The Sacramento County Public Health Laboratory

BACKGROUND In 1927 the legislature established local public health laboratories (PHL’s) to provide the technical information needed to carry out the Preventive Medicine Mission of the local health departments.  At the heart of this mandate is the belief that the prevention of disease is far more humane and less costly than the diagnosis, treatment, and post-treatment care for a preventable disease.  Under the authority of the County Health Officer, the Sacramento Public Health Laboratory provides routine and specialized laboratory services for the detection, control, and prevention of communicable diseases in Sacramento County.    THE CORE FUNCTION - PUBLIC HEALTH REFERENCE FOR DISEASE PREVENTION The Sacramento County Public Health Laboratory is the communicable disease reference lab for the County.  As a key resource for information, the PHL provides consultation to community physicians, hospitals, and other laboratories on diseases of public health significance.   Following the Preventive Medicine Mission, the PHL is a vital force against the spread of disease in Sacramento County.  The PHL provides a link between the County’s Disease Control Programs and the private medical community.  Microbes of established public health significance and unknown organisms with potential significance are submitted by commercial labs for definitive identification.  These reference cultures are often the first indication of large outbreaks and frequently initiate investigations, contact follow-up and other communicable disease control measures.  Undoubtedly, the Public Health Laboratory’s expertise would be critical in the event of a bioterrorist attack.   Testing of asymptomatic contacts to disease cases, analysis of food implicated in large foodborne outbreaks, and the testing of animals for Rabies are examples of Public Health Prevention Measures that are not done by private providers.    The PHL also acts as a conduit between the local medical community and State and National Public Health Networks for unusual and exotic diseases of public health significance (e.g. Hantavirus, Western Equine Encephalitis, and potentially Ebola virus.)  This coordination of testing for diseases of epidemic potential and for outbreak analysis is a unique function of the PHL.   DIAGNOSTIC TESTING   The PHL performs both routine and specialized diagnostic testing and has recently added diagnostic testing for West Nile Viruses, as well as other arboviral tests and respiratory viral testing.  Diseases requiring state mandated PHL confirmation include Typhoid, Salmonellosis, Malaria, Multi-drug resistant TB, Rabies, Botulism, Anthrax, Plague, Brucellosis, Cholera, and Diphtheria.  Routine diagnostic testing for infectious diseases are provided for the County’s Public Health Clinics, AIDS Prevention Programs, Primary Care Clinics, Jails, and Environmental Health Units.  Non-County customers include The Effort, Sacramento AIDS Foundation, the Mexican American Alcoholism Project, Harm Reduction, Chemical Dependency Center, UCDMC, the Blood Source, and private hospital and commercial labs.   STAFF   Professional Public Health Microbiologists and Laboratory Support staff test and maintain records on thousands of specimens each year for the Sacramento County Public Health Laboratory.   Unique to the PHL is the certification of the Public Health Microbiologists.  Public Health Microbiologists are specifically trained and certified to provide the types of examinations crucial to Public Health’s Preventive Medicine Mission.  The background required for the Public Health Microbiologist includes a baccalaureate or higher degree with a major in Medical or Public Health Microbiology and experience represented by a six month internship of specialized Public Health Laboratory training at an approved Public Health Laboratory.  After internship, the certificate is earned by passing a licensing examination administered by the California State Department of Health Services.   The Sacramento Public Health Laboratory staff is on-call 24/7 to provide emergency laboratory testing support to first responders in the community and for northern California clinical laboratories in order to rule-out / in potential bio-threat agents.   “There will always be a need for an emergency response effort, and that will probably always primarily mean the CDC.  But you need people on the ground to spot these things first.  You need a health care system.  And you need a place to call.”  - Laurie Garret quoting Joe McCormick in The Coming Plague, Newly Emerging Diseases in a World Out Of Balance

Specimen Collection Manual   APHL Magazine Article on Sac County Public Health Lab, Summer 2008   ANTIBIOGRAMS   Antibiogram Wound Chart 2008   Antibiogram Urine Chart 2008   Antibiogram Wound Chart 2007   Antibiogram Urine Chart 2007