Thursday, April 30, 2009

Public Health Laboratories To Assume Primary Responsibility for Confirmatory Testing of Swine Flu

/PRNewswire / -- Approximately sixty-five state and local public health laboratories around the United States will assume primary responsibility for confirmatory testing of Human Influenza A H1N1 of Swine Origin, or "Swine Flu," within the next week. Previously, all swine flu specimens had to be sent to CDC laboratories in Atlanta for final confirmatory testing, which identifies specimens to the strain level.

The rRT-PCR swine flu panel diagnostic test kits are being shipped this week from the Centers for Disease Control and Prevention (CDC), which developed the assay. Public health laboratories are slated to begin testing late next week following on-site validation of the test.

Deployment of the test was made possible via an emergency use authorization (EUA) issued by the U.S. Food and Drug Administration (FDA) on April 27 in response to a request from CDC.

"Testing will now proceed more rapidly, because we will have sites around the country that can fully characterize the virus, rather than only one at CDC in Atlanta," said Frances Pouch Downes, DrPH, APHL president, and director, Michigan Public Health Laboratory, Michigan Department of Community Health. "Public health labs are receiving considerable attention in connection with the deployment of the swine flu test, but this is really business as usual for us. We're there in the community, ready to protect the public's health as the situation warrants."

Each year state and local public health laboratories conduct routine surveillance to monitor circulating strains of influenza. Their findings are used to develop the influenza vaccine for the following season and to control the spread of the disease in the current year. Additionally, public health laboratories subtype influenza specimens received from clinical and hospital labs. Test results support decisions regarding patient treatment and measures to control the spread of disease.

Yet even though influenza surveillance and diagnostics are routine functions at public health laboratories, this year's outbreak poses particular challenges. "Lab folks are resilient, but even they have limits in how long they can manage to do more with less," said APHL Executive Director Scott Becker. "The economic downturn has really taken a toll on state and local health departments. I am seriously concerned about staff burnout if this outbreak continues more than a couple of months."

Results of a first quarter 2009 APHL survey indicate that the public health laboratory workforce, which numbers only 6500 nationwide, has been reduced by at least 500. These reductions apply to administrative and IT support as well as to laboratory staff. Survey results also show deep cuts to laboratory budgets -- sometimes requiring the elimination of entire public health programs, mandatory furloughs and reductions in funding for essential equipment and supplies. More cuts and staff reductions are anticipated in coming months based on initial responses to APHL's second quarter survey on the impact of the economic downturn.

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