credits
include: CEU/CE; CHES;
CME; CNE Contact Hours;
Pharmacist Contact Hours;
and AAVSB/RACE.
Register>>
IS-930: ERHMS System:
Leadership Training
This leadership training
course introduces the ERHMS
system to leaders in
organizations responsible for
planning and executing
incident response activities.
The Michigan Update
State of the Art Technology at MDCH
Submitted by Patty Clark, Outreach Manager, MDCH Bureau of
Laboratories
The Michigan Department of Community Health Bureau of
Laboratories has recently validated a MALDI-TOF MS (matrix-
assisted laser desorption/ionization time of flight mass
spectrometry) for use in the Bacteriology Laboratory. MALDI-TOF
MS replaces the routine use of 16s sequencing and biochemical
identification of microorganisms. Using the MALDI-TOF MS,
microorganisms can be detected and identified within one day
instead of the usual several days or weeks, at a fraction of the cost.
Currently, biochemical tests form the basis of most techniques used
to identify microorganisms. Organisms are added to media
containing specific carbohydrates or substrates. This leads, for
example, to a characteristic color change of the added reagent,
which can then be compared with reference values. Correlating the
results of a number of such tests on a sample culture provides an
indication of the organism's identity.
The Bruker MALDI Biotyper uses a different methodology - it
analyzes the expression of a microorganisms intrinsic proteins
using mass spectrometry. This mass spectral pattern of protein
expression is compared with reference patterns to determine the
identity of the microorganism.

Figure 1. The MALDI-TOF target plate has ninety-six spots that
can be inoculated using an applicator such as a toothpick. The spot
is then overlaid with the matrix solution and after drying it is loaded
into the analyzer. The whole process takes just minutes.
The course focuses on
optimizing the health and
safety of response,
remediation, recovery, and
volunteer workers. The
intended audience includes
local, regional, state, tribal,
and federal personnel who
are responsible for the
occupational safety and
health of responders.
Participants can receive 0.1
continuing education units for
completing the course.
Register>>
MCRA Annual Training
Conference
September 21-23, 2014
Tustin, MI
The Michigan Crisis
Response Association
(MCRA) will hold its annual
training for individuals and
groups interested in education
on Comprehensive Crisis
Intervention Systems.
Register>>
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Tools &
Resources
Responder Self Care App
This mobile app aids those
deployed to emergency
response events in
maintaining their own
physical, emotional, and
social wellbeing. It provides
checklists for before, during,
and after deployment that
help responders pack for
deployment, take care of daily
needs, maintain important
relationships, reflect on
experiences, and more.

