Molecular detection and typing of influenza viruses: are we ready for an influenza pandemic?
BACKGROUND
We cannot predict when an influenza pandemic will occur or which variant of the virus will cause it. Little information is currently available on the ability of laboratories to detect and subtype influenza viruses including the avian influenza viruses.


OBJECTIVE
To assess the ability of laboratories to detect and subtype influenza viruses.


METHODS
In 2006 QCMD distributed an External Quality Assessment panel for the molecular detection and haemagglutinin subtyping of influenza viruses to 87 laboratories in 34 countries Worldwide, which were given 6 weeks to return results. These data were analysed to assess laboratory performance.


RESULTS
Influenza virus positive panel samples were correctly identified by 35-98% of laboratories. The correct haemagglutinin subtype was reported by 32-87% of laboratories that detected the virus: incorrect subtyping results included the reporting of avian influenza viruses as human strains and vice versa. Twelve laboratories reported false positives with some avian influenza viruses reported.


CONCLUSIONS
These data suggest that improvements are needed in the molecular detection of influenza viruses and influenza virus A haemagglutinin subtyping. Only rapid and accurate identification of circulating pandemic influenza virus will ensure that the maximum time is available for intervention.
Mackay
W G
WG
The Neutral Office, Quality Control for Molecular Diagnostics (QCMD), Block 4, Kelvin Campus, West of Scotland Science Park, Glasgow G20 0SP, Scotland, UK. williammackay@qcmd.org
van Loon
A M
AM
Niedrig
M
M
Meijer
A
A
Lina
B
B
Niesters
H G M
HG
D000818:Animals; D004196:Disease Outbreaks; D005189:False Positive Reactions; D014943:Global Health; D019267:Hemagglutinin Glycoproteins, Influenza Virus / Q000145:classification / Q000235:genetics; D006801:Humans; D053122:Influenza A Virus, H3N2 Subtype / Q000145:classification / Q000235:genetics; D053124:Influenza A Virus, H5N1 Subtype / Q000145:classification / Q000235:genetics; D009980:Influenza A virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D009981:Influenza B virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D007753:Laboratories / Q000592:standards*; D011786:Quality Control; D012015:Reference Standards; D019562:Viral Load
D019267:Hemagglutinin Glycoproteins, Influenza Virus; C109963:hemagglutinin, avian influenza A virus; C483468:hemagglutinin, human influenza A virus