California and Washington Push for New Measles Testing Protocols

In May, health officials from California, Washington, Hawaii, and Oregon submitted a request to the U.S. Centers for Disease Control and Prevention (CDC) to validate a novel approach for testing measles. However, after two months of anticipation, the CDC declined their request, citing “other competing priorities,” as stated in a letter addressed to CDC Director Erica Schwartz.

Need for Rapid Testing Solutions

The West Coast Health Alliance, representing the concerned states, urged the CDC to reconsider its stance, emphasizing the importance of a rapid, high-volume testing protocol to prepare for potential measles outbreaks. The alliance also called for the creation of testing protocols for other critical pathogens to enhance readiness for future health emergencies.

Emily Hilliard, a spokesperson for the U.S. Department of Health and Human Services (HHS), affirmed that the CDC is providing necessary support to local health departments to bolster measles detection and outbreak responses. Additionally, she mentioned the agency’s focus on prioritizing emerging technologies to combat the measles situation. However, she did not address inquiries about plans to validate high-throughput measles testing.

Impacts of Low-Volume Testing

Currently, laboratories utilize lower-volume testing methods, such as individual polymerase chain reaction (PCR) tests, for measles diagnosis. These limitations hinder the rapid response necessary during outbreaks, where time is critical given that a single measles case can potentially infect 12 to 18 unvaccinated individuals.

In the wake of the COVID-19 pandemic, public health labs invested in high-volume testing equipment, like the Hologic Panther Fusion platform, which enables the processing of up to 500 tests within an eight-hour window. Despite this shift towards more efficient testing for other diseases, a validated high-throughput measles test remains unavailable.

Potential of Emerging Tests

Last year, during a measles outbreak in Texas, state laboratories developed a testing protocol, yet its distribution and publication remain outstanding. Meanwhile, ARUP Laboratories published their measles assay in the Journal of Clinical Microbiology, offering a possible model for validation by the CDC, which could enable broader access to this diagnostic capability.

Experts assert that high-throughput tests would significantly enhance laboratories’ ability to respond swiftly to outbreaks. Dr. Benjamin Bradley, an assistant professor at the University of Utah, emphasized the flexibility and speed associated with automated testing systems compared to manual methods. “With a measles outbreak, time is really of the essence,” Bradley noted, highlighting the rapid transmission rate of the virus.

Importance of Speed in Response

Quick diagnostic tests are vital for containing an outbreak; they facilitate the prompt identification and isolation of infected individuals. In combination with effective contact tracing, rapid testing enables public health officials to administer vaccines to those exposed within 72 hours, potentially preventing infection.

Calls for Systematic Protocol Creation

At present, commercially available tests for measles do not exist, and the onus falls on individual laboratories to develop these methods. This creates a substantial burden as labs must conduct extensive scientific validation to ensure reliability. Sharing validated protocols would enhance efficiency across facilities, according to Bradley.

The CDC reportedly has conducted studies on assays developed by Texas labs and ARUP Laboratories; however, these studies have not led to full validations or comprehensive comparisons, as indicated by the West Coast Health Alliance’s letter. The alliance has urged the CDC to develop and publish an assay to ensure preparedness for any prospective outbreaks.

A Call for Action

The alliance’s letter emphasizes the critical need for high-throughput testing capabilities, asserting that without them, scaling up diagnostic testing during a significant outbreak would pose considerable challenges, ultimately jeopardizing patient care and public health safety.