A longer time may be necessary if an extra extraction process is
needed adding approximately an hour.
Starting material for a classification using the MALDI Biotyper is an
individual colony from a culture on an agar plate. The sample is
transferred to a position on a MALDI target (figure 1) and air-
dried. After drying, a small quantity of matrix solution is added.
Once the matrix has crystallized, sample preparation is complete
and the samples can be analyzed. If this straightforward sample
preparation method is unsuccessful, a supplementary protocol
containing short chemical extraction steps can be used to increase
the range of organisms that can be identified by MALDI analysis.
MALDI-TOF mass spectrometry forms the basis of MALDI Biotyper
analyses. A laser in the MALDI-TOF mass spectrometer irradiates
the matrix/sample mixture, evaporating the matrix and releasing
positively charged proteins. The ability of the matrix to absorb UV
light and transfer protons onto the extracted proteins is crucial to
this process. The protein ions are electrostatically accelerated over
a short distance and arrive in the flight tube at a speed that is
proportional to their mass. Protein ions with different masses arrive
at the detector after different time periods. Simply by measuring the
time between pulsed acceleration and the corresponding detector
signal (in the nanosecond range), the speed of the ions can be
measured very precisely and converted into an accurate molecular
mass. Because this mass spectrum is species-specific for a large
number of microorganisms, it represents a 'molecular fingerprint'.
Unknown microorganisms can be identified by comparing their
'fingerprint' with the thousands of patterns in the
reference database.
A spectral pattern is compared to the database in the softwares
library generating an identification of the microorganism. Often, the
turnaround time for identification is within a day of receiving the
isolate. Previously, using biochemical testing and 16s sequencing,
it could take days or even a week or two for final identification.
When an identification cannot be obtained using our laboratory
algorithm the organism will be sequenced and submitted for
biochemical analysis.
Identification using MALDI-TOF has reduced the cost per test to
less than a dollar compared to more than forty dollars with previous
methods. The use of the MALDI-TOF will be expanded in the near
future to other areas in the Bureau of Laboratories.
Brief Updates From Region 1
Submitted by Matthew Price, Region 1 Healthcare Coalition
Coordinator
D1RMRC hosted a Basic Disaster Life Support (BDLS) on 6-5-2014
at D1RMRC Training Center. Many attendees are a part of the
District 1 Emergency Response Team.
Customizable reminders
ensure that critical tasks are
not forgotten and tips explain
why certain aspects of self
care are vital.
A variety of responders will
find this app useful to help
manage their self care while
working in demanding
situations, when caring for
oneself is essential in order to
help and care for others.
Read More>>
Provider Resilience App
Provider Resilience gives
health care providers tools to
guard against burnout and
compassion fatigue as they
help service members,
veterans, and their families.
Your responses to a short
self-assessment create
ratings of your risk for
compassion fatigue, burnout,
and secondary traumatic
stress. These ratings can also
be viewed as graphs so you
can monitor them over time.
A clock showing time since
your last day off, inspirational
cards, stretches, and Dilbert
comics all encourage you to
take restful breaks critical to
avoiding burnout. Finally,
videos by service members
describing the positive impact
health care providers had in
their lives are there when you
need a reminder of the value
of what you do.

Read More>>
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This team is comprised of professional medical volunteers from
across the region that could help with a coordinated medical
response.
D1RMRC conducted a DIRE PLAY 5 Mass Fatality Functional
Exercise on 6-12-2014 at Michigan State University. Multiple
disciplines attended including representation from the regions
Medical Examiners. This exercise was critical to help evaluate long
term response for public health emergencies.
D1RMRC piloted the Advanced Disaster Management System
Training (ADMS) on 6-10-2014. Ten first responders attended this
training. This training was a virtual environment training with
artificial intelligence. This training helped EMS command staff
develop more effective scene management skills using high level
simulation enhanced training.
D1RMRC presented at the Business Continuity of Operations
(COOP) meeting hosted by Sparrow Clinton Hospital on 6-6-2014.
This meeting was critical in gathering businesses from across the
Clinton County area to obtain education on the necessity of having
a COOP plan and their relationship with different healthcare
coalition partners.
D1RMRC hosted a discussion based exercise workshop on 6-17-
2014 to help healthcare organizations conduct drills, tabletops, and
full scale exercises within their organizations.
D1RMRC in conjunction with Shiawassee County Public Health
Department and emergency management conducted a Volunteer
Reception Center table top exercise and drill on 6-30-2014
exercising the volunteer request procedures and transfer of
volunteers to a disaster site from areas across the state.
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Research
There Are No Victims Here: Creating an Empowered
Survivor Culture
In Emergency Management, authors talk about how to better
empower the public to become more resilient after emergencies.
The campaign Be your own hero goes beyond the Be Prepared
message in that it empowers the public to use what they already
know and have access to be their own hero in an emergency. The
authors say that anyone can be affected by disasters including
those in the position of authority which the public depends on for
support. Empowering the public to take charge of their own
response encourages less dependence on governmental agency
support.

Read More>>




CDC Biosafety Issues Regarding Unsecured Lab
Samples
The Centers for Disease Control (CDC) released an after action
report on the potential anthrax exposure in June of 2014.
Read More>>
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This publication is supported by Cooperative Agreement Number 1U90TP000528-01 from the
Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of
the authors and do not necessarily represent the official views of CDC.

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