by Jody DeVoll, advisor, Communications, APHL
Public health laboratories have figured so prominently in media coverage of coronavirus (COVID-19) testing that one might assume that this was their sole function. In fact, they protect our health and safety through a multiplicity of programs and services that touch us at all stages of our lives. The examples below represent a mere fraction of public health laboratories’ wide-ranging activities on our behalf.
In the spring of 2020, public health laboratories’ communicable disease divisions are operating at full steam. In addition to testing for the coronavirus, they are conducting testing and surveillance for diseases ranging from HIV, hepatitis and TB, to rabies and vaccine-preventable diseases such as measles and mumps. They also are monitoring influenza viruses to aid in selection of strains to be included in next year’s flu vaccine. As the weather warms, they will begin testing and surveillance for West Nile Virus and other mosquito-borne diseases.
Environmental health divisions are balancing routine functions, such as oversight of drinking water quality, with readiness for emergencies. Any day could bring a chemical spill on the Interstate, PFAS contamination of a playground, flooding that leads to drinking water contamination or a toxic algae bloom.
A select group of laboratories, members of the National Biomonitoring Network, test human fluids for potentially harmful chemicals and their metabolites. This test data, when correlated with environmental studies, can help to pinpoint the location of health threats and assess the need for remedial action. In addition, many public health laboratories are involved in testing the quality of cannabis products, analyzing opioids common to their region and identifying the contents of locally available e-cigarette and vaping products.
Since babies continue to be born even during a pandemic, newborn screening divisions are screening newborns for heritable conditions not visible at birth. These conditions often require immediate treatment to prevent a lifetime of disabilities or death. Public health laboratories are responsible for screening of 97% of the more than four million newborns born in the US each year.
Food Safety teams continue to sleuth for pathogens causing outbreaks of foodborne disease. As members of PulseNet, the national laboratory network for foodborne disease surveillance, they identify the genetic signature of pathogens implicated in cases of foodborne disease. They compare these signatures with those from other cases and share the data with epidemiologists to identify and stop outbreaks before they spread. Food safety teams may also test foods suspected to have caused an outbreak and search for harmful contaminants and adulterants in human and animal food.
Emergency Response teams are supporting the COVID-19 response while detecting and responding to other biological, chemical and radiological threats and natural disasters. Because public health laboratories form the backbone of the Laboratory Response Network (LRN), emergency response teams are veterans of the 2009 H1N1 Influenza outbreak, Severe Acute Respiratory Syndrome-related Coronavirus (SARS), Middle East Respiratory Syndrome (MERS), Ebola, Zika and other events. A team from the Texas Department of State Health Services Public Health Laboratory was the first to detect Ebola in the US.
In addition, selected public health laboratory staff are assisting stakeholders from other countries to develop national laboratory systems, laboratory infrastructure and trained laboratory personnel. Their contributions include strategic planning, design of informatics systems, managerial and technical training, mentoring and other technical assistance.