Last month the World Health Organization (WHO) issued warnings that have important implications for clinical laboratories. Proclaiming that infectious diseases are spreading faster than at any time in history and are becoming increasingly difficult to treat, the UN health agency called on governments around the world to follow WHO's new regulations, which are meant to improve disease reporting worldwide.

During the last 5 years, WHO has verified more than 1,100 epidemics of different diseases. The annual World Health Report said that the next influenza pandemic could affect some 1.5 billion people. The last one in 1968 killed about 1 million people worldwide.

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Even more disturbing than influenza pandemics is the possibility of bioterrorism threats in which infectious agents could be exploited by terrorists. Brucellosis, a difficult to diagnose and treat bacterial infection carried by animals and passed to humans through milk products, is considered one such threat. The University of California, San Diego, landed a $4.7 million biodefense grant from the NIH's National Institute of Allergy and Infectious Diseases to develop an early diagnostic test for brucellosis.

Diagnostic test manufacturers (see Product Update, Covering the Spread) and clinical labs are at the forefront of the battle to identify and monitor outbreaks. For example, Ibis Biosciences, Carlsbad, Calif, has received $4.2 million from the Department of Homeland Security and other government agencies to develop tests to detect and identify microbial threat agents for biodefense applications.

The CDC is increasing its biosurveillance capabilities to combat increasing concern of a naturally occurring pandemic or a bioterrorism event. BioSense (www.cdc.gov/biosense) is a national clearinghouse that receives and provides data to laboratories and other health care organizations nationwide on widespread outbreaks and catastrophic public health emergencies. While BioSense is available on a national level, it is on the state and local levels that health departments can be more effective. North Carolina and New York are leading the way in linking their hospitals to electronic databases that help track outbreaks of infectious diseases.

Clinical laboratories are the first front in identifying pathogens and evaluating their susceptibility to antibiotics. It is therefore important for labs to know whether any infectious outbreaks are developing in their regions, so they can predict which tests to have on hand. Let us not forget that laboratory workers who perform testing for infectious diseases on a daily basis are the ones who provide early warnings of emerging outbreaks. We can all be thankful for them.

Cheryl Woodruff