1887

Abstract

Avian (H5N1) influenza continues to pose a significant threat to human health, although it remains a zoonotic infection. Sensitive and robust surveillance measures are required to detect any evidence that the virus has acquired the ability to transmit between humans and emerge as the next pandemic strain. An integral part of the pandemic planning response in the UK was the creation in 2005 of the UK National H5 Laboratory Network, capable of rapidly and accurately identifying potential human H5N1 infections in all regions of the UK, and the Republic of Ireland. This review details the challenges that designing molecular detection methods for a rapidly evolving virus present, and the strategic decisions and choices required to ensure successful establishment of a functional national laboratory network, providing round the clock testing for H5N1. Laboratory partnerships have delivered improved real-time one-step multiplex PCR methodologies to ensure streamlined testing capable of not only detecting H5 but also a differential diagnosis of seasonal influenza A/B. A range of fully validated real-time PCR H5 confirmatory assays have been developed to run in parallel with a universal first-screening assay. Regular proficiency panels together with weekly surveillance runs, intermittent on-call testing for suspect cases of avian flu in returning travellers, and several outbreaks of avian influenza outbreaks in poultry that have occurred since 2005 in the UK have fully tested the network and the current diagnostic strategies for avian influenza. The network has clearly demonstrated its capability of delivering a confirmed H5N1 diagnosis within 3–4 h of receipt of a sample, an essential prerequisite for administration of the appropriate antiviral therapy, effective clinical management, disease containment and implementation of infection control measures. A functional network is an important means of enhancing laboratory capability and building diagnostic capacity for a newly emerging pandemic of influenza, and is an essential part of pandemic preparedness.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.47336-0
2007-10-01
2024-04-20
Loading full text...

Full text loading...

/deliver/fulltext/jmm/56/10/1263.html?itemId=/content/journal/jmm/10.1099/jmm.0.47336-0&mimeType=html&fmt=ahah

References

  1. Chen W., He B., Li C., Zhang X., Wu W., Yin X., Fan B., Fan X., Wang J. 2007; Real-time RT-PCR for H5N1 avian influenza A virus detection. J Med Microbiol 56:603–607 [CrossRef]
    [Google Scholar]
  2. Coyle P. V., Ong G. M., O'Neill H. J., McCaughey C., De Ornellas D., Mitchell F., Mitchell S. J., Feeney S. A., Wyatt D. E. other authors 2004; A touchdown nucleic acid amplification protocol as an alternative to culture backup for immunofluorescence in the routine diagnosis of acute viral respiratory tract infections. BMC Microbiol 4:41 [CrossRef]
    [Google Scholar]
  3. Das A., Spackman E., Senne D., Pedersen J., Suarez D. L. 2006; Development of an internal positive control for rapid diagnosis of avian influenza virus infections by real-time reverse transcription-PCR with lyophilized reagents. J Clin Microbiol 44:3065–3073 [CrossRef]
    [Google Scholar]
  4. de Jong M. D., Simmons C. P., Thanh T. T., Hien V. M., Smith G. J., Chau T. N., Hoang D. M., Van Vinh Chau N., Khanh T. H. other authors 2006; Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia. Nat Med 12:1203–1207 [CrossRef]
    [Google Scholar]
  5. Di Trani L., Bedini B., Donatelli I., Campitelli L., Chiappini B., De Marco M. A., Delogu M., Buonavoglia C., Vaccari G. 2006; A sensitive one-step real-time PCR for detection of avian influenza viruses using a MGB probe and an internal positive control. BMC Infect Dis 6:87 [CrossRef]
    [Google Scholar]
  6. Ellis J. S., Smith J. D., Braham S., Lock M., Barlow K., Zambon M. C. 2007; Design and validation of an H5 TaqMan real-time one-step reverse transcription-PCR and confirmatory assays for detection and verification of influenza A virus H5 infections in humans. J Clin Microbiol 45:1535–1543 [CrossRef]
    [Google Scholar]
  7. Ferguson N. M., Cummings D. A., Fraser C., Cajka J. C., Cooley P. C., Burke D. J. 2006; Strategies for mitigating an influenza pandemic. Nature 442:448–452 [CrossRef]
    [Google Scholar]
  8. Gunson R. N., Collins T. C., Carman W. F. 2005; Real-time RT-PCR detection of 12 respiratory viral infections in four triplex reactions. J Clin Virol 33:341–344 [CrossRef]
    [Google Scholar]
  9. Imai M., Ninomiya A., Minekawa H., Notomi T., Ishizaki T., Tashiro M., Odagiri T. 2006; Development of H5-RT-LAMP (loop-mediated isothermal amplification) system for rapid diagnosis of H5 avian influenza virus infection. Vaccine 24:6679–6682 [CrossRef]
    [Google Scholar]
  10. Imai M., Ninomiya A., Minekawa H., Notomi T., Ishizaki T., Van Tu P., Tien N. T., Tashiro M., Odagiri T. 2007; Rapid diagnosis of H5N1 avian influenza virus infection by newly developed influenza H5 hemagglutinin gene-specific loop-mediated isothermal amplification method. J Virol Methods 141:173–180 [CrossRef]
    [Google Scholar]
  11. Moore C., Hibbitts S., Owen N., Corden S. A., Harrison G., Fox J., Gelder C., Westmoreland D. 2004; Development and evaluation of a real-time nucleic acid sequence based amplification assay for rapid detection of influenza A. J Med Virol 74:619–628 [CrossRef]
    [Google Scholar]
  12. Ng E. K., Cheng P. K., Ng A. Y., Hoang T. L., Lim W. W. 2005; Influenza A H5N1 detection. Emerg Infect Dis 11:1303–1305 [CrossRef]
    [Google Scholar]
  13. Payungporn S., Chutinimitkul S., Chaisingh A., Damrongwantanapokin S., Buranathai C., Amonsin A., Theamboonlers A., Poovorawan Y. 2006; Single step multiplex real-time RT-PCR for H5N1 influenza A virus detection. J Virol Methods 131:143–147 [CrossRef]
    [Google Scholar]
  14. Templeton K. E., Scheltinga S. A., Beersma M. F., Kroes A. C., Claas E. C. 2004; Rapid and sensitive method using multiplex real-time PCR for diagnosis of infections by influenza A and influenza B viruses, respiratory syncytial virus, and parainfluenza viruses 1, 2, 3, and 4. J Clin Microbiol 42:1564–1569 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.47336-0
Loading
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error