Outbreak preparedness and response in a globalized world: are we ready?

Background:
Recent global epidemics and pandemics have highlighted the need for adequate diagnostic capacities to respond to emerging threats. Strengthening operational capacities can lead to improved preparation; investing in emergency response infrastructure may diminish progression of outbreaks and prevent escalation.

Methods:
An email-linked survey was sent January-March-2025 to two global infectious disease surveillance networks' (GeoSentinel and TropNet) participating clinics assessing capacity for Oropouche virus (OROV) diagnostic testing. Data on testing capacity for other arboviruses was also requested.

Results:
Responses were obtained for 58 GeoSentinel/TropNet sites (58/104, 55.8%): 50% responding sites (29/ 58) had OROV diagnostic testing available at a public reference laboratory; 23 sites (40%) had capacity for OROV RNA detection; 10 sites (17%) had OROV serological testing onsite. Estimated median turn-around times from phlebotomy-molecular OROV results were 4 days onsite and 6 days at the reference laboratory. Viral culture was available onsite at 9% of sites (at the reference laboratory for 26%). Molecular diagnostics availability for other arboviruses onsite showed >50% could test for at least one other arbovirus: dengue virus (31/ 58, 53%), chikungunya virus (29/58, 50%), West Nile virus (22/58, 38%) and yellow fever virus (12/58, 21%). Onsite serologic testing for non-OROV arboviruses was available at 39/58 sites (67%).

Conclusions:
The survey identified potential weaknesses in novel pathogen preparedness with respect to diagnostic capacity for OROV testing at specialized travel medicine clinics participating in two international networks. These findings provide an opportunity to implement measures to improve communication and planning and to strengthen diagnostic infrastructure prior to future outbreaks.