Lab Matters Spring 2026 | Page 19

FEATURE

newborn screening( NBS) laboratory. MDH NBS Laboratory is tasked by state statute to perform NBS testing and screen every baby born in Maryland( approximately 65,000 births / year) for the conditions defined by the Recommended Uniform Screening Panel( RUSP). Maryland is one of 12 states that continues to perform a second screen. Prompt medical interventions based on the results of these fast and accurate screening tests prevent infant long-term morbidity and mortality. In fiscal year 2025. the MDH NBS Laboratories performed over 8.8 million tests. Under Maryland law, when conditions are added to the RUSP tests, they must be added to the Maryland NBS panel in a timely manner. Since December 2023, the MDH NBS Laboratory has validated and implemented four new tests to screen for additional heritable conditions * for virtually every baby born in Maryland, adding hundreds of thousands of additional NBS tests performed annually.

* New conditions screened for since December 2023:( 1) X-ALD( X-linked adrenoleukodystrophy,( 2) MPS-II) Mucopolysaccharidosis type II, also known as Hunter syndrome,-( GAMT) Guanidinoacetate methyltransferase( Creatine deficiency) and Krabbe Disease( globoid cell leukodystrophy).

Notable success story: In Summer 2024, test results generated by several MDH testing laboratories were instrumental in support of an investigation by the MDH epidemiologists and food protection regulators into a cluster of Listeria monocytogenes infections in Maryland that were ultimately linked to the consumption of contaminated processed sliced deli meats, which led to a national recall of contaminated products. Listeria infections are reportable conditions in Maryland and by statute, L. monocytogenes bacterial isolates recovered from these infections must also be submitted to the MDH Laboratory for confirmation of the identification of the isolate and further genetic characterization using national standardized whole genome sequencing( WGS) subtyping procedures. The results of these genetic subtyping procedures are uploaded to national databases managed by CDC and / or FDA. These data sets are constantly analyzed to find clusters of genetically related Listeria bacteria that might be linked to a common exposure to a contaminated food product. Through case interviews, MDH epidemiologists linked the consumption of a common food product— precooked Boar’ s Head deli meats— purchased at a local market to a local cluster of Listeria infections. Through PulseNet, Maryland made the initial link between a cluster of genetically related Listeria infections with the consumption of contaminated deli meat products collected from a local food store by isolating genetically indistinguishable genotypes of L. monocytogenes from unopened packages of deli meats. As of October 1, 2024, testing at the MDH Laboratory identified eight of the 59 infections reported in 13 states that were associated with this outbreak.

Biggest challenge: Historically, our biggest challenge has been the recruitment and retention of scientific talent. MDH laboratory scientists who possess specialized skills and advanced training, such as proficiency in performing mass spectrometry or WGS, are in high demand by biotechnology firms, commercial and federal government laboratories in the highly competitive Baltimore-Washington corridor job market. State salaries are substantially lower in comparison to comparable positions in the biotech industry, federal government laboratories or federal contractor positions, and Laboratories Administration frequently loses highly skilled fully trained laboratory scientists to attrition often because they cannot be adequately compensated by our organization. However, in light of recent events and the uncertainty of continued federal support for public health, our biggest challenge will be to find innovative alternatives to sustain some of these missioncritical programs if federal funding that now supports them is discontinued or drastically reduced. g

to false negatives and poor sensitivity. Thus, purpose-built workflows, like the one highlighted above, are needed to overcome these challenges. Thus far, New England Biolabs has supported rapid influenza A purification and detection from milk with qPCR and LAMP workflows.

Impact on Research and Surveillance

By overcoming matrix-related inhibition, streamlining RT-PCR and simplifying library preparation, these modular workflows empower teams to generate accurate genomic data from agricultural samples. This capability supports critical applications, including:

• Food contamination and safety monitoring

• Outbreak preparedness and strain tracking

• Zoonotic transmission studies

Robust and rapid influenza A sequencing capacity, from poultry sheds to milk tanks, can improve the US’ s ability to safeguard its food supply and consumers, detect novel variants before they cascade through trade networks and act decisively. Learn more about NEB’ s solutions for infectious disease surveillance and sequencing. g