CDC on AMD: “Nothin’ Against Canada”

Meanwhile, in the war against … er .. um … ah … right. Anyway, politics and priorities:

We have the technology  ....Many public health experts see the Centers for Disease Control and Prevention as the premier disease detection agency not just for the United States but for the entire planet.

Yet when it comes to employing the fastest and most precise method of spotting outbreaks of illness, the CDC is no longer at the cutting edge—and won’t be for years. Centers for Disease Control and Prevention Director Thomas Frieden along with public health and provider groups want to turn that around by investing in a sophisticated technology called “advanced molecular detection” that determines the genetic map of the viruses, bacteria and parasites that cause disease.

The effort began paying off early this year. Appropriators for the first time in several years decided to rewrite Labor-HHS-Education spending provisions. In doing so, they included $30 million for the AMD technology in the omnibus spending measure funding the government through the end of fiscal 2014.

(Reichard)

It almost sounds like a bureaucratic accident; indeed, the task remains for Frieden to convince Congress to maintain funding.

There are, of course, the political questions, from global health perspectives to budgetary questions, to “nightmare” pathogens that, unfortunately are not so unrealistic as the description might lead us to hope. Consider the idea of a contagion that cannot be killed with current technology, and can dance across species. The kind of thing they make bad suspense films about. Except real.

The viruses, bacteria and parasites that cause disease each have their own individual genetic makeups. Advanced molecular detection is used to determine what they are.

It does so by analyzing a small sample of virus or bacteria, for example. It prints out a sequence of the genes in the sample involved. That allows a precise match to a particular medical condition.

Also, the data can be made available within hours to the “bioinformatics” specialists who have the expertise to interpret it. These “rapid gene sequencing” techniques can be applied without the painstaking culturing of samples in labs over a period of days or weeks. It also can quickly determine whether bacteria is drug resistant—speed that could save thousands of lives, officials say.

“Imagine putting together a 10,000-piece jigsaw puzzle with the speed you could normally do a 100-piece puzzle—apply that to infectious disease control and that’s AMD at work,” says a CDC fact sheet on the technology. “Now imagine, while disease is spreading and people are dying, trying to put a 10,000 piece puzzle together when key pieces are missing. That’s what many CDC scientists are struggling against today” ….

…. “We’ve been concerned for a number of years that CDC is falling behind,” said Scott Becker, executive director of the Association of Public Health Laboratories. He cited investments 10 to 15 years ago in a technology known as PCR and in the PulseNet food illness surveillance network as ones that kept the agency then at the cutting edge of disease detection, but no longer.

It isn’t so much that the CDC is behind other nations as it is that the technology isn’t being used when dangerous new threats are emerging, said Becker.

“It’s more that the microbes are ahead of us,” agreed Frieden. “The microbes are evolving really quickly.”

But Frieden acknowledged a “painful” story. “During the [2010] cholera outbreak in Haiti we were able to sequence the genome of the cholera bacillus, but we couldn’t interpret it. So we had to send it to Canada to have it interpreted,” he said. “You know, I got nothin’ against Canada, but I never ever want to have to send something elsewhere to have it interpreted. They were ahead of us with bioinformatics.”

____________________

Reichard, John. “CDC Plans to Map DNA of Disease-Causing Viruses”. Roll Call. March 10, 2014.

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