Diagnostics and Surveillance
Development and standardisation of methods to detect and identify influenza viruses are essential to ensure the efficient diagnosis of influenza and to monitor spread of the virus in animal and human populations. This knowledge is, in turn, essential for the earliest possible intervention steps in control of the disease.
A broad range of different diagnostic tools is already available, ranging from direct antigen-detection and molecular assays such as (real-time) PCR to a variety of different serological tests that detect the response of the infected host. Two important problems that need to be tackled by researchers, however, are a) the adaptation of these methods to the strain H5N1, which has pandemic potential and is not well detected by several routine methods and b) the robustness and high-throughput use of these tests in 'field' or point-of-care conditions. These problems apply to both the animal and human health field. While during a true pandemic, health services are likely to have to rely on clinical diagnosis alone (also called 'syndromic triggering'), robust diagnostic tests are crucial in the early phase of a pandemic for surveillance purposes.
Mapping the spread of an epizootic (epidemic in animals) is a key part of targeting control measures such as culling or vaccination of animals as well as specific awareness-raising and training of the population in the affected area. Similarly, epidemiological surveillance in humans is a prerequisite not only to monitor potential outbreaks, but also as a basis for a number of important research questions, such as the seasonality of 'normal' influenza epidemics or its spread into different population and age groups. Sophisticated multi-parameter modelling becomes increasingly important in linking existing data and developing different scenarios for future outbreaks.
The vast majority of projects funded to date in the field of diagnostics and surveillance originate in the animal health community - and it will be the task of future calls for proposals to fill the respective gaps in the area of human health: NEW-FLUBIRD unites the expertise of virologists and ornithological organisations worldwide to study the contribution of migratory birds to the spread of avian influenza. FLURESIST and RIVERS examine the key public health question of how long influenza viruses can survive and be detected in animal carcasses, commodities and the environment. FLUTEST, LAB-ON-SITE (which also considers a number of other animal diseases) and AVIFLU (which also includes vaccine research) all focus on the development of sensitive and robust diagnostic tests. ESNIP and ESNIP2 are making important contributions to the diagnosis and surveillance of influenza infections in pigs - taking into account their role as potential 'mixing vessels' for human and avian viruses. The European Influenza Surveillance Scheme (EISS), funded through the Public Health Programme, has established an important Europewide surveillance network for human influenza infections.