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Infectious Diseases

APHL has compiled recent information on pandemic influenza. Refer to this page for updates on laboratory diagnosis of influenza, training opportunities, federal planning and response activities, and FAQs.

Overview

Infectious diseases pose a continuing menace to all people regardless of age, gender, life style, ethnic background or socioeconomic status. Though some have been conquered by antibiotics, vaccines and other advances, new infectious diseases are constantly emerging. HIV/AIDS, Legionnaires' disease, Lyme disease, hantavirus pulmonary syndrome, West Nile virus and SARS offer instructive examples. Other infectious diseases, such as tuberculosis and bacterial pneumonias, reemerge in drug-resistant forms or through bioterrorism. Because we cannot predict new diseases, laboratories must always be prepared for the unexpected.

In support of the Centers for Disease Control and Prevention’s (CDC) plan, “Emerging Infectious Diseases, a Strategy for the 21st Century,” APHL’s infectious disease program seeks to promote the role of the laboratory in infectious disease detection and surveillance and to build relationships between public health laboratories and their partners at CDC, federal and state agencies and other organizations engaged in complementary activities.

Accomplishments and Activities

Infectious Disease Molecular Diagnostics Web Board
Available to public health laboratory staff only. Web board password required. For more information, contact molecular@aphl.org.

Antimicrobial Resistance
APHL monitors implementation of the Interagency Action Plan to Combat Antimicrobial Resistance. The Antimicrobial Susceptibility Testing Methods training CD-ROM developed by CDC was distributed to over 14,000 laboratories. Although copies of the CD-ROM are no longer available, alternative sources for updates on AST methods can be found at the CDC MASTER website, and through the NLTN.

Bioterrorism
The infectious diseases program provides technical support to enhance national laboratory preparedness for bioterrorism. It collaborated with CDC and the American Society for Microbiology to develop testing protocols for the Laboratory Response Network, the laboratory system responsible for testing potential agents of bioterrorism. APHL continues to improve linkages with the FBI and federal legislators in order to define and implement policies for biosecurity and bioterrorism preparedness. The program is worked with CDC to develop laboratory diagnostic strategies for smallpox, smallpox look-alike diseases and assays to confirm adverse events resulting from vaccinia vaccine.

Emerging Infectious Diseases
APHL promotes funding to support EID laboratory activities supported through the CDC Epidemiology and Laboratory Capacity (ELC) and Emerging Infections Program (EIP) grants. APHL works to expand and enhance relationships between public health laboratories and CDC scientists and develops a biannual conference focusing on Laboratory Diagnosis of Infectious Diseases.

The program offers two, one-year influenza laboratory traineeships for public health laboratorians in partnership with CDC/NCID/DVRD. The first supports training of public health laboratory microbiologists in new and classic molecular methods for influenza detection and strain identification; the second funds training of public health laboratory and veterinary microbiologists.

The program also works closely with the National Laboratory Training Network to design infectious diseases, bioterrorism and biosafety training programs.

Foodborne Diseases
APHL coordinates public health laboratory activities in PulseNet, the National Molecular Subtyping Network for Foodborne Disease Surveillance. Click here for information on APHL activities pertaining to PulseNet. The association also supported development of the Food Safety Laboratory Capacity and Capability Assessment survey sponsored by APHL and CDC.

HIV
In addition to the OraQuick Rapid HIV-1 Antibody test, the FDA has recently approved two more HIV rapid tests for diagnostic use, the Reveal Rapid HIV-1 Antibody Test and the Uni-Gold Recombigen HIV Test. CDC issued specific quality assurance testing guidelines after the approval of OraQuick that must be followed when performing any HIV rapid test. The following is excerpted from the guidelines and specifically addresses confirmatory testing. All public health laboratories are urged to comply with these guidelines, which apply to confirmatory testing after any reactive rapid test.

For the summarized guidelines click here.

For the guidelines in their entirety, click here.

Tuberculosis

TB Task Force Report

In response to a May 2000 report by the Institute of Medicine, APHL and CDC commissioned a task force to address critical TB laboratory issues and improve tuberculosis control by promoting the optimal use of laboratory services and effective information and tracking. To view the final report from the Task Force entitled The Future of TB Laboratory Services, A Framework for Integration, Collaboration and Leadership, click here.

TB Conference
APHL sponsored the Fourth National Conference on Laboratory Aspects of Tuberculosis. APHL has convened a task force with representatives from CDC, public health and clinical laboratories, and TB controllers to consider the laboratory role in implementing recommendations from the IOM report “Ending Neglect, the Elimination of Tuberculosis in the United States.”

External Quality Assessment (EQA)
Through collaborations with international partners, including WHO and IUATLD, APHL has developed External Quality Assurance Guidelines for AFB smear microscopy to improve laboratory diagnosis of TB in high burden countries.

West Nile Virus
The infectious disease program works with CDC and state public health laboratories to assure availability of appropriate laboratory tests for the surveillance and prevention of West Nile virus and other arboviruses. Program staff have collaborated with CDC to facilitate technology transfer for laboratory detection of West Nile virus and to obtain a waiver of USDA permit requirements to enable laboratories to obtain necessary testing controls. In addition, APHL co-sponsored the second National Planning Meeting for the Surveillance, Prevention and Control of West Nile virus in the US.

Pandemic Influenza

APHL Infectious Disease Conferences

2005 APHL Infectious Disease Conference: “Emerging Infectious Diseases—Emerging Responses,” March 2-4, 2005, Orlando, FL.

2003 APHL Infectious Disease Conference: “Molecular Methods: Impact on Public Health Practice, From BT to STDs,” March 5-7, 2003, Denver, CO.

On the Horizon

APHL will continue to advance laboratory capacity and capability to detect infectious diseases via strategies linking public health laboratories with clinical, veterinary, food safety, agricultural, and academic laboratories; ongoing support for development and utilization of rapid, sensitive molecular detection assays; and monitoring the impact of federal regulatory actions on laboratory testing, biosafety and biosecurity.

For more information, please contact:
Rosemary Humes MS, MT(ASCP)SM
Director of Infectious Disease Programs and Preparedness
240.485.2763 | rhumes@aphl.org