Lab Matters Fall 2019 | Page 19

SPECIAL SECTION: THE LABORATORY RESPONSE NETWORK The LRN at 20: What’s Next? By Chris N. Mangal, MPH, director, public health preparedness and response 2019 marks the 20th Anniversary of the Laboratory Response Network (LRN), a national security asset for preparedness and rapid response to biological, chemical and other high-priority public health threats. The network, formed by APHL, CDC and FBI, has been pivotal in responses from anthrax to Zika and now, lung injuries associated with vaping or e-cigarette use. The LRN serves as model for other systems, offering an effective mechanism to detect and respond to public health emergencies of international concern. The success of the LRN can be attributed to its investments in people, technology and strong partnerships across various sectors including defense, law enforcement and public health. In fact, the network is often credited with strengthening the US public health laboratory system, with CDC providing approximately $70 million annually to state, local and territorial public health laboratories via the Public Health Emergency Preparedness (PHEP) Cooperative Agreement. Training and Workforce Development • Strengthening the public health workforce by providing technical training and other ongoing professional development activities • Providing technical assistance such as troubleshooting scientific assays and equipment. • Providing and/or ensuring access to proficiency testing and exercises • Leading the way on biosafety and biosecurity and supporting laboratories to ensure they have safe and secure facilities. PublicHealthLabs @APHL • Evaluating and implementing systems for electronic laboratory reporting while continuing to provide electronic data messaging standards for laboratory results that contribute to sound public health decisions • Examining data science and the utility of information collected to better inform responses • Engaging member laboratories to evaluate new technologies • Exploring new partnerships to have technologies ready for rapid deployment during emerging threats. Systems Maintenance and Enhancement The LRN has recognized the importance of collaborating with other federal agencies such as the Department of Defense (DoD) and leveraging their assay development expertise to deploy new new assays and platforms for rapid detection of threats, such as Ebola. For the next 20 years of the LRN, partnerships will continue to be on the forefront with continued investments in: Quality Systems Technology Enhancements • Strengthening public-private laboratory systems to ensure quality samples are submitted to the network and it is well positioned to accurately and timely respond to all threats • Providing standardized protocols and tests • Maintaining a restricted access website to house materials that can be accessed by member laboratories • Communicating with members on a routine basis (e.g., quarterly calls, technical meetings, national conferences) coupled with help desk support for member laboratories • Providing support for maintenance agreements and other equipment contracts. While the LRN is one network, it has two distinct components: Laboratory Response Network for Biological Threats Preparedness (LRN-B): comprised of three national laboratories, 130 reference laboratories and thousands of sentinel clinical laboratories, this arm of the network detects biological threats and emerging infectious diseases quickly and accurately anywhere in the US. Sentinel clinical laboratories are the foundation of the network and poised to rule-out and/or refer biological threats to reference laboratories such as state and local public health laboratories Laboratory Response Network for Chemical Threats Preparedness (LRN-C): comprised of 54 laboratories nationwide capable of responding to national, large-scale emergencies by rapidly identifying chemical agents such as cyanide. State and local public health laboratories also use analytical expertise and advanced instruments from the LRN-C to provide actionable laboratory results for urgent, local needs, including the US opioid overdose epidemic and the outbreak of lung injury associated with e-cigarette products. There is a third component, the Laboratory Response Network for Radiological Threats Preparedness (LRN-R) which is still is development and would provide support for the detection of radiological threats. As the LRN looks to the next 20 years, it will be a driver in the emerging field of data science since results from technologies in its member laboratories will be key to rapid responses. The network will also examine its strategic vision to determine its role in responding to emerging threats as well as engaging private clinical and commercial laboratories in surge responses. At the crux of this vision is the importance of ensuring scientists and the general public are safe from threats. n Fall 2019 LAB MATTERS 17