Sharing experiences from a reference laboratory in the public health response for Ebola viral disease, MERS-CoV and H7N9 influenza virus investigations

Abstract

An efficient public health preparedness and response plan for infectious disease management is important in recent times when emerging and exotic diseases that hitherto were not common have surfaced in countries with potential to spread outside borders. Stewardship from a reference laboratory is important to take the lead for the laboratory network, to proactively set up disease surveillance, provide referral diagnostic services, on-going training and mentorship and to ensure coordination of an effective laboratory response. In Malaysia, the Institute for Medical Research has provided the stewardship for the Ministry of Health's laboratory network that comprises of hospital pathology, public health and university laboratories. In this paper we share our experiences in recent infectious disease outbreak investigations as a reference laboratory within the Ministry of Health infectious disease surveillance network.

Emerging infectious disease laboratory and diagnostic preparedness to accelerate vaccine development

“…62 EID public health and countermeasure programs have unique challenges for diagnostic and vaccine clinical assay development purposes. 2,39,41,[63][64][65][66][67][68][69][70][71] There may be an incomplete understanding of the biology or epidemiology of a new pathogen, which can delay or confound the selection of a relevant vaccine target and the subsequent assay development to be used to evaluate the candidates. The field may suffer from a lack of available reagent sources or with inconsistency in quantity and quality of those available, especially early in the discovery and development process.…”

“…Efforts to prepare reagents, collect well-characterized samples, develop research materials, and international standards in advance for EIDs for whom alerts have already been raised, such as the WHO priority pathogens, through collaborative partnerships with governmental and philanthropic agencies along with academic and industry-based researchers will make us better suited to respond with speed to an outbreak. 24,61,69,73 Assay standardization for these or any other newly emergent infectious disease will be challenging and take time to develop, collect and characterize quality reagents, to achieve sufficient sources samples for the establishment of serological or molecular standards. 10 The commitment of researchers and companies invested in the research, diagnosis, treatment, and prevention of EIDs to participate and contribute to organized efforts to create and validate internationally recognized standardized reagents, assays and controls for priority pathogens in advance of an emergency is imperative and the time to start building this framework is now.…”

A Competency Framework for Developing Global Laboratory Leaders

“…However, reliable laboratory services continue to be limited in many low- and middle-income countries (2, 3). Although there have been positive examples of laboratory responses to outbreaks (4–6), a number of well-documented events including some at the convergence of human, animal and environmental health have shown how a lack of robust laboratory systems can impede disease detection, control and prevention efforts (7–9). These circumstances highlight the importance of building sustainable national health laboratory systems including strong linkages and cooperation between sectors and within the health system.…”