CDC Responds: Coping with Bioterrorism—The Role of the Laboratorian
(November 9, 2001)
(View the webcast on the University
of North Carolina School of Public Health site.)
Segment 9 of 9
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We have time for just a couple of questions each, and Susan, I’ll start with you. You touched on a number of very important issues in your presentation. Maybe the first question would be—how does a laboratory become identified as a Level A laboratory?
Well, that’s good question. First of all, the fact is you don’t have to wait to be identified as a Level A laboratory. If you’re a laboratory that performs diagnostic testing in a clinical setting for human disease, you are a Level A laboratory by default. There are no inspections or certifications that will be done by the CDC or the public health authorities.
Thank you. Norm, a question for you. One of the concerns we all have is what happens if this event becomes even more widespread or if a subsequent event becomes more widespread—could the CDC provide enough confirmatory reagents to meet the demands of Level B laboratories?
That’s an important question. And the answer to that is in the present situation the CDC has thought about this, and they have decided to increase at least twofold the availability of these reagents or the amount of these reagents that are available. And so in that situation, if there would be a large surge, what the CDC will do is provide the emergency response and target it to the areas of the country where the surge is the greatest, so that they can utilize the additional reagents effectively.
And, Susan, if all of the clinical microbiology laboratories in this country are potentially Level A laboratories, how will training be provided to such a large audience?
Well, in some states, the public health laboratories have already sponsored a number of Level A training sessions. The National Laboratory Training Network has provided 95 different courses to approximately 5,000 participants since January of 1999. Now, granted, a lot of these participants were Level A laboratory personnel, but there’s still a lot of work to be done in this area. To this effort, currently, every laboratory that subscribes to a higher proficiency testing sample in the United States will be receiving or has already received a two-tape video and a CD-ROM that’s produced by the National Laboratory Training Network for the purpose of educating Level A laboratory staff. In addition to this, you can find additional information for training and protocols on bioterrorism on both the CDC and the ASM Web sites.
Thank you. And the final question for Norm, as we mentioned earlier, safety is always something that’s uppermost in our minds when working in the laboratory. If laboratories working with culture isolates at the bench, for example, in a Level B laboratory where you’re actually trying to rule in or rule out anthrax, should one receive antibiotics or vaccine? I know Dr. Miller addressed this a little earlier, but I would like you to reemphasize that point.
Dr. Miller did address this. If you’re working in a Level B laboratory where you may be working with powders, you’re working with a wide variety of samples and materials, as I indicated in my first slide, then the recommendations may become that we will in fact need to vaccinate individuals that work in those situations. Because there is some risk. While this is a level 2 agent, when we’re working with large amounts of material that we can’t be sure about, it would be expedient to do that.
Thank you. As we have heard from Dr. Koplan and from our panelists, the link between the clinical laboratory community and the public health laboratories is an essential link in addressing bioterrorism. At CDC, we’re currently working on the development of the concept of a national system of laboratories that brings existing public and private laboratories together in a closer working relationship. That link is also essential for many public health initiatives, including emerging infectious diseases, food safety, HIV AIDS, and many other programs that effect both individual health and the health of the community. The concept of developing better bi-directional communication with the clinical laboratories is the focus of the National Laboratory System. In addition to the project in Minnesota directed by Dr. Crouch, we have three other projects in Washington, Nebraska, and in Michigan. Working within these states, the public health and clinical laboratories are developing partnerships, assessing capabilities and capacities, determining laboratory work force training needs, and developing standards to ensure comparability of information. Included among the consultants for this initiative are many of the organizations that co-sponsored this videoconference. Again, working with our partners, we hope to extend this concept nationwide so that every state becomes involved, thereby establishing a true national laboratory system. With closer working relationships, initiatives such as the important one we are all involved in now, bioterrorism, will be addressed in a manner that assures availability of consistent laboratory capacity for public health across the nation. Thank you. Lisa?
Dr. Martin, thank you. And thank you, panelists, for your timely information during this timely crisis in America. Thank you all. And I’d like to thank you, our audience, for joining us for this, our first program in a series that will deal with important public health issues. Please join us again next Friday for our next CDC response program, bioterrorism and the infection control community. On behalf of everyone at CDC and the public health training network, I’m Lisa Rayam, wishing you a good day from Atlanta.
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