Diagnostics to deal with new diseases
Maria Brytting at the Swedish Institute for Infectious Disease Control, SMI, will share her experiences from April 2009 when the new influenza A virus, H1N1, was first reported globally.
“That’s when we responded at SMI and thought that these are signs of a pandemic,” says Brytting, a microbiologist at SMI.
National competence important
But before the test results of the viral DNA were received on April 25 from the US, Sweden had its first suspected case of H1N1 and needed a way to establish what type of influenza it was.
“At first we could only verify that it was some type of flu and that it was not the regular seasonal flu,” says Brytting.
At this point she sat down and analyzed the Swedish sample and decided what type of targets she would use for PCR diagnosis.
“Having the possibility to establish new diagnostics on a national level is extremely important in a case like this. Waiting for CE-approved commercial tests would have delayed us until August. With our own diagnostics, we knew within a week that it was H1N1,” says Brytting, continuing:
“As soon as it was diagnosed as H1N1, we sent our recommendations for PCR targets to the labs doing this type of diagnosis in Sweden,” she says.
The infrastructure is essential
Brytting considers a functioning infrastructure essential for dealing with risks like H1N1. WHO has about 40 centers that deal with spreading information and connecting countries globally in situations like a potential pandemic. In the case of H1N1, the US sent samples of the virus to WHO, which distributed it to countries all over the world.
“It’s really a fantastic system. We also distributed the recommended PCR targets from the US, which are not the same as the ones we had identified,” Brytting says.
According to her, this variation in testing is very important, too.
She makes an analogy to a situation in Sweden a few years ago, when some strains of the Chlamydia bacterium changed the targeted part of their plasmids and half of the tests therefore showed no signs of infection.
“In such situations it is extremely important that we use different types of targets for PCR testing to double check,” she says.
