Emerging Infections: Implications for Sentinel and Public Health Laboratories

After reading the popular novel, “The Cobra Event,” then U.S. President Bill Clinton, concerned with the prospect of use of a biologic agent against the United States, issued Presidential Directive 39. This executive act resulted in the formation of the Laboratory Response Network (LRN), a structured consortium of clinical, governmental, and public health laboratories. The LRN became operational in August 1999, and though few in the laboratory field noticed its birth, by the fall of 2001 and the anthrax letter events, the alliance of clinical and public health laboratories was becoming a reality. The LRN provided the framework for much closer cooperation between clinical (sentinel) laboratories and their public health counterparts and set the stage for a cooperative approach to the ever-evolving list of emerging infections. Subsequently, the National Laboratory System program has been added to reinforce this framework.