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Each year, the ISDH virology and molecular virology laboratory continues its active participation in the U.S World Health Organization (WHO) collaborating laboratories influenza virus surveillance program. Influenza isolates are grown in the virology laboratory and submitted to the CDC at different intervals throughout the season for antigenic analysis and antiviral resistance testing. The data obtained from IN isolates, coupled with the data obtained worldwide, enables the CDC to determine what strains of influenza are circulating. It is this data that also contributes significantly towards the influenza vaccine recommendations made each year by the WHO. In addition to our involvement with CDC, the virology laboratory works very closely with ISDH Epidemiology, especially during peak influenza season. Data obtained from the lab is transmitted to the ISDH Influenza and Respiratory Diseases Surveillance Database. This database allows the respiratory epidemiologist to easily keep track of influenza and other respiratory virus activity within the State.
What is the role of the Public Health Lab (PHL) in dealing with Pandemic Influenza? There are three phases involved in a pandemic and are defined as the pre-pandemic phase (the period preceding the pandemic), the pandemic phase and the post-pandemic phase (the period immediately following the pandemic phase). During the pre-pandemic phase, the role of the PHL is two-fold. We conduct preparedness planning as well as conduct surveillance testing of seasonal flu subtypes. Preparedness planning is not an easy task to take on, but in order for the lab to function efficiently and effectively during a pandemic, this planning must occur prior to an influenza outbreak. During this phase, the lab conducts and monitors year-round surveillance of seasonal flu subtypes. This is the type of testing that the lab conducts each flu season by testing specimens that are submitted through the IN influenza physicians surveillance network (Influenza sentinel sites).
During the pandemic phase, the ISDH Lab’s role changes considerably. While inventory is scaled up due to a significant increase in specimen submissions, it is important to remember that testing is conducted during this time for epidemiological reason only. Testing at PHL’s is not performed for diagnosis or for clinical management. PHL’s are strongly encouraged to show some restraint when it comes to testing and to only test enough specimens to be able to continue adequate surveillance of the virus. Providing guidance to providers in terms of proper specimen collection, transport and results interpretation as well as participating in national influenza surveillance programs are also roles of PHL’s during the pandemic phase.
Once the pandemic phase is over, the post-pandemic phase begins. During this time, the PHL’s continue once again to monitor the surveillance of both the pandemic influenza strain as well as the normal seasonal flu strains. It is important to continue this surveillance so that changes in the flu virus can be detected as quickly as possible.