PUBLIC HEALTH PREPAREDNESS & RESPONSE
Mpox : A Year of Partnerships
By Rana Rahmat , specialist , Laboratory Response Network through sexual contact . Samples were received by LRN-B laboratories from submitters that had previously not worked with the network in this capacity , including sexual health clinics . To mitigate this unprecedented event , communication and testing were targeted through these same avenues to ensure that the messaging was reaching the at-risk population . Close engagement of partners and transparency in relaying information and preventative measures were major contributing factors in outbreak mitigation .
Colorized transmission electron micrograph of mpox particles ( teal ) found within an infected cell ( brown ), cultured in the laboratory . Image captured and color-enhanced at the NIAID Integrated Research Facility ( IRF ) in Fort Detrick , MD . Photo : NIAID
After more than two years of COVID-19 pandemic response , public health laboratory scientists were exhausted and ready for even the slightest break , but it wasn ’ t meant to be . In early May 2022 , the first cases of mpox were detected in London and less than two weeks later , the Massachusetts State Public Health Laboratory detected the first case of mpox in the United States . What followed was an increased number of infections being reported from countries around the world , making this the first time mpox had spread widely outside of endemic areas in Western and Central Africa .
Mpox is an orthopoxvirus which is categorized into two types , Clade I and II . Clade I has a fatality rate of around 10 % and is considered a Select Agent . Clade II , which is rarely fatal , has a recovery rate of around 99 %. Due to the virulence of Clade I , all suspected cases of mpox sent to public health laboratories were tested by the Laboratory Response Network for Biological Threats Preparedness ( LRN- B ). With guidance from the US Centers for Disease Control and Prevention
( CDC ), LRN-B laboratories , which include federal and Department of Defense ( DoD ) laboratories , were able to quickly meet the testing demands .
Collaboration is Key
A key factor in the success of responding to this outbreak was the collaboration and coordination between partners . Frequent communication was quickly established between the US Department of Health and Human Services ( HHS ), CDC , LRN-B laboratories and clinicians across the country . Weekly webinars and Zoom meetings ensured that guidance was being shared in a timely manner . The quick development of guidance documents for laboratories and their clinical partners was also instrumental in informing proper sample collection , sharing and shipping to avoid delays in testing .
A component of this outbreak that served as a complication and an outreach avenue for impacted populations was the way mpox spread , which was primarily
The partnerships between LRN-B laboratories and CDC were also instrumental in the response , particularly in the early days of the outbreak . These partnerships accelerated testing implementation and validation of new technologies , and several laboratories were involved in implementing laboratory developed tests to increase testing capacity . Other laboratories within the network were leveraged for validating the use of technologies such as automated extraction platforms to optimize testing capacity . A select number of laboratories within the network were also able to perform whole genome sequencing on their positive samples , and were able to share those data , processes and challenges with other LRN-B laboratories .
Eventually collaboration between the various parties moved beyond the response . In December 2022 , APHL in collaboration with the Association for Molecular Pathology ( AMP ) hosted The Science Behind Mpox webinar , which brought together various experts to discuss the state of the response , the science behind the virus and its biosafety implications . Webinar attendees were an eclectic group including public health laboratorians , clinicians , academics and those from the commercial sector . g
24 LAB MATTERS Summer 2023
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