A skunk brain, barely the size of a golf ball, sits in a clear container in a refrigerator behind a sliding glass door. A county animal control officer delivered it here, worried the animal might have been infected with rabies.
It falls to the Monterey County Health Department’s Consolidated Chemistry Laboratory to find out.
Lab Director Gerry Guibert pulls on a fresh pair of gloves to show off the pink brain his team will dissect.
Other sinister pathogens lurk inside glass vials secured in this lab. “We don’t publicize a lot about the bacteria we work with,” he says.
Two closed doors, marked Biosafety Level 3, are designed to contain specimens that could readily spread through the air, like tuberculosis and avian flu. The rooms are kept at negative air pressure, sucking air in rather than letting it flow out into the building.
Every day, Guibert and his staff process dozens of specimens from local hospitals in these highly secure rooms. They double as the county’s Environmental Health Laboratory, examining water samples from farms and treated wastewater from the Monterey Regional Water Pollution Control Agency.
“IF YOU’RE CAREFUL, IT’S NOT DANGEROUS AT ALL. BUT YOU CAN NEVER GET TOO COMFORTABLE.”
Guibert and his staff routinely handle some of the most awful diseases out there. Lately, they’ve been testing a lot for measles and pertussis. Local hospitals haven’t sent any samples for Ebola testing – yet – but Guibert is prepared for any that may come. He’ll air-freight them to the U.S. Centers for Disease Control and Prevention in Atlanta.
Guibert’s been working as a public health microbiologist since 1976, long enough that he’s stopped worrying about contracting the pathogens he deals with. “I’m still alive,” he says, donning a wrinkled white lab coat. “If you’re careful, it’s not dangerous at all. But you can never get too comfortable.”
This Salinas lab yields results that could end up as headlines: salmonella or measles outbreaks, dangerous levels of nitrates in drinking water, possible anthrax in a suspicious package.
The general public can hire the lab for more commonplace testing, too. An asbestos test is $200, a storm drain analysis $104. Tests for coliform and E. coli, which farmers run to make sure their irrigation water is safe, run $25. A broader panel of pathogen testing for salmonella, listeria and shigella is $62.
“The kinds of things public health labs engage in, there’s not much profit,” Guibert says. “We avoid trying to compete with the private sector.”
That’s why he’s all but stopped testing for sexually transmitted diseases. That used to constitute more than half of public health labs’ work, he says, before STD tests became widely available, and cheaper, in private labs.
But the results from some of these commercial tests are less detailed than what the county’s lab is equipped to find. That’s not really an individual health problem, Guibert says, but it can be a public health problem.
One example: Commercial tests can confirm the presence of E. coli, helping a doctor treat a patient. But they won’t identify the strain, which is essential information for public health officials to identify the source of an outbreak.
The lab can also get results faster for critical public health concerns, like measles. Kristy Michie, an epidemiologist with the County Health Department, relied on Guibert’s team to provide day-of measles results during the Christmas-season outbreak.
Instead of blood testing, which can take five days, they use a polymerase chain reaction: extracting DNA and copying it in a test tube, doubling the genetic material every 2-3 minutes. This produces enough pure DNA to test within 24 hours. (None of the local results were positive, though testing confirmed two measles cases in spring 2014.)
“Other jurisdictions without that [expedited] testing capability have to proceed as if that person does have measles,” Michie says. “We can find out very quickly, so that saves our resources.”
For especially contagious diseases, Michie’s epidemiology team makes house calls to collect specimens, keeping potentially sick patients out of waiting rooms. Testing for diphtheria, pertussis and valley fever happens daily.
A few days later, the results of the skunk rabies test are in: positive.
“Rabies is the most awful way of dying imaginable,” Guibert says.
A young Royal Oaks dog killed the skunk, and the pet owners notified the county Animal Control Officer. The bad news left the family with a choice to quarantine their dog for six months, or put it down. They chose the latter, potentially saving their dog from a slow, gruesome death.