The CDC has halted testing for several diseases—including rabies, poxviruses, certain parasites, and lymphocytic choriomeningitis—leaving state and local laboratories to seek alternative testing pathways in the interim. The pause is expected to last at least a few weeks, though some experts predict a longer timeline before full services resume.
Testing conducted by the CDC plays a critical role in national disease surveillance, particularly for smaller or resource-limited public health labs that rely on federal support for complex or uncommon diagnostics. According to an article from CIDRAP News, without that capacity, experts warn, there could be delays in identifying outbreaks or tracking disease spread.
“They’ve been very transparent about this all along,” Becker said, noting that the CDC’s testing portfolio is “enormous” and requires periodic review. (Photo credit: APHL)
“Right now, it is not clear that this level of coordination is in place, and that uncertainty is concerning,” she said.
State and Commercial Labs Step In as Capacity Strains Highlight Need for Systemwide Resilience
In the meantime, larger state and commercial laboratories are stepping in to fill the gap. Facilities such as the Wadsworth Center report they have significant but limited capacity to absorb additional testing demand.
Further, CIDRAP News reported that public health officials are cautioning that even temporary disruptions could impact early disease detection. “A strong public health system has redundancy,” said Ewa King, PhD, chief program officer at APHL, noting that labs are accustomed to sharing resources across jurisdictions.
For clinical laboratory professionals, the CDC’s temporary testing pause is a reminder of the essential role labs play in sustaining a resilient public health system. As demand shifts to state, local, and commercial laboratories, the ability to maintain turnaround times, ensure quality, and coordinate across jurisdictions becomes even more critical. While redundancy within the laboratory network helps absorb short-term disruptions, the situation underscores the importance of continued investment in workforce capacity, infrastructure, and inter-laboratory collaboration, areas that many clinical labs currently struggle with. In an environment where early detection drives effective response, clinical labs remain at the center of protecting population health.
A top public hospital CEO says AI could soon take over radiology functions to cut costs—raising similar automation questions for clinical labs—though critics warn the technology is not ready to replace physicians.
The CEO of NYC Health + Hospitals says his system is prepared to begin replacing radiologists with artificial intelligence (AI) in certain use cases, once regulatory barriers are addressed. From a clinical lab professional perspective, health systems are actively evaluating where AI can reduce reliance on highly trained specialists while maintaining diagnostic throughput.
“We could replace a great deal of radiologists with AI at this moment, if we are ready to do the regulatory challenge,” Katz said.
AI as a Cost and Workflow Strategy
Katz noted that AI could expand access to screening—particularly in breast cancer—while lowering operational costs. One proposed model would shift radiologists into a secondary review role, validating only abnormal findings flagged by AI.
For clinical laboratories, this mirrors ongoing discussions around digital pathology, AI-assisted test interpretation, and automated workflows in areas such as hematology, microbiology, and molecular diagnostics. If imaging adopts a “AI-first, specialist-second” model, similar expectations could follow in the lab.
This approach could deliver what Katz described as “major savings,” particularly for large systems facing staffing shortages and increasing test volumes.
“For women who aren’t considered high risk, if the test comes back negative, it’s wrong only about 3 times out of 10,000,” Lubarsky said, adding that the technology is “actually better than human beings.” (Photo credit: Westchester Medical Center Health Network)
Katz also questioned whether regulations should evolve to allow AI to interpret imaging independently—potentially establishing a precedent that could influence how regulators approach AI in laboratory medicine.
Why Clinical Labs Should Pay Attention
While the discussion centers on radiology, the underlying drivers—cost containment, workforce shortages, and demand for faster turnaround times—are identical pressures facing clinical laboratories.
If regulators permit AI to operate with reduced physician oversight in imaging, labs could see accelerated adoption of AI-driven decision support, automated result interpretation, and even reduced hands-on review in certain testing workflows.
At the same time, the debate highlights a key risk of balancing efficiency gains with diagnostic accuracy and patient safety.
Pushback Raises Safety Concerns
Not all healthcare professionals agree with the direction. Some radiologists warn that current AI tools are not ready for independent clinical use.
“Undeniable proof that confidently uninformed hospital administrators are a danger to patients: easily duped by AI companies that are nowhere near capable of providing patient care,” said Mohammed Suhail, MD, of North Coast Imaging.
“Any attempt to implement AI-only reads would immediately result in patient harm and death, and only someone with zero understanding of radiology would say something so naive.”
The debate signals what may be ahead for the broader diagnostics industry. As health systems test AI-driven models in radiology, clinical laboratories may soon face similar expectations to leverage automation for cost savings—while defending the continued role of expert oversight in ensuring quality and patient safety.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
New research shows a single toxic exposure during pregnancy may drive disease risk across generations, highlighting emerging opportunities for clinical labs to leverage epigenetic biomarkers for earlier, preventative diagnostics.
A new study from Washington State University suggests that a single exposure to a toxic fungicide during pregnancy may influence disease risk for up to 20 generations, with implications for how clinical laboratories understand chronic disease and prevention strategies.
