have it, the LA lab had an opening for an assistant laboratory director
trainee and microbiology supervisor II. WaKabongo was accepted and
enrolled in LabAspire—California’s PHL director training program—
and then passed the American Association of Bioanalysts board
certification exam to qualify as a high complexity laboratory director.
The laboratory directorship in Placer County opened up in 2010, and
WaKabongo was hired that summer. She said, “I love it here, because
the laboratory is small and manageable and the traffic is not like in
Southern California.” WaKabongo jokes, “I have been in this country
longer than I lived in Africa. The funny thing is, I’m like a person who
doesn’t belong anywhere. Even when I talk to people from home, they
say, ‘You have an accent.’”
staff
The laboratory has two part-time public health microbiologists and
eight full-time staff members: WaKabongo, a senior microbiologist/
BT coordinator, two microbiologists, a senior administrative clerk and
three laboratory technicians. There are no vacancies. Of note, Senior
Microbiologist Bret Becker, BS, PHM was part of the National Center
for Public Health Laboratory Leadership’s Emerging Leaders Cohort III
(2010-2011).
Said WaKabongo, “I really like my staff. We work as a team and they
are very open to training. That is so important to me.”
revenue
The annual laboratory operating budget is just under $1.4 million.
Roughly two-thirds of this revenue comes from Placer County general
funds and the remainder from fees and grants.
Testing
In 2008, the laboratory performed more than 24,000 tests/year, the
vast majority for adult drug screening for the local public health
system. When the county moved the service to an outside lab in 2009,
annual testing volume fell to about 5,600, mostly for Chlamydia/
gonorrhea. “It was a big drop,” said WaKabongo.
Current fee-for-service tests include well water testing, tick testing
for Lyme disease, STD and TB testing for public health clinics, and
STD and drug testing for the local juvenile court system. Other
services include tests for rabies, foodborne diseases, blood lead,
parasites, influenza, and bacterial contamination in sewage,
recreational water and drinking water. The laboratory restarted its
mycology testing program after WaKabongo took the helm and
recently became part of a norovirus surveillance program. As of
September 2011, the laboratory is approved to test for all select agents
in high-risk environmental and clinical samples, but stores only
non-Tier A agents.
success stories
• The Placer County laboratory was the first public health laboratory
in California to perform drug screening for non-medical reasons.
The program began at the behest of the local probation department,
which was interested in urine screening for the judicial system—a
service comparable to ELISA testing performed in the laboratory.
Laboratory staff subsequently trained several other counties to
perform urine-based drug screening.
• Prompted by concerned area residents, state wildlife biologists
solicited the collaboration of laboratory scientists in a study on
vector pathways for Lyme disease. The effort resulted in a 1999
article in The Journal of Medical Entomology. The laboratory subsequently began offering tick testing for patients and physicians
throughout the area, and has performed tick pool testing for LA
County for more than a decade.
• In 2011, the laboratory joined the Respiratory Laboratory Network
for influenza surveillance and early this year joined the norovirus
surveillance program.
• Since WaKabongo’s arrival, the laboratory has conducted a number
of activities for local partners. It organized its first all-hazards
preparedness workshop for first responders in late 2011; participated in two exercises with the 95th Civil Support Team (one in
2012 and one in 2013), alongside FBI officials and Roseville HAZMAT
teams; and just completed a hands-on workshop for local, clinical
sentinel laboratories.
• WaKabongo initiated the updating of laboratory standard
operating procedures and installation of an electronic document
control system.
• The laboratory’s latest CLIA inspection, in May 2012, turned up
no deficiencies.
Challenges
• Revenue. “We didn’t used to worry about revenue when we had the
adult drug testing program. After the big drop, revenue became
an issue.”
• Staffing. “We are short of help. The county is looking into giving us
another full-time microbiologist. There’s a hope there.”
goals
After the loss of its adult drug testing program, WaKabongo said the
laboratory is “always looking for new tests.” She said, “In this area, we
have naturally-occurring arsenic in the soil. Can we test for it?” She
would also like to implement PCR testing for Bordetella pertussis and
other priority pathogens. Finally, WaKabongo has not given up hope
for re-establishing adult drug testing: “One of the reasons the county
went with an outside lab for drug testing was because our laboratory
was not able to witness the urine collection. So we are looking at
different ways of doing the testing; for example, saliva testing. There
are still some legal issues, but we keep our eyes open.” u
