Lab Matters Spring 2018 | Page 17

partner profile What excites you most about advanced molecular diagnostic technologies such as NGS, MALDI-TOF and CARB (carbohydrate-based microarrays)? With a severe influenza season drawing to a close, have flu specialists acquired any new insights into vaccine development, diagnostics and/or surveillance? Influenza is an incredible challenge to study and to prevent and treat. Seasonal influenza accounts for a large burden of disease every year, and novel influenza viruses pose an ever-present threat for an influenza pandemic. Systems in the United States and around the world that characterize and investigate influenza viruses have improved dramatically following large-scale investments that were made in pandemic preparedness. We have learned so much about influenza, but we have many questions that need answers for us to move forward in reducing the burden of disease. This flu season was notable for widespread and high flu activity in many regions of the United States simultaneously and for record-breaking hospitalization rates. This flu season is a reminder of how serious flu can be and why we need to improve our ability to fight flu. We saw this season again that flu vaccines don’t work as well as we would like, especially against the H3N2 viruses that predominated this season. CDC’s vaccine effectiveness network allowed us to measure how well the vaccine was working overall this season, but we would like to be able to increase the breadth and depth of vaccine effectiveness monitoring to support development of more effective vaccines. We would like to increase our laboratory capacity to support vaccine manufacturers and developers to make better performing vaccines. We would also like to be able to work with public health laboratories and other public health partners to improve influenza virus characterization and disease monitoring domestically and globally. Enhancing our collective ability to rapidly detect changes in circulating viruses that could be associated with lower vaccine effectiveness could go a long way to informing development of better performing flu vaccines. PublicHealthLabs @APHL I’m pleased to see that once funding and infrastructure were made available through the Advanced Molecular Detection program, public health laboratories were quickly able to apply the technologies in many areas—improving surveillance, detecting outbreaks earlier and responding to public health threats more effectively. It’s exciting to see how this technology is being used in state health labs across the United States. As a veteran of many public health responses, what is your perspective on the status of US infrastructure for public health surveillance? There have been significant improvements in the infrastructure for public health surveillance in recent years, but more are needed. Often during an emergency response, we are forced to set up a new surveillance system to collect important data, rather than adapting a currently functioning system. We need to continue to invest in improving day-to-day systems so we are ready for the next emergency response. Another critical investment is the infrastructure supporting improved risk assessment processes and biosafety programs. This infrastructure helps to protect our frontline laboratory workers and reassure the public that we are able to safely respond to new public health threats. How can communities support the needs of pregnant women during an influenza pandemic? Because pregnant women are at increased risk of serious complications related to pandemic and seasonal influenza, they need to have access to prompt treatment with antiviral medications and to the pandemic flu vaccine, once it becomes available. Pregnant women and children have historically been prioritized in pandemic planning to receive antiviral medications and pandemic vaccine earlier APHL.org than the general population. In addition, public health professionals need to work with obstetric providers to ensure they and the patients they care for are aware of CDC recommendations for antiviral medications and flu vaccine so pregnant women can be protected from severe complications In your opinion, which emerging infectious diseases pose the greatest danger to public health? Experts in the field overwhelmingly say that a severe flu pandemic is the biggest danger to public health. We saw in this year’s flu season how severe and widespread flu can be – but this was with flu viruses to which many people were already immune and for which we had a relatively effective vaccine. A novel influenza virus that causes a severe illness could wreak havoc since most people would not have immunity against the new virus. Therefore, many people could become severely ill quickly and options for preventing morbidity and mortality would be limited. It is essential that we continue to prioritize preparedness for the next influenza pandemic. In addition, preparedness for an influenza pandemic helps us to prepare for other emerging infectious diseases, given that some of the same public health interventions can be useful for other infections. APHL has been working with CDC to strengthen infectious disease testing at clinical and public health laboratories across the US. How can APHL continue to advance these practices for laboratories both in the US and globally? APHL is an essential partner for CDC and public health as we work to improve testing for infectious diseases. We lean on APHL and its members to share their expertise and their real-world experience with infectious disease testing. Keep doing what you’re doing—we need you! n Spring 2018 LAB MATTERS 15