it now consists of 120 state and local public health, veterinary, and military laboratories and international laboratories of those types, that normally perform public health analyses. Collectively, the facilities are equipped to respond quickly to acts of biological terrorism, emerging infectious disease, and other public health threats (CDC, 2004). The LRN national network of laboratories includes:

Federal—These include laboratories at CDC, the U.S. Department of Agriculture, the Food and Drug Administration, and other facilities run by federal agencies.

State and local public health—These are laboratories run by state and local departments of health. In addition to being able to test for Category A biological agents, a few LRN public health laboratories are able to measure human exposure to toxic chemicals through tests on clinical specimens.

Military—Laboratories operated by the Department of Defense, including the U.S. Army Medical Research Institute for Infectious Diseases (USAMRIID) at Fort Detrick, Maryland.

Some laboratories are designated as national, reference, or sentinel, according to the tests they perform and how they handle infectious agents to protect workers and the public.

National laboratories include the CDC and USAMRIID. They have unique resources to handle highly infectious agents and the ability to identify specific agent strains.

Reference laboratories, sometimes referred to as “confirmatory reference,” can perform tests to detect and confirm the presence of a threat agent. Reference laboratories are intended to provide local authorities with effective laboratory support on a timely and responsive basis, so that they do not need to rely on CDC support for all cases.

Sentinel laboratories represent the thousands of hospital-based laboratories that are on the front lines. Sentinel laboratories have direct contact with patients. In an unannounced or covert terrorist attack, patients provide specimens during routine patient care. Sentinel laboratories could be the first facility to spot a suspicious specimen. A sentinel laboratory’s responsibility is to refer a suspicious sample to the right reference laboratory.

Bacillus anthracis has been identified as an agent used by bioterrorists. Its spores cause disease readily, and it is resistant to most adverse environmental conditions, such as extremes in temperature, sunlight, and drying (Bohm, 1990).

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