Epigenetic Inheritance Expands the Diagnostic Timeline
The study found that exposure to vinclozolin—a fungicide commonly used in agriculture—triggered disease patterns in rats that persisted for 20 generations. Notably, disease incidence not only continued but worsened in later generations, with severe reproductive complications emerging.
“This study really does say that this is not going to go away,” Skinner said. “We need to do something about it. We can use epigenetics to move us away from reactionary medicine and toward preventative medicine.” (Photo credit: Washington State University)
For clinical laboratories, these findings show a growing shift toward understanding disease not just as an immediate or genetic condition, but as one influenced by ancestral environmental exposures.
Germline Changes Drive Long-Term Risk
Unlike traditional toxicology models, the study highlights how disease risk is transmitted through epigenetic changes in germline cells—sperm and eggs—rather than direct exposure alone.
“Essentially, when a gestating female is exposed, the fetus is exposed,” Skinner explained. “And then the germline inside the fetus is also exposed… Once it’s programmed in the germline, it’s as stable as a genetic mutation.”
This mechanism suggests that clinical labs may need to consider multi-generational risk factors when interpreting biomarkers or assessing patient risk profiles.
Disease Burden Intensifies Over Generations
While disease prevalence remained relatively stable across early generations, researchers observed a sharp increase in severity beginning around the 15th generation.
“By the 16th, 17th, 18th generations, disease became very prominent and we started to see abnormalities during the birth process,” Skinner noted. “Either the mother would die, or all the pups would die, so it was a really lethal sort of pathology.”
These findings suggest that long-term population health trends—such as rising chronic disease rates—may have roots in historical environmental exposures.
Implications for Clinical Laboratories
The research aligns with broader epidemiological trends showing increased rates of chronic diseases, including cancer and cardiovascular conditions. According to the CDC, more than three-quarters of Americans now live with at least one chronic disease.
For laboratories, the study underscores the potential value of epigenetic biomarkers in predicting disease susceptibility well before clinical symptoms appear.
Moving Toward Preventative Diagnostics
As clinical laboratories continue to expand their role in precision medicine, epigenetic testing may offer a pathway to earlier intervention and improved patient outcomes.
By identifying individuals at elevated risk decades in advance, labs could support a shift toward preventative care models—helping clinicians intervene before disease onset rather than reacting after diagnosis.
For lab leaders and pathologists, the study highlights that diagnostics may soon extend beyond the individual patient to include inherited environmental risk factors spanning generations.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
Walk-in lab testing in West Virginia is giving patients faster, more affordable access to diagnostics—while pushing clinical labs to adapt to a more consumer-driven care model.
Across the clinical laboratory industry, the shift toward consumer-directed healthcare continues to gain momentum. A recent report by the Charleston Gazette-Mail highlights a growing trend in West Virginia of walk-in laboratory services that allow patients to bypass traditional physician referrals for routine diagnostic testing.
For pathologists and clinical lab professionals, this shift represents a significant evolution in the traditional diagnostic workflow. Facilities like Any Lab Test Now and local hospital-affiliated outreach centers are increasingly offering direct-to-consumer (DTC) options, allowing individuals to purchase tests such as lipid panels, glucose levels, DNA, and toxicology screens.
Key Drivers of Walk-In Testing
The article identifies several factors pushing patients toward walk-in labs:
Cost transparency: Many patients with high-deductible health plans are choosing walk-in labs that offer transparent, upfront pricing, often avoiding the “sticker shock” of traditional hospital billing.
Convenience and speed: The ability to walk in without an appointment and receive results via secure online portals—often within 24 to 48 hours—appeals to the modern healthcare consumer.
Proactive health management: There is a growing demographic of proactive patients who wish to monitor chronic conditions or wellness markers more frequently than their annual, insurance-covered physical allows.
“This gives [patients] an opportunity to manage their own health,” said Matt Brooks, director of clinical laboratory services at Marshall Health Network based in Huntington, W.V. “And it gives patients the opportunity to pay for the test without having to go through their insurance.” (Photo credit: Marshall Health Network).
The Changing Role of the Provider
While the convenience is clear, the trend raises questions regarding the interpretation of results. Patients have access to more data, yet they still require professional guidance to put that data into clinical context.
Most walk-in models encourage patients to share their results with their primary care physicians, but the “patient-as-the-customer” model places the initial responsibility for action squarely on the individual.
Implications for Clinical Labs
For traditional clinical laboratories, the growth of walk-in testing in regions like West Virginia serves as a signal to adapt. As patients become more accustomed to retail-style healthcare experiences, laboratories may need to invest more heavily in user-friendly digital interfaces and transparent pricing structures to remain competitive.
This trend also underscores a broader national movement. As more states relax regulations regarding DTC testing, the laboratory’s role is shifting from a behind-the-scenes diagnostic provider to a front-facing participant in the patient’s healthcare.
WHO introduces faster, more accessible TB testing strategies while CDC maintains a targeted, risk-based approach in the United States.
