Perspectives of public health laboratories in emerging infectious diseases

Chua, Kaw Bing; Gubler, Duane J

In countries with limited resources, an interim centralized national public health diagnostic laboratory can take on some of the roles and functions of a national reference laboratory, especially in supporting laboratory training and quality assurance. For countries without such an idealistic centralized public health reference laboratory, an in-place system of networking should be developed to link to regional and international high-end laboratories or WHO Collaborative Centers to rapidly identify and characterize novel pathogens and provide other specialized laboratory diagnostic reagents, assays or validation. In addition, each region should have a regional center for reference Public health laboratories in emerging infectious diseases KB Chua and DJ Gubler 4 and research to help the national reference and/or diagnostic laboratories train and maintain laboratory quality control. The US Centers for Disease Control and Prevention is a major WHO collaborative partner and provides laboratory service not only for the American region, but also for many other countries in the world. Investigations into the diagnosis of Nipah virus, SARS coronavirus, pandemic influenza A virus and hemorrhagic fever viruses are just a few examples illustrating its worldwide function. The placement of the centralized reference laboratory under the National Center for Disease Control strengthens close communication and coordination among public health specialists, epidemiologist and laboratory personnel and serves as an important coordinating center to support the functions and activities pertaining to biorisk issues, centralized pathogen characterization and storage, laboratory-based surveillance and laboratory quality assurance, as shown in Figure 2 .