with CDC’s infectious disease laboratories, which serve as a national and global diagnostic reference center for all infectious threats, including rare zoonotic viruses, drug‐resistant bacteria, and potential bioterror agents. Public health laboratory scientists also work with epidemiologists to monitor endemic diseases and measure progress in disease prevention and control; assist healthcare partners and clinical laboratories by conducting testing to facilitate treatment; and collaborate with other researchers to investigate disease pathology and progression. CDC works with the Association of Public Health Laboratories (APHL), the American Society for Microbiology (ASM), and many other partners to enhance and upgrade laboratory detection capacities. Essential in these efforts are well‐integrated and highly capable laboratory networks such as the Laboratory Response Network (LRN), a network of laboratories assembled to rapidly respond to acts of chemical or biological terrorism, emerging infectious diseases, and other public health emergencies; and PulseNet, a national and global network of public health and food regulatory agency laboratories that identifies and links foodborne disease outbreaks. As an example of these enhanced laboratory capacities, a new DNA fingerprinting technique (the Multiple‐Locus Variable‐Number Tandem Repeat Analysis) developed by PulseNet is helping public health laboratories and the USDA Food Safety Inspection Service (FSIS) to differentiate among strains of Escherichia coli O157:H7 and Salmonella and to pinpoint the source of local and multistate foodborne outbreaks. Diagnostic testing to detect and characterize infectious pathogens is an integral component of day‐to‐day responsibilities at public health and clinical laboratories and the essential means of identifying the causative agents of outbreaks. 10 | CDC ID Framework Key activities to expand laboratory detection and reporting include the following: • Developing, validating, and disseminating diagnostic innovations, e.g., - Accurate, multi-pathogen and point-of-care tests that can rapidly identify or rule out pathoge during field investigations as well as during clinical care - Rapid methods to detect, measure, and monitor antimicrobial resistance and ensure proper selection of antibiotics - New tools and assays for detecting and characterizing emerging threats, e.g., techniques for o rapid identification of potential bioterror agents o environmental sampling of microbes in water, air, and soil o genotypic surveillance of foodborne, waterborne, and enteric microbes and vaccinepreventable diseases o identification of new and reemerging threats (e.g., pathogen discovery, zoonotic and vectorborne infections) - New tools for scaling up laboratory activities during emergencies (e.g., automated, highthroughput diagnostic testing and DNA sequencing) - Tools and techniques for analyzing large amounts of protein or nucleic acid data (e.g., proteomic and genomic profiling tools along with bioinformatics analysis and information management tools) to advance pathogen identification and typing, host response, disease treatment, and vaccine development • Improving information flow among clinicians, clinical labs, public health labs, and CDC, e.g., - Implementing automatic electronic laboratory reporting of notifiable diseases from clinical laboratories to state health departments and CDC - Implementing electronic mechanisms for exchange of public health information—including laboratory orders and test results—between diagnostic laboratories (both public and private) • Conducting long-range planning to ensure continued capacity at CDC to serve as a national and global reference center for all infectious diseases • Developing strategies to help strengthen public health laboratory capacity through high-efficiency operating models and improved testing platforms and informatics capabilities • Developing new and advancing existing standards and protocols for safe and rapid transfer of patient specimens to clinical and public health laboratories. ns Priority 1C. Improve capacity for epidemiologic investigations and public health response CDC and state and local health departments are working with partners in healthcare, government, emergency response, animal health, community development, and other areas to improve capacity for epidemiologic investigations and public health response. Included in these efforts are routine epidemiologic activities such as investigations of cases, clusters, and outbreaks of known and unusual diseases, including nationally notifiable diseases that are reported to CDC by state health departments. These daily activities improve knowledge of disease risk factors and control measures and also help epidemiologists hone the skills needed during emergencies. For example, during the 2009–2010 H1N1 pandemic, state and local health authorities and their healthcare partners October 2011 | 11 strengthened existing laboratory‐based surveillance mechanisms and used their basic knowledge of influenza and respiratory disease to provide real‐time guidance about the novel influenza virus to healthcare providers and members of the public. Key activities to improve epidemiologic investigations and public health response include • Developing innovative tools for outbreak investigations—