PUBLIC HEALTH AND PREPAREDNESS RESPONSE
Celebrating 25 Years of the Laboratory Response Network
By Chris N . Mangal , MPH , director , Public Health Preparedness and Response ; and Rana Rahmat , MPH , specialist , Laboratory Response Network
In 1999 , the US Centers for Disease Control and Prevention ( CDC ), in partnership with APHL and the Federal Bureau of Investigation ( FBI ) launched the Laboratory Response Network ( LRN ) to strengthen the nation ’ s ability to rapidly detect biological and chemical threats . Over the past 25 years , the network has prepared for and responded to numerous threats that can cause serious illness or death , and they have been involved in several high-profile public health emergencies including Anthrax , Severe Acute Respiratory Syndrome ( SARS ), Middle East Respiratory Syndrome ( MERS ), Ebola , Zika and Mpox as well as supported responses for pandemic influenza . Presently , the network has two components : Biological Threats Preparedness ( LRN-B ) and Chemical Threats Preparedness ( LRN-C ). CDC and its partners recognize the need to expand the network to address radiological threats .
LRN-B
In 1999 , the LRN-B began with only 17 laboratories and has since expanded to approximately 120 member facilities that include domestic and international laboratories , and sentinel clinical laboratories , which form the foundation of the system . The LRN-B is diverse and encompasses public health , military , veterinary , environmental and food laboratories providing reference testing for a wide array of sample types including environmental samples and clinical specimens .
The LRN-B ’ s role in ongoing responses underscores its crucial importance in enhancing the nation ’ s ability to detect and respond to public health threats promptly .
LRN-C
The LRN-C began with only five laboratories and has since expanded to 54 member facilities located in the US
History of the LRN-B
1999 LRN established in 17 laboratories
2001 Anthrax attacks : LRN activates for first major response
2002 SARS : CDC develops and deploys new test to LRN-B member laboratories
2004 RNC and DNC : LRN-B experts deploy for rapid response
2009 Anthrax in New Hampshire : quick diagnosis for prevention of additional cases
2012 MERS : CDC develops and deploys new test to LRN-B member laboratories
2014 Ebola : CDC develops and deploys new tests to LRN-B member laboratories
2016 Zika : CDC develops and deploys new test to LRN-B member laboratories 2020 – 2024 LRN laboratories utilize their assets to respond to COVID-19
2022 – 2024 Mpox : LRN laboratories utilize CDC FDA 510 ( k ) Non-Variola Orthopox test to detect first and subsequent cases of Mpox in the US
2024 Over 120 LRN-B member laboratories maintain preparedness to respond to biological and other emerging threats
including one US territory . During largescale national events , LRN-C member laboratories assist CDC in testing samples for chemical exposures and serve as front-line conduits for communication among CDC and local health officials , hospitals and poison control centers .
Forty-four LRN-C laboratories can identify exposures to toxic chemical agents such as cyanide , nerve agents and toxic metal , and 10 LRN-C laboratories have high-threat testing capabilities for mustard agents , nerve agents and toxic industrial chemical exposures . Within a 24-hour period , 8,500 clinical samples can be processed , tested and reported to CDC . The LRN-C utilizes a surge capacity model :
• Level 1 laboratories have the highest level capability and provide 24 / 7 assistance to CDC by testing samples in the event of a large-scale chemical emergency . These laboratories must maintain adequate staffing and equipment to support high volume testing with quick turnaround times . CDC also requires these laboratories maintain testing capabilities for exposures to high-threat chemical agents . In addition , Level 1 laboratories maintain all Level 2 testing capabilities .
• Level 2 laboratories maintain testing capabilities for exposures to chemical terrorism agents such as cyanide , toxic metals and toxic industrial chemicals .
• Level 3 laboratories provide local support with sample logistics as well as training and outreach with local hospitals . All LRN-C laboratories maintain Level 3 capabilities .
The LRN is an excellent model of an interconnected yet distributed system that has proven its value by detecting several threats . However , perhaps the most successful aspect of this network is its role in strengthening the US public health laboratory system .
• Strengthens existing public health and defense laboratory systems — public health laboratories use CDC-provided funds to
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34 LAB MATTERS Fall 2024
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