Those who monitor disease detection policy note that it’s cheaper and faster to move away from a system that relies heavily on the time-consuming growth in the lab of cultures of disease-causing bugs.
But moving to “advanced molecular detection” technology to reap those advantages could create new problems if the transition isn’t managed properly, experts say.
AMD is used to determine the individual genetic makeups of the viruses, bacteria and parasites that cause disease.
The PulseNet system of labs for tracking foodborne illness, for example, relies on cultures to make a diagnosis rather than the culture-free approach AMD allows. That may make it important to move to the new system now, while the nation still has that PulseNet capability as a backup.
That would also retain scientists’ ability to identify certain strains of diseases and the power to trace foodborne outbreaks back to their source.
“We are concerned about the loss of surveillance data with new technologies,” said Scott Becker, executive director of the Association of Public Health Laboratories.
Eventually scientists will be able to relate what they now see in PulseNet to the data produced by AMD. One example is Genome Trakr. This project led by the Food and Drug Administration is building just such a system sequencing listeria, a disease-causing bacteria found in certain food.
The FDA is working with the Centers for Disease Control and Prevention to relate those sequences to data in PulseNet.
“In short, we need to keep with the tried and true while we work to develop the shiny and new,” Becker said.
CDC Director Thomas Frieden also acknowledges there are risks involved in the transition.
“If new diagnostics lead to a lack of cultures, we could lose the ability to identify outbreaks unless we make rapid progress with AMD,” he said. “Cultures are expensive and complicated to do. So what we hope to do is gain the ability to identify [disease] clusters from specimens themselves without the need for cultures. In an interim period we hope to work with others to maintain specimens from patients who get rapid testing done and are positive.”