Recent cuts in federal grants to public health laboratories—including the Emerging Infectious Disease, Epidemiology and Laboratory Capacity, Public Health Emergency Preparedness and bioterrorism grants—are compromising this vital public health laboratory function.
In testimony submitted to the US House of Representatives’ Committee on Homeland Security in 2006, Pete Shult, director of the communicable disease division at the Wisconsin State Laboratory of Hygiene, noted that public health laboratories’ “diagnostic technology” and other laboratory resources “now may be in jeopardy” in the face of declining federal support.
Perhaps the most feared and closely monitored disease in the world today is avian influenza. Based on data from past pandemics, some experts predict an influenza pandemic would affect about a quarter of the world’s population—more than 1.5 billion people. Public health laboratories have been in the forefront of efforts to track influenza A virus subtype H5N1 so that health authorities and government officials can take steps to contain it.
Other diseases, however, cannot be ignored. Two diseases that are not yet established in the US, but are of growing concern are dengue and chikungunya virus.
Dengue, a mosquito-borne flavivirus causing flu-like symptoms, has been around for hundreds of years, and for much of that time was considered a disease of the tropics.
In 2005, the Texas state public health laboratory documented the first case of locally acquired dengue hemorrhagic fever, a potentially fatal form of the disease, ever recorded in the United States—a heads-up for health authorities.
Chikungunya virus, a mosquito-borne alphavirus that causes crippling joint pain, was first documented in Africa in 1952. The virus has caused explosive outbreaks in urban settings in East Africa, Asia and the islands of the Indian Ocean, collectively involving millions of cases. A 2007 outbreak in Italy’s Ravenna province marks the first recorded instance of transmission in Europe.
Lyle Petersen, director of the CDC Division of Vector-borne Infectious Diseases, said, “So far we’ve been lucky that this virus hasn’t established yet in the Americas. But if it does, I think it’s going to spread like wildfire. We definitely have the right mosquitoes for it.”
If the disease does surface in the US, public health laboratory scientists will be the ones to find it, if resources allow.