Lab Matters Summer 2025 | Page 43

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

By Chris N Mangal, MPH, senior director, Public Health Preparedness and Response

Recognizing LRN leaders at the 2024 LRN-B Technical Meeting, Atlanta, GA.

In 2001, following the worst terrorist attack on the United States, a second wave of terrorism followed with the use of biological weapons— specifically Bacillus anthracis spores— distributed via the postal system and resulting in 22 infections and five deaths. The anthrax attacks of 2001 highlighted vulnerabilities in biological defense but also brought to light the value of the Laboratory Response Network( LRN) as a critical asset poised to detect acts of terrorism as well as other emerging threats. Using the system developed primarily with federal funding, laboratories across the LRN collaborated to identify the cause of the infections with the Florida Department of Health, Bureau of Public Health Laboratories Microbiologist, Philip A Lee, MSc, identifying the first case of anthrax in 2001.

The LRN was established in 1999 through a collaborative effort involving founding partners, US Centers for Disease Control and Prevention( CDC), Federal Bureau of Investigation( FBI) and APHL to ensure an effective laboratory response to bioterrism. Today, the LRN is an integrated network of local, state and federal public health, hospital-based, food testing, veterinary, environmental testing and international laboratories providing laboratory diagnostics and capacity for biological and chemical threats, other public health emergencies and looking to integrate radiological testing as well.

The LRN is a unique asset in the nation’ s growing preparedness for public health threats. The linking of state and local public health laboratories, veterinary, agricultural, military and water and food testing laboratories is vital and unprecedented.

The LRN is comprised of a variety of laboratories with public health laboratories mainly serving as reference laboratories— these are laboratories that perform higher level tests to detect threat agents and provide training and guidance to other laboratories, such as private clinical laboratories. Following the anthrax attacks of 2001, public health laboratories across the US saw their role quickly evolve to include working with new partners such as the FBI. This new and evolving role was supported with funding via the Public Health Emergency Preparedness Cooperative Agreement( PHEP), administered by the CDC’ S Division of State and Local Readiness( DSLR), and scientific leadership from subject matters experts across the CDC.

Following the anthrax attacks of 2001, the total CDC PHEP Cooperative Agreement funding to public health agencies peaked

in 2003 at $ 970 million( unadjusted)— a year in which public health laboratories received $ 167.7 million for biological and chemical threats preparedness. Over the years, the CDC PHEP Cooperative Agreement funding has steadily decreased, with 62 jurisdictions receiving $ 653,738,609 in FY24. Jurisdictions across the US rely on the CDC to provide support for public health preparedness and response. In fact, on an annual basis, approximately 90 % of funding for laboratory preparedness and response comes from the CDC PHEP Cooperative Agreement.

Since 2002, the CDC PHEP Cooperative Agreement has provided significant assistance to public health departments, including laboratories, across the US. These funds have enabled laboratories to:

• Bolster its workforce by recruiting and hiring personnel such as laboratory scientists and threat preparedness coordinators who lead assay develop development and testing; training and outreach staff who connect with and engage private clinical laboratories and hospitals; and safety officers

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