Detecting Emerging Infectious Diseases: An Overview of the Laboratory Response Network for Biological Threats

Villanueva, Julie; Schweitzer, Beth; Odle, Marcella; Aden, Tricia

doi:10.1177/0033354919874354

Cited by 12 publications

(7 citation statements)

References 12 publications

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“…Controlling the COVID-19 pandemic requires leveraging the tight cooperation between diagnostic laboratories and the public health infrastructure developed over the decades to assure that these insights effectively impact policy. 19 There are few investments that are as important as carefully designed testing strategies.…”

Section: Resultsmentioning

confidence: 99%

Linking Statistics With Testing Policy to Manage COVID-19 in the Community

Hilborne

Wagner

Cabreros

et al. 2020

American Journal of Clinical Pathology

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Abstract Objectives To determine the public health surveillance severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing volume needed, both for acute infection and seroprevalence. Methods Required testing volumes were developed using standard statistical methods based on test analytical performance, disease prevalence, desired precision, and population size. Results Widespread testing for individual health management cannot address surveillance needs. The number of people who must be sampled for public health surveillance and decision making, although not trivial, is potentially in the thousands for any given population or subpopulation, not millions. Conclusions While the contributions of diagnostic testing for SARS-CoV-2 have received considerable attention, concerns abound regarding the availability of sufficient testing capacity to meet demand. Different testing goals require different numbers of tests and different testing strategies; testing strategies for national or local disease surveillance, including monitoring of prevalence, receive less attention. Our clinical laboratory and diagnostic infrastructure are capable of incorporating required volumes for many local, regional, and national public health surveillance studies into their current and projected testing capacity. However, testing for surveillance requires careful design and randomization to provide meaningful insights.

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Section: Resultsmentioning

confidence: 99%

Linking Statistics With Testing Policy to Manage COVID-19 in the Community

Hilborne

Wagner

Cabreros

et al. 2020

American Journal of Clinical Pathology

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“…The backbone of the U.S. public health surveillance system is the LRN developed by the US CDC in partnership with the FBI and the Association of Public Health Laboratory. The legal basis for the creation of the LRN was the Presidential Decision Directive‐39 (PDD‐39), issued in 1999 to deal with terrorist threats (White House 1995). The counterterrorism foundation of the LRN was further strengthened by the emergence of the homeland security domain post‐Amerithrax, and the LRN mission subsequently expanded to include other public health emergency threats, such as severe acute respiratory syndrome (SARS), H1N1 (2009 influenza pandemic), MERS, and Ebola, as well as chemical threats (Mangal and Maryogo‐Robinson 2014).…”

Section: Case Presentations: Different Responses In a Public Health E...mentioning

confidence: 99%

“…Reports show that the United States has rarely conducted large-scale diagnostic testing. According to Villanueva, Odle and Aden (2019), the Zika outbreak challenged the U.S. LRN-B systems to implement high-volume testing practices; the LRN-B tested 1,097 cases during the 2014 MERS outbreak, 180 cases during the 2014-2015 Ebola outbreak, and 92,686 cases during the 2016-2017 Zika virus outbreak (Villanueva, Odle and Aden 2019). However, the figure of 92,686 Zika tests in a year can be reversely calculated as 7,700 cases per month, or 250 cases per day.…”

Section: Public Health Surveillance Differences-lrn Versus 3tmentioning

confidence: 99%

The Red Flag of Emergency Use Authorization (Eua)

Kim

2023

World Affairs

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The Emergency Use Authorization (EUA) policy, a representative biodefense policy, was legislated in the United States in 2001 based on lessons learned from Amerithrax, whereas Korea's EUA policy was based on lessons learned from the Middle East Respiratory Syndrome outbreak in 2015. Due to these divergent origins, the U.S. EUA's homeland security objectives were specialized to deal with highly pathogenic biological agents that could be exploited for bioterrorism, whereas the Korean EUA pursues disease containment purposes to strengthen mass-testing practices. During the early phase of the COVID-19 pandemic, the U.S. EUA revealed limitations in its integration with public health surveillance, laboratory partnerships, and insurance systems, which hampered the rapid expansion of testing capacities. Thereafter, once the limitations of the EUA were circumvented, the testing capacity of the United States began to catch up with that of South Korea, and later skyrocketed after solving these issues.

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“…5 The Department of Defense is an important LRN stakeholder, joining in strategic planning and assay development and supporting LRN-B response activities. 6 While the LRN was initially designed to respond to bioterrorism, specifically anthrax, it has since expanded to include chemical threats and emerging infectious diseases. Given this expansion, it is unclear why CDC did not use the network to coordinate its response to COVID-19.…”

Section: Challenges Faced By Public Health Laboratoriesmentioning

confidence: 99%