A Test in Time Saves Lives: The Nebraska Lab’s Expedited Response to Andes Hantavirus

The recent hantavirus outbreak on a cruise ship bound for the US highlighted America’s public health infrastructure shortcomings in diagnosing rare and exotic diseases. The incident is not an isolated case, but rather a symptom of a broader issue: the country’s lack of preparedness against emerging infectious threats.

One laboratory stood out for its proactive response to the crisis: the University of Nebraska Medical Center. In a remarkable display of speed and ingenuity, the lab developed its own diagnostic test for Andes hantavirus, a pathogen previously unknown in the US. This achievement is particularly noteworthy given that the CDC’s PCR test was deemed unsuitable for patient management.

The Nebraska team’s rapid mobilization was made possible by their existing expertise in biocontainment and infectious disease management, as well as their ability to draw on external resources. Peter Iwen, the lab’s director, demonstrated a keen awareness of the need for a homegrown solution. He recognized that the CDC’s test would not detect the South American strain of Andes virus.

Iwen’s decision to contact Steven Bradfute, a hantavirus scientist at the University of New Mexico, proved crucial. By building on Frannie Twohig’s existing research on an Andes virus PCR test, the Nebraska team was able to accelerate their development process and circumvent the limitations imposed by the CDC’s test.

This success story raises uncomfortable questions about America’s reliance on federal agencies for public health preparedness. Kelly Wroblewski, senior director of infectious diseases at the Association of Public Health Laboratories, noted that “Nebraska’s ability to stand up a test is a valuable lesson learned: get ready before you even need to test.” This sentiment echoes painful memories from the Covid-19 pandemic, where the CDC’s initial inability to distribute reliable test kits hindered early efforts to track the spread of the virus.

The Andes hantavirus outbreak serves as a stark reminder that the global health landscape is constantly evolving. In an era where novel pathogens are increasingly being detected in new regions, public health infrastructure must be similarly adaptable. Rather than relying on federal agencies or importing foreign-developed tests, laboratories like Nebraska’s should be empowered to develop their own solutions.

To move forward effectively, policymakers must prioritize developing homegrown diagnostic capabilities and invest in a more resilient public health system. This might involve providing resources for state-level labs to establish PCR testing infrastructure, as well as supporting research into novel pathogens and emerging infectious threats.

The Nebraska lab’s expedited response serves as a testament to the power of proactive preparedness in the face of uncertainty. As we navigate the complex landscape of global health security, one thing is clear: a test in time truly saves lives.