Automated collection of pathogen-specific diagnostic data for real-time syndromic epidemiological studies

Lindsay Meyers; Christine C. Ginocchio; Aimie N. Faucett; Frederick S. Nolte; Per H. Gesteland; Amy Leber; Diane Janowiak; Virginia Donovan; Jennifer Dien Bard; Silvia Spitzer; Kathleen A. Stellrecht; Hossein Salimnia; Rangaraj Selvarangan; Stefan Juretschko; Judy A. Daly; Jeremy C. Wallentine; Kristy Lindsey; Franklin Moore; Sharon L. Reed; Maria Aguero-Rosenfeld; Paul D. Fey; Gregory A. Storch; Steve J. Melnick; Christine C. Robinson; Jennifer F. Meredith; Camille V. Cook; Robert K. Nelson; Jay D. Jones; Samuel V. Scarpino; Benjamin M. Althouse; Kirk M. Ririe; Bradley A. Malin; Mark A. Poritz

It is not always possible to accurately diagnose the causative agents of most infectious diseases from symptoms alone due to overlapping clinical presentation. Thus, to achieve maximal utility, 90 infectious disease surveillance systems should move beyond syndrome-based reporting and be pathogen-specific and comprehensive, reporting on as many of the common pathogens for a particular syndrome as possible. Sensitive and specific automated molecular diagnostic systems that detect up to four different pathogens in a single sample have been available from in vitro diagnostic (IVD) manufacturers for some time [31] [32] [33] . However adoption of IVD platforms with 95 broad multiplexing capability has become widespread only in the last few years. Commercially available systems that can detect most of the known etiological agents for respiratory, gastrointestinal and other multi-pathogen syndromes [34] [35] [36] include the BioFire (Salt Lake City, UT) FilmArray ® System [37] ; the GenMark (Carlsbad, CA) eSensor XT-8 ® [38] and ePlex ® [39] ; and the Luminex (Austin, TX) xTAG ® [40] , nxTag ® [41] and Verigene ® systems [42] . 100 Multi-analyte diagnostic tests provide the raw data needed for real-time pathogen-specific surveillance but there remain a number of obstacles to sharing these results (reviewed in [43] ).