FEATURE SPOTLIGHT : PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Strengthening the Nation ’ s Laboratory Response System
By Chris N Mangal , MPH , director , Public Health Preparedness and Response
Responses to public health threats rely on timely and accurate data to identify the cause as well as assess ongoing disease prevalence , transmission routes and effectiveness of interventions designed to reduce morbidity and mortality . Whether the threat is chemical in nature — as seen with lead chromate in cinnamon applesauce — or biological — as demonstrated by the evolving mpox virus over the last two years — laboratories must be ready to respond . To ensure an effective response — where public and private systems work together — national laboratory coordination is critical . In the wake of the COVID-19 pandemic , APHL has spearheaded several efforts designed to strengthen the nation ’ s laboratory response system and called attention to the urgent need for a coordinated national laboratory response system .
A Robust Network …
Chief among APHL ’ s efforts is the collaboration with the US Centers for Disease Control and Prevention ( CDC ) to bolster the Laboratory Response Network ( LRN ). Formed in 1999 by CDC in partnership with APHL and the Federal Bureau of Investigation ( FBI ), the LRN was initially designed to ensure an effective laboratory response to bioterrorism . 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 . The LRN is looking to integrate radiological testing as well .
The linking of state and local public health laboratories , veterinary , agricultural , military and water and food testing laboratories is vital and unprecedented . As a founding member of the LRN , APHL works closely with CDC to ensure LRN laboratories are ready to respond to threats . For instance , APHL partners with the American Society for Microbiology ( ASM ) to develop and issue LRN Sentinel Level Clinical Laboratory Protocols , a suite of standardized , practical methods and techniques to rule out microorganisms suspected as agents of bioterrorism or emerging infectious disease threat , or to refer specimens to public health laboratories for confirmation . Similarly , APHL partners with CDC and the College of American Pathologists ( CAP ) to issue the Laboratory Preparedness Exercise to approximately 1,300 laboratories twice a year . In these exercises , CAP sends live organisms that either exhibit characteristics of bioterrorism agents or demonstrate epidemiologic importance . Participating laboratories are expected to respond following the LRN Sentinel Level Clinical Laboratory Protocols if a bioterrorism agent is suspected . APHL ’ s collaboration with CDC , CAP and ASM ensures that private and public laboratories have the protocols to prepare for a threat and then the option of an exercise to test that readiness .
APHL is also a key partner to the CDC Division of Laboratory System ’ s Memorandum of Understanding ( MOU ), which articulates the roles of various organizations to collaborate on enhancing laboratory testing surge capacity outside of CDC and public health laboratories before and during public health emergencies .
… Leads to Strong Partnerships …
In addition to efforts to strengthen the LRN , APHL has a vital objective to bolster strategic system partnerships , including using APHL ’ s elevated voice to strengthen laboratory coordination at a national level . To address this objective , APHL engaged diverse members via the National Laboratory Coordination Strategic Implementation Group . With the support of a consultant , Raphael Barishansky , DrPH , these members identified laboratory networks charged with responding to various threats and engaged partners via key informant interviews and focus groups . Based on these discussions , APHL issued a report , Strengthening National Laboratory Coordination A Vision for a National Laboratory System . This report highlights the importance of much-needed national laboratory coordination to ensure that both private and public laboratories are well positioned to respond to the next threat .
Key findings from these discussions highlighted the need for :
1 . Flexibility and staffing to better pivot from routine day-to-day operations to response activities
20 LAB MATTERS Winter 2024
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