Sentinel laboratories are mainly involved in:

Because communication between clinical and public health laboratories is so critical in the post-2001 era, Centre for Disease Control (CDC) created an organizational structure whereby isolates and lines of communication flow freely among numbers. The Laboratory Response Network (LRN) was originally designed as a four-tier system. Clinical laboratories (Level A) were at the bottom of a triangle, sending specimens to a public health laboratory (level B) or Level C (state public health laboratory) for confirmation. Isolates were ultimately sent to CDC or United States Army Medical Research Institute for Infectious Diseases (USMRIID)-Level D, for archiving ang sophisticated molecular testing. This original system has now been changed to a three-tier system in which Level A laboratories are now called Sentinel laboratories; Level B & C laboratories are called Reference laboratories & Level D are called National laboratories. The main role of Sentinel Microbiology laboratories is to raise suspicion when a targeted agent is suspected in a human specimen. Detection of a possible bioterrorism event will depend on: A laboratory having an active microbial surveillance and monitoring program Vigilant technologists looking for a disease that does not occur naturally in a paicular geographic region (eg: Plague in New York city); is transmitted by an aerosol route of infection; is a single case of disease caused by an unusual agent (eg: Burkholderia mallei usually only seen in the far east); Good communication with infection control practitioners, infectious disease Physicians and local or regional public health laboratories. Ref: Bailey & Scott's Diagnostic Microbiology; 12th edition; Page: 954-955