Thomas Katharine L, Aden Tricia A, Blevins Patricia A, Raziano Amanda J, Wolford Tyler, Honein Margaret A, Villanueva Julie M
Division of Infectious Disease Readiness and Innovation, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Association of Public Health Laboratories, Bethesda, MD, USA.
Public Health Rep. 2024 Aug 27:333549241269497. doi: 10.1177/00333549241269497.
The Laboratory Response Network (LRN) consists of US and international laboratories that respond to public health emergencies, such as biothreats. We used a qualitative approach to assess the successes and challenges of the LRN during the initial 10 weeks of the 2022 mpox outbreak (May 17-July 31, 2022).
We conducted 9 unstructured interviews, which included 3 interviews with subject matter experts from the Centers for Disease Control and Prevention (CDC) and 6 interviews with state and local public health laboratories and epidemiologists and Association of Public Health Laboratories (APHL) staff. We asked guiding questions on investments in preparedness, successes, and challenges during the initial mpox response and asked for suggestions to improve future LRN responses to infectious disease outbreaks. We also reviewed data from 2 contemporaneous APHL surveys conducted in June and July 2022 in 84 LRN public health laboratories.
Notable successes included availability of an assay that had received clearance from the US Food and Drug Administration (FDA) for testing orthopoxviruses (non-variola [NVO] assay) and a trained workforce; strong relationships among FDA, CDC, and the LRN; and strong communications between LRN laboratories and CDC. Challenges included variability among LRN laboratories in self-reported testing capacity, barriers to accessing the NVO assay for health care providers, and gaps in LRN function during surges of testing needs.
The LRN system plays an essential role in the response to emerging infectious disease outbreaks in the United States. Lessons learned from the LRN's initial response to the mpox outbreak can help guide improvements to better position the LRN for future responses, including continued engagement with health care providers, commercial laboratories, and laboratories in health care settings.
实验室响应网络（LRN）由美国和国际实验室组成，这些实验室应对生物威胁等公共卫生紧急情况。我们采用定性方法评估了LRN在2022年猴痘疫情最初10周（2022年5月17日至7月31日）期间的成功经验和挑战。
我们进行了9次非结构化访谈，其中包括对疾病控制与预防中心（CDC）的3名主题专家的访谈，以及对州和地方公共卫生实验室、流行病学家和公共卫生实验室协会（APHL）工作人员的6次访谈。我们就猴痘疫情初期应对工作中的准备工作投入、成功经验和挑战提出了指导性问题，并征求了改进LRN未来对传染病疫情应对工作的建议。我们还审查了2022年6月和7月在84个LRN公共卫生实验室进行的两项同期APHL调查的数据。
显著的成功经验包括有一项已获得美国食品药品监督管理局（FDA）批准用于检测正痘病毒的检测方法（非天花[NVO]检测法）以及一支训练有素的工作人员队伍；FDA、CDC和LRN之间的紧密关系；以及LRN实验室与CDC之间的良好沟通。挑战包括LRN实验室自我报告的检测能力存在差异、医疗保健提供者获取NVO检测法存在障碍以及检测需求激增期间LRN功能存在差距。
LRN系统在美国应对新发传染病疫情中发挥着至关重要的作用。从LRN对猴痘疫情的初期应对中吸取的经验教训有助于指导改进工作，以便更好地使LRN为未来的应对做好准备，包括继续与医疗保健提供者、商业实验室以及医疗机构中的实验室保持合作。
