This article has been updated with a comment from an unnamed HHS official.
NEW YORK – As the Centers for Disease Control and Prevention started to slash its workforce on Tuesday, a laboratory that appears to be at the center of its mission — containing disease epidemics and outbreaks — was eliminated: the viral hepatitis laboratory.
On Tuesday, the 25 full-time employees of the lab — one of three branches of the Division of Viral Hepatitis (DVH), which is part of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) — received "reduction in force" (RIF) notices and were put on administrative leave, GenomeWeb has learned. The other two DVH branches, Epidemiology & Surveillance and Prevention, remain intact. Laboratory branches in the center's other three divisions — HIV Prevention, STD Prevention, and Tuberculosis Elimination — were also affected by the cuts, though it is unclear to what extent.
The move is part of a wider restructuring by the Department of Health and Human Services, under which the CDC will reduce its staff by about 2,400 employees. According to HHS, the goal is to return the CDC's focus "to its core mission of preparing and responding to epidemics and outbreaks."
However, closing the viral hepatitis laboratory appears to run counter to that goal. According to a former CDC employee, who requested anonymity, the lab has been investigating viral hepatitis outbreaks across the country through genetic testing for years, including two ongoing outbreaks.
In addition, it has served as a national reference laboratory for serologic and molecular diagnostic hepatitis testing. Tests developed and run in its CLIA lab, including one for a rare type of infection with hepatitis delta virus, would be difficult to move to another CDC laboratory, as they would need to be independently revalidated in that lab, according to the source.
While hepatitis A outbreaks can be either foodborne or transmitted between people, hepatitis B and C outbreaks occur through person-to-person transmission and often happen in healthcare settings. Vaccines exist for hepatitis A and B but not for hepatitis C, and only hepatitis C has a curative drug treatment.
To analyze hepatitis outbreaks, the DVH lab has developed the cloud-based Global Hepatitis Outbreak and Surveillance Technology (GHOST) system, which determines viral genotypes and transmission links between patients using next-generation sequencing and has helped with outbreak investigations by state and local health departments.
While state health departments have started using GHOST independently, "the GHOST infrastructure requires continued maintenance and upgrade to accommodate more users and to adapt GHOST models to rapidly changing next-generation sequencing," the former employee said, adding that the DVH lab had been "deeply engaged" in moving to new sequencing technologies.
"There is no replacement for genetic testing to conduct efficient and timely outbreak investigations," according to the former staffer, who added that the CDC lab has "investigated more hepatitis outbreaks than any laboratory in the world and developed molecular technologies that are most efficient for outbreak investigations."
Such testing will no longer be possible at the viral hepatitis lab, though, since the only person left right now is its quality manager, who has more of an administrative role and is not familiar with lab work, according to the source.
"The epidemiology [and surveillance] branch questioned how they will confirm transmissions without all the genetic data generated by the lab from outbreak samples," the former CDC staff member said, adding that the lab had been "actively working" on two outbreak investigations.
Besides running diagnostic tests and analyzing outbreaks, the lab also maintains an archive of more than a million specimens going back to the 1970s, including samples from primates, that will be worthless without the accompanying expertise.
"The loss of the laboratorians who research hepatitis is a loss of subject matter experts who can no longer advise health departments and perinatal prevention programs to prevent mother-to-child transmission of hepatitis B," said another former CDC employee, who also requested anonymity.
It is unclear what prompted the CDC to shut down the entire viral hepatitis laboratory. The CDC press office directed an inquiry to HHS, which did not respond to a request for comment before press time. On Thursday, an unnamed HHS official told GenomeWeb that "the work of the CDC's NCHHSTP will continue elsewhere at HHS. As announced by Secretary Kennedy last week, HHS is taking action to streamline operations, consolidate duplicative programs, and make HHS more efficient in its service to the American people."
Members of the laboratory were given no explanation for the abrupt closure, and did not expect it to happen. "The secretary [of Health and Human Services] had been saying that first responders will not get affected, and this is the lab branch, so if we have an outbreak, we are the ones that get tasked with sequencing all the samples that are associated with outbreak investigations for hepatitis A, B, and C," the first former CDC employee said.
"We were expecting some staff to be affected, probably, but not the entire branch."