Dodging the A/H1N1 Influenza Bullet

DID THE UNITED STATES AND THE WORLD DODGE A BULLET because the first outbreak of A/H1N1 influenza was neither as lethal nor as virulent as long-predicted by public health officials? That might be true today. But wait until the next flu season.

No one knows if the A/H1N1 virus will mutate in ways that make it more virulent and more lethal. Only time will provide the answer. Meanwhile, this spring’s relatively short-lived A/H1N1 influenza outbreak has lessons for the laboratory testing industry—and many are described in this issue of THE DARK REPORT. Three separate intelligence briefings detail some rather remarkable stories of how laboratories and lab industry vendors met the unexpected challenges presented by the A/H1N1 outbreak.

First is an analysis of how clinical laboratories and public health laboratories coped with the surge of influenza specimens. Influenza assays currently available to clinical laboratories are less than ideal when a new influenza strain like A/H1N1 appears. Also, the supply chain can be quickly overwhelmed, as laboratories increase their orders and vendors struggle to keep enough lab supplies in the distribution pipeline. (See pages 3-5.)

Second is a fascinating story about how the testing capacity and capabilities of many public health labs were increased literally overnight! A unique collaboration involving the Centers for Disease Control and Prevention (CDC), the Association of Public Health Laboratories (APHL), and Applied Biosystems, a division of Life Technologies Corporation, led to the installation and validation of 40 new molecular test systems in public health labs in this country because of a 24/7 crash program. (See pages 6-8.)

Third, THE DARK REPORT interviews two laboratory professionals about how their organizations stepped up to meet the increased volume of flu specimens that needed testing during the peak of the A/H1N1 outbreak. Both lab companies are gearing up for a busy flu season this fall and have useful advice to share with other pathologists and lab directors. (See pages 17-18.)

In my view, the United States and the laboratory medicine profession got a lucky break with this outbreak of A/H1N1. Similar to the SARS outbreak in 2003, this country avoided a serious epidemic for reasons unrelated to preparedness. However, the good news is that the public health establishment has greatly enhanced its ability to respond to similar outbreaks in the future.


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