California and Washington asked the US Centers for Disease Control and Prevention (CDC) in May to validate a new way to test for measles \u2013 but after waiting two months, the CDC denied the request, citing \u201cother competing priorities\u201d, according to a letter from the West Coast Health Alliance to the CDC director, Erica Schwartz.<\/p>\n
The letter, signed by health officials in California<\/a>, Hawaii, Oregon and Washington, asks Schwartz to reconsider and validate a rapid, high-volume measles test in preparation for major outbreaks. The alliance also asked the CDC to create protocols to test for other high-priority pathogens to prepare for future outbreaks.<\/p>\n The CDC is \u201censuring state and local health departments have the support needed to strengthen measles detection and outbreak response\u201d, said Emily Hilliard, a spokesperson for the US Department of Health and Human Services (HHS). The agency was \u201cprioritizing emerging technologies\u201d to respond to the measles outbreak, Hilliard said.<\/p>\n The spokesperson did not answer questions about whether the CDC had plans to validate a high-throughput measles test, or assay.<\/p>\n Such a test would \u201cdramatically strengthen\u201d the ability of laboratories to respond quickly to outbreaks, the health officials said \u2013 which would help preparedness for known pathogens like Ebola or hantavirus as well as emerging threats.<\/p>\n Right now, laboratories have to rely on lower-volume tests for measles, like individual polymerase chain reaction (PCR) tests.<\/p>\n In the Covid<\/a> pandemic, most public health labs bought high volume equipment, like the Hologic Panther Fusion, a PCR platform for diagnosing illness that can process up to 500 tests in eight hours. That way, labs could process large batches of Covid tests very quickly.<\/p>\n But there is no high-throughput test to diagnose measles that has been validated by the CDC.<\/p>\n Texas state laboratories developed such a test during the measles outbreak in west Texas last year, but they have not distributed or published the protocol. ARUP Laboratories, a national, academic, non-profit reference laboratory, published<\/a> their assay for measles in the Journal of Clinical Microbiology in December. The CDC could validate this or another protocol so other public health labs could run diagnostic tests.<\/p>\n High-throughput tests can process a lot of samples at once, but the automated instruments can also be faster and easier than manually conducting tests. \u201cOne of the big advantages that they offer is essentially more flexibility,\u201d said Benjamin Bradley, an assistant professor of pathology at the University of Utah and medical director of virology at ARUP.<\/p>\n That\u2019s especially important in a fast-moving outbreak. \u201cWith a measles outbreak, time is really of the essence,\u201d Bradley said. One measles patient can infect 12 to 18 other unvaccinated people, and the virus can linger in the air for two hours. \u201cYou can quickly see how that goes exponential, from a handful of cases to an entire community of cases,\u201d he said.<\/p>\n Quicker tests can help curb an outbreak like that, helping to identify and isolate positive patients as quickly as possible and leading to faster contact tracing. It also means officials can promptly offer vaccines to anyone who was exposed and isn\u2019t already vaccinated. If vaccines are taken within 72 hours of exposure, they can prevent infection.<\/p>\n There are no commercially available tests for measles; the current tests are developed by laboratories. Validating and publishing the process for creating these tests is crucial for labs to be able to create and conduct them.<\/p>\n \u201cYou essentially have to do science for it,\u201d said Bradley. That means planning, undergoing and documenting experiments, and then checking to make sure the test is reliable. \u201cA lot of that work is very burdensome for laboratories to put together. So by having groups that can share their protocols, that helps labs,\u201d Bradley said.<\/p>\n