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03 Jul 2017

WHO workshop builds capacity to enhance Asia Pacific influenza surveillance

A major function of WHO National Influenza Centres (NICs) around the world is to generate virus isolates from clinical specimens. Virus isolates are obtained by introducing clinical specimens into mammalian cell culture to amplify the number of infectious virus particles.

This is a critical step to generate sufficient material for identification and characterisation of circulating influenza viruses – which ultimately determine the composition of each season’s flu vaccine. But in recent years, isolating and characterising some subtypes has become challenging. This prompted the WHO Collaborating Centre for Reference and Research on Influenza (the Centre) to develop initiatives to support and enhance the capabilities of NICs in the Asia-Pacific Region to generate and analyse viral isolates.

Testing the capacity to isolate and analyse influenza viruses

In late 2016, the Centre developed and organised an External Quality Assessment (EQA) program with the WHO Regional Offices for the Western Pacific (WPRO) and South-East Asia  (SEARO) to test the capacity of NICs in these regions to isolate and analyse influenza viruses in cell culture. A panel of 16 test samples prepared at the Centre was distributed to 14 NIC laboratories in the Western Pacific Region (WPR) and 7 NIC laboratories in the South-East Asia Region (SEAR). These labs attempted to isolate influenza virus from the test samples, prior to identifying the type and subtype of any virus isolated. Participating laboratories then sent their results back to the Centre for assessment. This programme was coordinated by Dr Patrick Reading, the Educator at the WHO CC for Influenza in Melbourne.

L-R: Carole Manaute (New Caledonia), Malet Aban (Doherty Institute), Jonjee Calaor Morin (Philippines)
L-R: Carole Manaute (New Caledonia), Malet Aban (Doherty Institute), Jonjee Calaor Morin (Philippines)

 “The EQA highlighted the diversity in techniques used by different laboratories, as well as identifying laboratories that had issues with particular techniques or the overall sensitivity of virus isolation.” Patrick said.

Following the EQA, the Centre organised and hosted a week-long workshop on cell culture and virus isolation in May 2017, held at the Doherty Institute. It brought together 17 scientists from NICs in different countries in the WPR. Patrick and staff from the Centre in Melbourne, as well as Dr Kazuya Nakamura (WHO CC for Influenza in Japan) and Dr Frank Konings (WHO/WPRO, Philippines) presented lectures and led laboratory demonstrations and practical sessions in techniques relevant to cell culture and isolation of influenza, as well as other respiratory viruses.

“It was a great opportunity to utilise the Practical Teaching Laboratories at the Doherty Institute, which provide excellent facilities, and support for running a wet-lab workshop of this type. Overall, the participants were really impressed,” Patrick said.

Feedback from the participants following the workshop was overwhelmingly positive, with many reporting an increased understanding of cell culture and different methods for identifying and characterising influenza viruses, as well as influenza vaccine development in general. All participants indicated that their learnings from the workshop would be useful and applicable in their work upon returning to their respective laboratories.

Broader benefits for surveillance beyond influenza

Dr Frank Konings (WHO/WPRO), commented on the connections formed between participants and identified broader benefits for regional surveillance capabilities, both for influenza and other infectious diseases.

“The Asia-Pacific Region is a hotspot for emerging infectious diseases. This includes influenza, one of the priority pathogens for the region. The ability of countries to detect and characterise such agents is key for surveillance and response. Increased capacities for influenza laboratory testing, such as those covered by this training, will also contribute to testing for other pathogens, such as Middle East respiratory syndrome (MERS) coronavirus.

“Taking such a generic approach is one of the features of the WHO Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III). The workshop has also created an understanding among the participants to share clinical specimens and isolates more frequently and in a timely way with WHO Collaborating Centres.”

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