They were on the ground in Beijing to fight the SARS pandemic in 2003 and more recently in Saudi Arabia to hunt for the origins of MERS. Now the Mailman School’s Center for Infection and Immunity (CII) is heading to the heart of the Ebola outbreak to set up a state-of-the-art diagnostic laboratory by early next year.
Currently only 12 labs serve the countries most affected by Ebola. At best they can perform 100 tests a day, far less that what’s needed to handle what the World Health Organization estimates will be 10,000 cases per week by December.
The new facility, staffed and equipped by CII scientists with logistical support from the World Health Organization, will alleviate this shortage with an additional benefit: it will test for more than just Ebola. A multiplex diagnostic system built in collaboration with a leading medical technology company can screen for a range of viruses and parasites like malaria, shigellosis, yellow fever, and Lassa fever.
“Ours is the only center to my knowledge that will offer this kind of sophisticated testing,” says Dr. Ian Lipkin, John Snow Professor of Epidemiology and director of CII. “We’ll be able to give a more coherent and comprehensive picture of why people might be sick.”
Testing for a range of infections is critical in this outbreak since symptoms like fever and vomiting are shared between Ebola and other deadly diseases. “Right now, patients are kept at the clinic until they test negative three days apart. During the interim they could die of malaria,” says Dr. Lipkin. The goal is a quick diagnosis to get patients the treatment they need, and if they don’t have Ebola, to isolate them from patients with the disease to lower risk that the get infected at the clinic.
Getting the lab up and running will take considerable resources. Two infectious disease specialists from CII will staff the facility in four-week rotations for a minimum of six months. The added burden of travel and quarantine on their return to New York will double the costs, according to Dr. Lipkin. In all, 24 months of salary is needed along with supplies and equipment.
CII’s experience developing diagnostics in outbreaks positions them to build what will be the most advanced diagnostic lab in the region. At the height of the SARS epidemic, Dr. Lipkin and CII Associate Director Thomas Briese hand-delivered 10,000 SARS test kits to Beijing. In 2012 they deployed a mobile field laboratory in Saudi Arabia that identified camels and bats as carriers for MERS.
The new lab will be situated adjacent to an Ebola treatment center at a location to be determined. Dr. Lipkin believes it might be Sierra Leone, where the outbreak continues to escalate, but he admits it could be anywhere in the region. “This outbreak is evolving. It’s capricious; it can pop up somewhere else. We’ll go wherever we can be most helpful.”