Laboratory Response Network: Frequently Asked Questions

The LRN is composed of local, state and federal public health, food testing, veterinary diagnostic, and environmental testing laboratories. They provide the laboratory infrastructure and capacity to respond to biological and chemical terrorism, and other public health emergencies. The laboratories that make up the LRN are affiliated with federal agencies, military installations, international partners, and state and local public health departments.

The LRN is also a partnership between key stakeholders in the preparedness for and response to biological and chemical terrorism. The Centers for Disease Control and Prevention (CDC), the Federal Bureau of Investigation (FBI), and the Association of Public Health Laboratories (APHL) were key partners in establishing the LRN.

The LRN was launched by CDC in 1999. While oversight of the LRN is accomplished by a committee made up of leaders from the CDC and LRN partners, the CDC is ultimately accountable for the program.

On the biological side, approximately 120 domestic laboratories are members, representing all 50 states. The LRN represents a vast network in both testing capabilities and in location. In addition to domestic laboratories, the LRN includes several international laboratories that provide various levels of testing capabilities. The majority of current members are public health laboratories. One of the LRN's goals is to broaden the scope of biological agent detection among its members.

On the chemical side, 53 laboratories are members, including 46 state and local public health laboratories that provide testing on clinical specimens to measure human exposure to toxic chemicals.

The LRN is one network that encompasses both bioterrorism and chemical terrorism preparedness and response. In fact, LRN chemical laboratories that have the capacity to measure metabolites in clinical specimens are also public health laboratories that have been designated as reference testing laboratories for biological agent detection.

The approaches to a response, however, are different. The biological side of the LRN (LRN-B), emphasizes local laboratory response by helping to increase the number of trained laboratory workers in state and local public health facilities, distributing standardized test methods and reagents to local labs, promoting the acquisition of advanced technologies, and supporting facility improvements. The chemical side of the LRN (LRN-C) employs a more centralized structure. This means initial testing in a suspected chemical event will occur at CDC. Using sophisticated mass spectrometry, CDC laboratories perform tests on the first 40 clinical specimens to measure human exposure. Results of these tests would be reported to affected states, and if needed, appropriate LRN members may be asked to test additional samples. This approach is necessary because the analytical expertise and technology resources required to respond to a chemical event is substantially high.

Inclusion as a reference testing facility is not automatic, and prospective members must demonstrate certain capabilities and capacities, and meet established agent-specific performance standards. For both biological and chemical laboratory membership, the state public health laboratory director has a key role in determining whether additional laboratory capacity is critical to the state's overall emergency response goals.

Just as laboratories must demonstrate certain capabilities and capacities to be admitted to the LRN, they must also continue to prove those same characteristics. Laboratories are subjected to routine proficiency testing in order to prove testing accuracy.

The LRN is a CDC program. Congress appropriates money through the Department of Health and Human Services, which oversees CDC activities. Each year, through a governmental cooperative agreement, the money is distributed among LRN-member laboratories to fund laboratory positions, laboratory reagents, renovations, and acquire the latest technology. Individual states are responsible for determining how the funds are divided up among public health laboratories in their states.

There are an estimated 25,000 private and commercial laboratories in the United States, many of which can provide critical sentinel laboratory capacity. While most of these laboratories do not have the facilities or the technology to perform confirmatory testing for biothreat agents, they represent the first contact with patients and are in a position to alert public health officials. They can also conduct tests to rule out other diseases and ship samples to appropriate LRN-B reference laboratories.

Many diseases, such as anthrax, plague, and tularemia, are zoonotic, meaning that they can be shared by both humans and animals. Disease outbreaks are often preceded by illness among animal populations. Veterinary diagnostic laboratories serve as reference laboratories for animals and can alert public health officials to potential disease outbreaks so that agent-specific response plans can be implemented.

CDC has assisted LRN members with purchasing instruments needed for measuring chemicals in blood and urine. Because of the complexity of the instrumentation, on-site operation training is provided by the instrument vendor as part of the purchase package. Through hands-on training at CDC and computer-based training, CDC is training Level 1 and Level 2 labs on analytical methods. Network members that receive methods and instrumentation must also participate in a rigorous quality assurance program to ensure that network labs provide precise, accurate, high-quality data. CDC is also providing a "train-the-trainer" course that will give chemical terrorism coordinators the tools they need to train partners in their jurisdictions, such as hospital staff, about sample collection and shipping.