Deployable Laboratory Response to Influenza Pandemic; PCR Assay Field Trials and Comparison with Reference Methods
Inglis, TJJ and Merritt, AJ and Levy, A and Vietheer, P and Bradbury, R and Scholler, A and Chidlow, G and Smith, DW, Deployable Laboratory Response to Influenza Pandemic; PCR Assay Field Trials and Comparison with Reference Methods, PLoS One, 6, (10) EJ ISSN 1932-6203 (2011) [Refereed Article]
Background: The influenza A/H1N1/09 pandemic spread quickly during the Southern Hemisphere winter in 2009 and
reached epidemic proportions within weeks of the official WHO alert. Vulnerable population groups included indigenous
Australians and remote northern population centres visited by international travellers. At the height of the Australian
epidemic a large number of troops converged on a training area in northern Australia for an international exercise, raising
concerns about their potential exposure to the emerging influenza threat before, during and immediately after their arrival
in the area. Influenza A/H1N1/09 became the dominant seasonal variant and returned to Australia during the Southern
winter the following year.
Methods: A duplex nucleic acid amplification assay was developed within weeks of the first WHO influenza pandemic alert,
demonstrated in northwestern Australia shortly afterwards and deployed as part of the pathology support for a field
hospital during a military exercise during the initial epidemic surge in June 2009.
Results: The nucleic acid amplification assay was twice as sensitive as a point of care influenza immunoassay, as specific but
a little less sensitive than the reference laboratory nucleic acid amplification assay. Repetition of the field assay with blinded
clinical samples obtained during the 2010 winter influenza season demonstrated a 91.7% congruence with the reference
Conclusions: Rapid in-house development of a deployable epidemic influenza assay allowed a flexible laboratory response,
effective targeting of limited disease control resources in an austere military environment, and provided the public health
laboratory service with a set of verification tools for resource-limited settings. The assay method was suitable for rapid
deployment in time for the 2010 Northern winter.