Biology Reference
In-Depth Information
17.2.3 laboratory Capacity for rapid Diagnosis
During the past decade, growth in laboratory diagnostic capability at all
levels of the public health system has been a rare and consistently bright
spot on the spectrum of emergency preparedness. In 1998, a survey by the
Association of Public Health Laboratories (ASPL) found that only a hand-
ful of state laboratories had Biosafety Level 3 (BSL-3) capability (CDC 2007).
BSL-3 laboratories have the requisite safety features for processing and test-
ing most infectious agents that can cause serious public health harm, such as
highly infectious influenza viruses or anthrax bacteria. Why were there so
few of these laboratories available? The general sense at the turn of the 21st
century was that the public health infrastructure was woefully inadequate
to respond to any emerging infectious disease threats. Years of budget cuts
and lack of investment, fueled by ignorance and insufficient advocacy, had
taken their toll.
The 1999 Department of Health and Human Services (DHHS) Budget
Initiative for Bioterrorism Preparedness, when appropriated into law, became
a landmark in reinvigorating the infrastructure of public health, including
that of state public health laboratories. Congress provided multiple DHHS
agencies—the National Institutes of Health (NIH), the U.S. Food and Drug
Administration (FDA), the Agency for Healthcare Research and Quality
(AHRQ), and CDC—with funding. CDC's $121 million allocation was used to
create the newly minted Bioterrorism Preparedness and Response Program,
whose mission was to “upgrade infrastructure and capacity to respond to
a large-scale epidemic, regardless of whether it … [was] … the result of a
bioterrorist attack or a naturally occurring infectious disease outbreak” (U.S.
GAO 2001).
The Laboratory Response Network (LRN), an offspring of the initial bio-
terrorism budget initiative, was cofounded by the CDC, the Association
of Public Health Laboratories (APHL), the Federal Bureau of Investigation
(FBI), and the U.S. Army Medical Research Institute of Infectious Diseases
(USAMRIID) (Gilchrist 2000). The purpose of the LRN was to create a linkage
of local, state, and federal diagnostic laboratories that could be mobilized to
provide diagnostic support for any biological threats to humans, both natu-
rally occurring (and emerging) as well as those considered intentional. CDC
provided support to the LRN by supplying funding, training, and technical
assistance in diagnostic methodology. The number of LRN laboratories has
continued to grow each year.
Meanwhile, CDC has invested in its own infrastructure, both reflected in
an accelerated construction of new laboratory facilities on its main Atlanta
campus, as well as in individual laboratory programs within its centers.
Neighborhoods adjacent to the Clifton Road facility were purchased and
razed to make room for the expansion. While training provided through
the LRN has been credited with facilitating recognition of the 2001 anthrax
outbreak in Florida, the same epidemic also forced the creation of new
