The Mississippi Public Health Laboratory is temporarily outsourcing some services to neighboring states after building repairs forced the facility to pause roughly a third of the tests it performs, including those for HIV, flu, COVID-19, whooping cough and measles.
The repairs are expected to take several weeks and include updates to the building’s HVAC and exhaust ventilation systems, Mississippi State Department of Health spokesperson Greg Flynn said in an April 14 email to Mississippi Today.
“The temporary discontinuation of certain tests was done as a precaution to ensure the safety of our lab personnel,” Flynn wrote.
On April 10, county health departments and other stakeholders were notified that the state had paused 16 of the 51 total tests the public health lab conducts.
The health department established agreements with Alabama and Tennessee on April 15 to resume testing at facilities in those states. Flynn said the agency does not expect delays in turnaround times or any impact on the number of tests performed, though he said impacts are possible.
The lab has specific operating procedures for shipping that are compliant with federal and state standards, Flynn said.
The Mississippi Public Health Laboratory, established in 1910, conducts environmental and clinical testing to assist in the prevention and control of disease and improve community health. The lab is staffed by approximately 60 employees and performs over 400,000 tests annually, according to the Health Department’s website.
The laboratory monitors outbreaks of infectious diseases including whooping cough, mumps and HIV, and tests uncommon diseases, such as novel influenza strains. It acts as a first responder for terrorism events and is the state’s only laboratory that performs rabies tests.
In 2016, the Health Department opened a new state public health lab, replacing its 1959 facility and bringing it up to national standards for handling highly infectious diseases. The new lab is twice as big as the old laboratory and took seven years to complete.
The $36 million facility was praised for reducing costs by eliminating the need to send tests to outside laboratories.
A testing pause is not uncommon, but still a cause for concern
Flynn said the pause in testing is “not an uncommon situation,” noting that public health labs in the consortium frequently rely on partner agencies for assistance.
Nearly every state is a member of a regional public health laboratory consortium. Mississippi is a member of Southeast ColLABorators, a group formed in 2015, according to the Association of Public Health Laboratories, a national association that represents state and local laboratories.
Regional consortiums exist to step in and ensure that there are no disruptions in testing, said Kelly Wroblewski, the association’s senior director for infectious diseases. She pointed to building repairs and natural disasters as examples of reasons why public health laboratories might outsource services.
Public health laboratories emerged in the U.S. in the late 1800s to curb infectious diseases, growing over time to take on food safety and water monitoring to protect communities from environmental risks. State health laboratories have become more coordinated since the early 2000s, when APHL formally defined the core functions of public health labs to ensure consistency across state lines. Events like the 2001 anthrax attacks necessitated cooperation between public health labs to respond to bioterrorism threats.
State public health labs also perform unique functions, like providing timely testing for rabies and serving patient populations that are uninsured or underinsured through county health departments, Wroblewski said.
Flynn said the health department does not expect the pause in testing to impact the state’s ability to monitor the prevalence and trends of diseases and outbreaks.
But even short pauses in testing can be cause for concern because state public health laboratories are designed to respond to outbreaks quickly when they occur, said Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Center at Brown University School of Public Health.
“It’s like turning off the surveillance cameras,” she said. “You’re gambling that no one’s going to break in.”
Nuzzo added that delays in identifying disease outbreaks can lead to higher costs for states in the long term.
Mississippi’s public health laboratory performs surveillance testing and clinical diagnostic testing for county health departments.
Wroblewski said pauses in diagnostic testing can be critical because they delay identifying illnesses in patients.
Testing pause coincides with rising rates of infectious diseases
Mississippi’s brief pause in testing comes as the state and the nation face rising rates of some infectious diseases.
Mississippi has some of the nation’s highest rates of sexually transmitted infections. In September, Mississippi reported its first whooping cough death in 13 years as the number of cases rose to the highest figure in a decade. In March, the state Health Department announced its first pediatric flu death of the season.
No measles cases have yet been reported in Mississippi as of April 24, though 33 other states have reported over 1,700 new infections and 19 new outbreaks this year, according to the Centers for Disease Prevention and Control. Louisiana reported its first measles case of the year on Wednesday.
Measles was declared eliminated in the U.S. in 2000 as a result of the measles vaccination. But outbreaks of the highly contagious viral respiratory illness have provoked concern that the nation could lose its elimination status for the illness. Childhood vaccination rates have declined in Mississippi since a federal judge ruled in 2023 that parents can opt out of vaccinating their children for school on account of religious beliefs, leaving more residents vulnerable to preventable diseases.
Tuberculosis cases across the U.S. have also risen in recent years, reaching their highest level in a decade in 2024, the most recent year for which federal data is available.
Funding cuts impacted Mississippi’s public health lab last year when it discontinued free STI testing following the discontinuation of a federal program to bolster infrastructure to support COVID-19 and STI prevention efforts.
Nuzzo said she worries that further cuts could jeopardize effective public health monitoring systems, like wastewater testing. This surveillance tool played a critical role during the COVID-19 pandemic but has also been used as an early warning for outbreaks of measles, flu and other respiratory illnesses.
“The future of these programs is in the balance, because they were supported from leftover COVID funding, and there is no indication that they will be sustained,” Nuzzo said.
‘It all works together’
Commercial and state level labs have also picked up the slack in recent weeks after the CDC paused some lab tests, including testing for rabies, monkeypox and some other infectious disease, reportedly as a part of a routine review.
Nuzzo said the public health system works best through a three-pronged approach when clinical labs serve patients in clinical care contexts, state public health labs perform surveillance testing and state labs send a portion of their specimens to the CDC for further testing.
“It all works together to have a general sense of what is happening in the country,” she said.
On March 19, the state Health Department entered into a contract with APHL to provide an external assessment of the public health lab to evaluate its business operations, staffing levels, equipment, test menus and funding, according to state contract records.
Labs may request a review from APHL when they are looking for recommendations for running a lab more efficiently or improving facilities, said Wroblewski.
Mississippi’s public health lab also recently outsourced its public water testing to several private companies. On April 8, State Health Officer Dr. Dan Edney said the Health Department is outsourcing the testing to achieve faster turnaround times and meet federally required timelines. He said the laboratory also eliminated eight positions in the department as a result of these changes.
“Contracting that out saves the state a lot of money and then keeps us in compliance with the EPA,” Edney said.
Flynn said contracting out these services to two companies, Indiana-based Eurofins Eaton Analytical and Minnesota-based Pace Analytical, will save the health department close to $2 million a year.
According to Flynn, the health department is outsourcing the following tests:
