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The closure of the Centers for Disease Control and Prevention (CDC)’s Division of Viral Hepatitis in the wake of the administration’s restructuring of the Department of Health and Human Services leaves clinicians and public officials with no resources to process specimens and track outbreaks, according to several experts. 

The CDC’s website for the National Center for HIV, viral hepatitis, sexually transmitted disease, and tuberculosis exists, but is dated February 2, 2024. As reported by STAT, CDC employees working in surveillance and hepatitis control were retained, but all full-time staffers of the lab were cut. 

“The CDC’s viral hepatitis lab is crucial to investigating viral hepatitis outbreaks and pinpointing the source of outbreaks,” said Shirin Mazumder, MD, an infectious diseases specialist in Memphis, Tennessee, in an interview.

“With the lab now dismantled, an outbreak situation cannot be properly investigated or contained, which means that infections can go unchecked and continue to spread. This has the potential to significantly impact the general population,” said Mazumder. 

The CDC’s lab has played a role in several important areas of viral hepatitis research including contributing to hepatitis vaccine development and helping to identify new strains of viral hepatitis, Mazumder told Medscape Medical News. “The closure of this lab is a loss to public health advances, as well as viral hepatitis detection and prevention,” she added.

Despite its public health value, the lack of profitability in the work done by the CDC’s viral hepatitis lab makes it less likely that other labs and agencies will pick up the slack, said Mazumder. “The lab conducts genomic analysis and tracing using a special type of program called Global Hepatitis Outbreak and Surveillance Technology (GHOST), which other states can access remotely to upload samples,” she noted. 

Individuals living with chronic hepatitis B will be affected by the cuts and closures as well, with reduced access to essential services for prevention, testing, and treatment, said Chari A. Cohen, DrPH, MPH, president of the nonprofit Hepatitis B Foundation, in a statement.

“Confusion, fear, and poor preparedness will be the consequence of the changes that have been so rapidly imposed, putting us all at risk,” said Cohen.

Safety Concerns With Sudden Closures

As reported by CBS News, CDC employees have said that the abrupt closure of the division did not allow for proper shutdown of labs, and that specimens were still being delivered for testing.

“Hepatitis B and C can pose a hazard due to the potential exposure that can occur from blood products and other bodily fluids,” Mazumder told Medscape Medical News. “Care and specific precautions must be taken when handling these samples,” she emphasized.

If the laboratory capacity of the CDC’s Division of Viral Hepatitis is closed or limited, “it would impair the sophistication and thoroughness with which some outbreak investigations could be conducted,” said William Schaffner, MD, professor of infectious diseases at Vanderbilt University Medical Center, Nashville, Tennessee, in an interview.

Simple diagnosis of hepatitis A, B, and C occurs in every hospital in the country, and state and local laboratories provide a great deal of information, Schaffner said. However, “there are times when you would like the more sophisticated molecular fingerprinting to make more precise conclusions and bring an outbreak to a close,” he said.

For example, local public health departments working on outbreaks that they suspect might be related would need a more sophisticated lab for molecular testing to determine whether cases are part of a single outbreak. Without advanced testing, it might be harder to tie cases together epidemiologically, he said. If epidemiologists remain in place for hepatitis work at the CDC but lack access to the laboratory, their capacity to make precise conclusions will be limited, and there will be less certainty that an outbreak has been brought to a close, Schaffner explained.

Regardless of the status of the CDC’s hepatitis lab, clinicians should continue to be vigilant to signs of hepatitis and immediately contact their local and state health department, Schaffner told Medscape Medical News. “It is often the alert and informed clinician who reports to local health departments that can get involved and conduct community investigations to prevent further spread,” he emphasized.

Mazumder and Schaffner had no financial conflicts to disclose.