The World Health Organization (WHO) has issued new recommendations aimed at improving access to faster, more efficient tuberculosis (TB) diagnostics by introducing near point-of-care molecular testing, alternative sample collection methods, and pooled testing strategies, according to a news release.
For the first time, WHO is recommending a new class of near point-of-care nucleic acid amplification tests (NPOC-NAATs) that can be deployed in decentralized settings such as primary care clinics and community health centers. These systems are designed to deliver faster results at lower cost compared to traditional laboratory-based molecular platforms, potentially shifting more TB testing closer to the patient.
Clinical laboratory scientists should note that the WHO’s guidelines diverge noticeably from those of the Centers for Disease Control and Prevention (CDC).
The updated guidance also endorses tongue swabs as an alternative specimen type for TB detection, particularly for patients unable to produce sputum. In parallel, WHO recommends sputum pooling as a strategy to improve efficiency and reduce costs, allowing laboratories to increase throughput while conserving reagents in resource-constrained environments.
“These new WHO recommendations mark a major step forward in making TB testing faster and more accessible,” said Tereza Kasaeva, director of WHO’s Department for HIV, TB, Hepatitis & STIs. “WHO urges countries and partners to work together to roll out these guidelines to close persistent diagnostic gaps and ensure that everyone with TB can be diagnosed early and start life-saving treatment without delay.” (Photo credit: WHO)
The recommendations arrive as global diagnostic gaps persist despite international commitments to expand access to rapid molecular testing. Many patients still experience delays due to reliance on sputum samples, centralized laboratory infrastructure, and the high cost of testing platforms.
New WHO Recommendations Emphasize Access and Efficiency
WHO’s updated Module 3: Diagnosis guidelines, expected later this year, reflect a broader shift toward decentralization and scalability in TB diagnostics.
By enabling testing at peripheral healthcare levels, the new NPOC-NAAT systems could reduce turnaround times and expand access in underserved regions. Tongue swabs further simplify sample collection, while pooling strategies offer laboratories a practical way to stretch limited resources without sacrificing diagnostic reach.
Supporting materials, including an operational handbook and implementation toolkit, will guide laboratories and national TB programs through adoption, training, and workflow integration.
CDC Maintains Targeted Testing Approach in the US
In contrast to WHO’s global push for expanded access, the CDC continues to emphasize a targeted testing strategy for tuberculosis in the United States, focusing on high-risk individuals rather than universal screening.
TB case counts and rates have been increasing since 2021, the CDC noted in late 2025. The US saw a 7.9% increase in case count and a 6.9% increase in rate in 2024 as compared to a year earlier. In 2024, there were 10,388 TB cases in the US with a corresponding incidence rate of 3.1 per 100,000 population.
Two Types of TB Infection Tests
The CDC recognizes two primary methods to detect TB infection, though neither distinguishes between latent infection and active disease:
TB blood tests: Preferred for most individuals, particularly those vaccinated with Bacille Calmette-Guérin (BCG). (BCG is primarily used to prevent severe childhood TB particularly in high-prevalence countries. BCG is generally not recommended in the US.)
TB skin test: Still used in certain cases, especially for children under age five, and for baseline testing scenarios requiring a two-step approach.
Five Components of a Full Diagnostic Evaluation
If a patient tests positive or presents symptoms such as chronic cough, night sweats, or weight loss, the CDC recommends a comprehensive evaluation that includes:
Medical history and risk assessment
Physical examination
Chest X-ray
Bacteriologic testing using sputum samples (typically three), including:
NAAT for rapid detection
Sputum smear microscopy
Culture
Drug susceptibility testing to guide treatment decisions
Updated Guidance for Healthcare Personnel
Recent CDC guidance, developed with the National Tuberculosis Controllers Association, reflects a shift in screening practices for healthcare workers:
Baseline TB testing is required upon hire
Routine annual testing is no longer recommended for most healthcare workers
Post-exposure testing is advised immediately and again eight to 10 weeks later if initial results are negative
For 2026, the CDC emphasizes several important nuances for clinicians and laboratories interpreting TB test results. Blood-based interferon-gamma release assays (IGRAs) are strongly preferred for individuals who have received the BCG vaccine, as they are less likely to produce false-positive results compared to skin tests. In addition, for individuals considered low risk for TB, a positive result should be confirmed with a second test—ideally using a different method—before treatment is initiated, helping to avoid unnecessary therapy and ensure diagnostic accuracy.
Implications for Clinical Laboratories
Together, WHO and CDC guidance illustrate a divergence in strategy shaped by global versus domestic needs. WHO’s recommendations prioritize expanded access, decentralization, and cost efficiency—particularly in high-burden or resource-limited settings—while CDC guidance reflects a more targeted, risk-based approach within a lower-incidence environment.
For clinical laboratories, the evolving landscape signals both opportunity and complexity: Adoption of decentralized molecular platforms, validation of alternative specimen types, and optimization of high-throughput workflows such as pooling may become increasingly important as TB diagnostic strategies continue to evolve.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
