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Military Health System

Innovative mobile technologies impact DOD health surveillance

Image of Medical personnel using a syringe to inject a fluid into a test tube. Dr. Peter Larson loads an Oxford Nanopore MinION sequencer in support of COVID-19 sequencing assay development at the U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland. (Photo by John Braun Jr., USAMRIID.)

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The COVID-19 pandemic has highlighted the importance of collaboration and information-sharing forums for those working in the health field.

An example of one such forum is the Armed Forces Health Surveillance Division (AFHSD), Global Emerging Infections Surveillance (GEIS) Branch’s Next Generation Sequencing and Bioinformatics Consortium (NGSBC) and their mobile next generation sequencing (NGS) working group.

The NGSBC was created in 2017, bringing together DOD partners for coordination and improvement of pathogen genetic sequencing and analysis efforts. Subject matter experts from the Naval Medical Research Center, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Walter Reed Army Institute of Research, U.S. Air Force School of Aerospace Medicine, and the Naval Health Research Center assist the overseas service laboratories and other partners with protocol development, sample processing, and sequence data analysis.

As genetic sequencing capabilities have evolved and grown, so has the desire to have mobile platforms that could shorten the time from sample collection to final results reporting. Therefore GEIS and partners are exploring the use of mobile NGS technology in the laboratory, the field, and austere environments. To support these efforts, the mobile NGS working group was derived from the NGSBC in 2019 and focuses on increasing knowledge and use of mobile NGS technologies.

“This is a much needed working group to connect portable sequencing platform users across the DOD,” said Dr. Cory Bernhards, a member of the group who uses mobile NGS methods. “It will boost efficiency and foster collaboration among the different laboratories.”

The mobile NGS forum supports communication and collaboration between DOD and other government laboratories by creating a platform for partners to share protocols and provide training sessions. Participants meet regularly to discuss issues like how to address unique matters related to the way work is conducted in the field and not in a traditional lab - such as how to keep reagents and supplies at safe temperatures and how to perform remote complex computer-based data analysis. They also present use cases of pathogenic viruses including SARS-CoV-2 sequencing results from the Oxford Nanopore MinION, a type of mobile NGS technology.

“This working group will greatly accelerate progress toward fielding sequencing capabilities to serve and protect the warfighter,” said Bernhards.

The working group currently has more than 100 participants from 28 different organizations, including interagency partners from Centers for Disease Control and Prevention and Food and Drug Administration.

GEIS will continue to support partners in implementing capabilities for mobile NGS platforms, to set goals for using the technology, and to provide resources to address challenges. Navy Capt. Guillermo Pimentel, chief of GEIS, expressed his optimism for this mobile lab capability. 

"Having a mobile sequencing capability could provide an advantage in the early detection of an infectious disease that could negatively impact our deployed forces." Pimentel also highlighted the potential use of the technology, “The platform could also be used to determine if insects collected as part of regular vector surveillance carry viruses that could cause diseases in an operational setting."

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