By A. Christian Whelen, PhD, D(ABMM), laboratory director, Hawaii Department of Health State Laboratories; president, APHL Board of Directors
Hau`oli Makahiki Hou (“Happy New Year” in Hawaiian)! In 2017, APHL and its members face some significant undertakings. From Zika to superbugs, public health laboratories can and should utilize their extensive experience and knowledge coupled with new approaches to tackle these pressing issues.
As APHL’s president, these are my top three priorities for 2017:
Coordinated & Integrated Zika Testing
We’ve been here before. Specimens flood into our public health laboratories because of a new threat, and we work with local and national partners to establish algorithms, activate our response and continuity plans, and do what it takes to stop it. The Zika virus outbreak has been unique in its own right. Most of the people infected don’t get sick, yet it causes potentially life-threatening birth defects. It’s mosquito-borne AND sexually-transmitted. Cross-reactivity in serological tests with other flaviviruses like dengue disrupts screening and confuses confirmation. We clearly had our work cut out for us from the beginning, and the problem wasn’t going away anytime soon. Consequently, a successful and sustained response to this threat is going to require corporate, clinical and public health coordination and integration.
Coordination: Public health laboratory leaders need to reach out and bring together stakeholders. We need to identify barriers to timely case identification and specimen transport (pre-analytic) as well as meaningful results delivery (post-analytic). We need to continue to improve Zika algorithms, and keep everyone informed of those changes. We need to convene the meetings today that will outline our activities month and years from now.
Integration: We need to help corporate test developers understand testing demands and requirements so they can leverage their strengths to make new tests available to our clinical partners. We need to work with developers, regulators and clinical partners to ensure that we maintain continuity if/when transitioning testing to non-public health labs. We need to ensure reporting to public health is not overlooked and that access to confirmatory services are available.
So, the Zika response is a bit like a relay race. We have the baton now, but we also need to make sure it is firmly in the hands of another “runner” before we let go. APHL is committed to helping with this; I certainly am as president.
Learn more about Zika testing
Smarter Antimicrobic Therapy
Speaking of races, the bugs seem to be beating the drugs. Alarming resistance mechanisms have (finally) gotten enough attention for us to witness significant funding for public health efforts to combat the antimicrobial resistance epidemic. Lab folks may not control prescriptions, but we need to get in the game with providers, epidemiologists, pharmacists, clinical labs and manufacturers to reassert our collective dominance over the single cell super bugs. We need to get advanced detection and characterization methodologies validated and available to improve antibiotic awareness that can lead to better decisions for individuals (e.g., detection of Tamiflu-resistant influenza A, confirmation of carbapenemase-resistant Enterobacteriaceae, etc.) and populations (e.g., high-quality antibiograms, etc.) In 2017, the Antimicrobial Resistance Laboratory Network will begin providing services, and the new APHL/CDC Antimicrobial Resistance Fellowship, which offers master’s and doctoral level graduates the chance to explore related topics, will welcome its first cohort. Hard work at multiple levels is needed to reverse losses in the efficacy of life-saving therapeutics.
Learn more about antimicrobial resistance
Laboratory Science Leadership
Whether we like it or not, our communities look to public health laboratory scientists for leadership. This role extends far beyond the position description we read before getting hired for our jobs. It’s more than managing the people we directly supervise. It’s influencing people, policy and procedures throughout our sphere of influence. APHL’s vision is a healthier world through quality laboratory systems, so we cannot limit ourselves to those resources we control directly. We need to provide leadership throughout our sphere of influence. That can be as big as testifying on Capitol Hill, or as (seemingly) small as encouraging a student on his or her science project. The opportunities are TNTC*, however in the two subjects I outline above, the emphasis is on initiating and leading cross-cutting collaborations that strengthen laboratory systems and make the world a safer place.
Hmmm, not a bad thing to list as an accomplishment to get your boss’ attention during your next performance evaluation…am I right?
*TNTC – Too numerous to count; an amusing reference to the acronym used in microbial quantitative plate counting.
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