Lab Matters Fall 2018 | Page 21

PUBLIC HEALTH PREPAREDNESS AND RESPONSE The LRN Turns 20: Two Decades of Detecting Threats from Anthrax to Zika By Tyler Wolford, MS, senior specialist, Laboratory Response Network In 2019, the Laboratory Response Network (LRN) will celebrate 20 years of public health preparedness and response for biological, chemical, radiological and emerging threats. The nationwide, all-hazards network has come far since 1999, when public health laboratory (PHL) scientists were largely classically-trained microbiologists. With rapid detection of threat agents now a priority, they had to transition quickly from culture to molecular-based methods. But sample testing was only one piece of the puzzle. PHLs also had to build partnerships with first responders, the Federal Bureau of Investigation (FBI), US Centers for Disease Control and Prevention (CDC), Department of Defense and others to respond to evolving public health threats. In the beginning, only a few public health laboratories had the capability to respond to a limited number of biological threats such as anthrax. Now the LRN is a robust network of over 130 federal, state and local public health, veterinary, agriculture, military, and water- and food-testing laboratories. Over time, these facilities have expanded their capabilities to respond to chemical and radiological threats and to emerging threats such as H1N1 in 2009 and, most recently, Zika in 2016. It takes determination, adaptability and passion to build, maintain and evolve a robust response network, as described by two veterans of the network. Building a Laboratory Response Network “In 1999, I accepted the challenge of building the LRN program at the State Laboratories Division (SLD) with mixed feelings because I had never worked with first responders or the FBI and had very little interaction with our community laboratory partners. The diagnostic testing part of my job was equally challenging because I’m a classical microbiologist by @APHL training and real-time polymerase chain reaction and time-resolved fluorescence were very new. I got involved in training with the National Laboratory Training Network, learned how to develop and conduct tabletop exercises, train sentinel clinical laboratories and much more. “For years, SLD had lagged behind the private laboratories in the acquisition of advanced detection systems and laboratory information systems for secure data exchange. Because of the influx of CDC Public Health Emergency Preparedness (PHEP) funds, in 2002 we were able to acquire modern instrumentation that dramatically improved our detection capabilities. We now have a total of eight microbiologists, three chemists and one administrative staff member. SLD has taken significant strides over the years to manage and use newly acquired resources to address the threat of emerging infectious diseases including Ebola and Middle Eastern Respiratory Syndrome Coronavirus.” “This has been a very rewarding experience that is rapidly evolving. To be successful as a public health scientist in the future, it is vital that we are able to adapt to our changing environment with new research, instruments and technologies. If we restrict ourselves to only what we know and feel comfortable with, we will hinder the progression of addressing the needs of the population by limiting the ability to detect and prevent infectious diseases.” The success of the network is continually dependent on the knowledge and skills of public health scientists. It is important to sustain current knowledge, but also to expand skill sets to meet the demand of an ever changing network. The future depends on the next generation of public health scientists; success depends on their willingness to adapt and determination to go above and beyond. n The Evolution of Public Health Scientists Rebecca Sciulli, MS, MT Acting Laboratory Director, Hawaii Department of Health, State Laboratories Division PublicHealthLabs (from l to r:) Alexis Peterson, Derek Harauchi, Cheryl-Lynn Daquip and Rebecca Sciulli, Hawaii Department of Health, State Laboratories Division. Photo: HDHSLD to address population issues surrounding disease and injury prevention, education and policy making. Likewise, I have embraced the many changes that have occurred in public health as well as the Laboratory Reponse Network. Some remarkable advancements such as whole genome sequencing and mass spectrometry have decreased turnaround time while providing a deeper understanding of current and emerging pathogens to help protect the health of our communities. Michael J. Perry, MS, MS Ed. Associate Director, Biodefense Laboratory, New York State Department of Health–Wadsworth Center “The role of public health has a slightly different meaning from person to person. Over my ten years as a public health scientist, I have been able to understand the important interdisciplinary role that public health takes Michael J. Perry, MS, MS Ed., associate director, Biodefense Laboratory, New York State Department of Health–Wadsworth Center Fall 2018 LAB MATTERS 19