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Title: Surveillance for Emerging Diseases with Multiplexed Point-of-Care Diagnostics

Journal Article · · Health Security
DOI:https://doi.org/10.1089/hs.2016.0005· OSTI ID:1340961
 [1];  [2];  [1];  [1];  [3];  [3];  [4]
  1. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Analytics, Intelligence and Technology Division
  2. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Theoretical Division
  3. Dept. of Homeland Security, Washington, DC (United States). Homeland Security Advanced Research Projects Agency (HSARPA)
  4. US Food and Drug Administration, Washington, DC (United States)

Here, we present an analysis of the diagnostic technologies that were used to identify historical outbreaks of ebola virus disease and consider systematic surveillance strategies that may greatly reduce the peak size of future epidemics. We observe that clinical signs and symptoms alone are often insufficient to recognize index cases of diseases of global concern against the considerable background infectious disease burden that is present throughout the developing world. We propose a simple sampling strategy to enrich in especially dangerous pathogens with a low background for molecular diagnostics by targeting blood borne pathogens in the healthiest age groups. With existing multiplexed diagnostic technologies, such a system could be combined with existing public health screening and reference laboratory systems for malaria, dengue, and common bacteremia or be used to develop such an infrastructure in less-developed locations. Because the needs for valid samples and accurate recording of patient attributes are aligned with needs for global biosurveillance, local public health needs, and improving patient care, co-development of these capabilities appears to be quite natural, flexible, and extensible as capabilities, technologies, and needs evolve over time. Furthermore, implementation of multiplexed diagnostic technologies to enhance fundamental clinical lab capacity will increase public health monitoring and biosurveillance as a natural extension.

Research Organization:
Los Alamos National Laboratory (LANL), Los Alamos, NM (United States)
Sponsoring Organization:
USDOE; US Department of Homeland Security (DHS)
Grant/Contract Number:
AC52-06NA25396; HSHQPM- 14-X-00069
OSTI ID:
1340961
Report Number(s):
LA-UR-16-20747
Journal Information:
Health Security, Vol. 14, Issue 3; ISSN 2326-5094
Publisher:
Mary Ann Liebert, Inc.Copyright Statement
Country of Publication:
United States
Language:
English

References (18)

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The Evolution and Expansion of Regional Disease Surveillance Networks and Their Role in Mitigating the Threat of Infectious Disease Outbreaks journal January 2013
Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition journal November 2015
Multiplexed nucleic acid-based assays for molecular diagnostics of human disease journal July 2012
Evaluation of Rapid Diagnostic Tests for Typhoid Fever journal May 2004
Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak journal August 2014
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Chikungunya: a re-emerging virus journal February 2012
Present and future arboviral threats journal February 2010
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The global distribution and burden of dengue journal April 2013
Emerging Infectious Diseases and Public Health Policy: Insights from Cambodia, Hong Kong and Indonesia journal March 2013
Profile: The KEMRI/CDC Health and Demographic Surveillance System--Western Kenya journal August 2012

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