How Honduras succeeded in performing genomic sequencing for the first time

Genomic surveillance provides information on the evolution of viruses and other pathogens as they change over time. Knowing the changes or mutations that can modify their transmissibility and severity can guide public health measures. During the pandemic, it was a key strategy for monitoring the behavior of SARS-CoV-2 and is now being integrated into the surveillance of other pathogens.

Karla Romero, another microbiologist in charge of genomic surveillance, acknowledges that the implementation of sequencing in Honduras has been "a great challenge" that required a lot of "sacrifice and commitment," both inside and outside the laboratory.

Karla and Soany lacked experience or knowledge in analyzing large sequences of genetic material (DNA), a complex process that requires technology, a particular work area and workflows, preparation of gene libraries, and a special sequencing process.

The sequencing area had to be designed from scratch. In 2022, authorities selected and prepared a space within the National Virology Laboratory. With PAHO support, a sequencer, supplies, reagents, and laboratory furniture were acquired, and Soany and Karla traveled to the Gorgas Memorial Institute in Panama for bioinformatics and genomic sequencing training.

"All of this has the objective of creating genomic surveillance capacities for SARS-CoV-2 and other pathogens of public health importance in the country," said Gabriela Rodriguez Segura, coordinator of PAHO's genomic sequencing capacity building project in Honduras. Before these capacities were created at the local level, samples used to determine the variants circulating in the country were sent to the reference laboratories of the Regional Genomic Surveillance Network of COVID-19 (COVIGEN) created by PAHO to support countries without the capacity to carry out sequencing in their territory.

In March 2023, their efforts paid off and excitement gripped the National Virology Laboratory when,after several attempts, the first SARS-CoV-2 sequencing in the country was performed successfully. "We couldn't believe it," says Soany. "We felt very happy because it was a great challenge and the result made us feel accomplished."

On March 21, 2023, results were obtained, and it was the first time that the Omicron variant XBB sub-lineage was detected in the country and by health professionals in Honduras. For Karla, the key was "not to give up in the face of the greatest challenge."

"It is a milestone for the country's public health that genomic sequencing is being carried out," says Dr. Mitzi Castro, head of the National Health Surveillance Laboratory of Honduras. "It is a historic moment because this is the starting point for future genomic surveillance of other pathogens of health interest," she added. 

According to Dr. Castro, the country now has state-of-the-art technology. "The laboratory is at the forefront, and that is a success and a source of pride, for which we thank all those who have done their bit to ensure that Honduras is not left behind."

PAHO has been strengthening or building the sequencing capacities of countries in the region since 2020 when it created the COVIGEN network. In addition to Honduras, public health laboratories in Bahamas, Barbados, Guatemala, and Haiti, among others, have also begun genomic sequencing for the first time between 2021 and 2022. The Pan American Health Organization continues to work with countries in the region to expand surveillance beyond COVID-19 to ensure timely detection and characterization of agents that may emerge in the region.