Lab Matters Fall 2018 | Page 26

INFECTIOUS DISEASES Behind the Scenes, APHL is a Key Partner and Driving Force in Influenza Surveillance by Kim Krisberg, writer APHL’s most recent influenza efforts date back to when it began work with CDC to help shift public health influenza diagnostics from the conventional virus culture to the much quicker, more accurate molecular assay. Since then, APHL has continued its work to expand, hone and streamline influenza surveillance at home and globally. “Seasonal or pandemic, influenza is always a dangerous threat, as we saw during last year’s particularly bad flu season,” Wroblewski said. “Our goal at APHL is to help laboratories strengthen and sustain the flu surveillance systems they’ve built and stay ready in their role as first responders.” An APHL Priority Abroad… H1N1 influenza In 2009, within two weeks of confirming the first case of H1N1 influenza, the US Centers for Disease Control and Prevention (CDC) was ready with a new laboratory test for quickly and accurately identifying the pandemic virus. A couple weeks after that, 40 state public health laboratories, having proved they could use the molecular assay to consistently get reliable results, were ready to deploy it on the ground. The laboratories began churning out close to real-time data on H1N1 activity, which gave first responders the best opportunity to get ahead of the virus and stop its spread. In fact, the H1N1 effort is often described as a pivotal point in laboratory response and its use of molecular diagnostics, as well as a clear demonstration of the benefits of investing in public health influenza surveillance in the US and abroad. It was also the culmination of years of work, exercise and collaboration between CDC, state 24 LAB MATTERS Fall 2018 and local public health laboratories, and partners such as APHL. “Flu surveillance and pandemic readiness are some of a public health laboratory’s most critical functions,” said Kelly Wroblewski, MPH, director of APHL’s Infectious Diseases Program. “Enhancing and sustaining those capacities not only boosts overall laboratory capacity, it keeps the public health system’s readiness on par with a viral threat that’s constantly changing.” The 2009 pandemic—which killed upwards of half a million people worldwide, including more than 12,400 people in the US—was a grim reminder of the critical importance of having effective influenza surveillance systems around the world. APHL was a key partner in the H1N1 response, acting as a conduit between CDC and public health laboratories in all 50 states, pushing out updates and guidance on implementing the new H1N1 assay and shifting into emergency response gear. Today, much of APHL’s influenza work zeros in on expanding advanced influenza surveillance and streamlining the system to keep up with a virus that’s not only always changing, but that CDC describes as “one of the world’s greatest infectious disease challenges.” Back in 2009, in the lull between the spring and fall pandemic waves, APHL began working with CDC to develop an assessment tool that could be used globally to gauge a laboratory’s influenza testing capacity and generate critical data for identifying gaps and needed improvement in the global surveillance system. The result is the CDC-APHL PublicHealthLabs @APHL