RFK Jr.'s cuts to CDC eliminate labs tracking STIs, hepatitis outbreaks
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'CDC cannot focus on infectious disease prevention and response without all CDC laboratories being intact and fully supported,' wrote Scott Becker, chief executive of the Association of Public Health Laboratories, which represents state and local public health labs across the U.S.
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The group has written a letter to Health Secretary Robert F. Kennedy Jr. asking for the personnel to be reinstated. 'Their loss eliminated critical national testing services that do not exist anywhere else within the HHS agencies,' the letter said.
'In essence, we're flying blind,' Becker said in an interview.
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An HHS spokesperson did not respond to a request for comment.
The increase in hepatitis C infections has been 'stupendous in the past 20 to 25 years,' said Judith Feinberg, a professor of medicine and infectious diseases at West Virginia University.
'The CDC lab was capable of showing the genetic linkage between isolates of virus … and that helps you control it from public health policy. It helps you understand how and where disease is spreading, how the virus is evolving,' Feinberg said.
Though hepatitis can be caused by heavy alcohol use and some medications, it can also be sparked by a virus that causes liver inflammation, jaundice, fever and other symptoms. Tens of thousands of new cases of viral hepatitis occur every year in the U.S., according to the CDC. Viral hepatitis kills thousands of Americans every year and is a leading cause of liver cancer. The three most common viruses that cause hepatitis are hepatitis A, hepatitis B and hepatitis C, and depending on the type can be spread through close contact, consuming contaminated food, sharing needles or contact with infected blood.
In recent years, hepatitis C outbreaks have been linked to pain clinics, dialysis facilities, outpatient surgery clinics and prisons, according to CDC data. Other labs can provide testing to confirm whether someone has hepatitis, but they cannot perform the genetic testing to identify whether someone's infection is part of a transmission cluster, lab experts said.
The CDC's viral hepatitis lab had already identified nine infected patients in a Florida outbreak and had begun receiving blood samples from additional patients to piece together how the outbreak spread when scientists were fired, according to internal CDC documents and two lab scientists who spoke on the condition of anonymity for fear of retribution. The lab would have used its advanced technology to identify whether additional patients carried the same strain of the virus, which would mean they were part of the same transmission cluster, the employee said.
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Last week, the CDC sent an email to state and local health departments and other partners saying it was no longer providing viral-hepatitis-related laboratory services, according to a copy obtained by The Washington Post. 'Specimen submissions will no longer be accepted,' the email said.
It's unclear how states will handle future cases. A spokesperson for the Florida Department of Health did not respond to request for comment.
The CDC's 77 staff members who worked on preventing sexually transmitted diseases were also fired, including 49 staff who were embedded in state health departments helping with STI outbreak investigations, and all 28 scientists in the lab that provides surveillance for chlamydia, gonorrhea and syphilis, and other sexually transmitted infections in the U.S., according to employees and outside lab experts.
'They are one of three laboratories in the world and the only in the U.S. that performs extensive antimicrobial susceptibility testing for gonorrhea,' said Kelly Wroblewski, director of infectious-disease programs at the Association of Public Health Laboratories. That's especially important for 'super gonorrhea' that has been able to outsmart all five common drugs used to treat it, she said.
The information about which antibiotics are no longer working against the disease is then used to update recommendations for doctors treating STIs, she said. The CDC relies on this information to provide the most up-to-date recommendations, she said.
More than 2 million sexually transmitted infections were diagnosed and reported in the U.S. in 2023, the latest data available, including more than 600,000 cases of gonorrhea, according to the CDC. While there are signs that the gonorrhea and syphilis epidemics are slowing, chlamydia, gonorrhea and syphilis infections are 90 percent higher than 20 years ago, data shows.
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Untreated gonorrhea in women can cause serious and permanent health problems. It can cause pelvic inflammatory disease, which can lead to scarring, ectopic pregnancies and infertility.
The lab's work was critical for clinicians. Last week, the CDC notified state and local health departments that it was no longer taking any specimens.
'We have seen highly resistant gonorrhea become a problem in other countries,' said Colleen Kelley, a professor of medicine at Emory University who treats patients with HIV and sexually transmitted infections.
Without the lab, Kelley said, 'no one will tell us if we are seeing more cases of this, and no one will be there to sound the alarm bells.'
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