Use of Highly Pathogenic Avian Influenza A(H5N1) Gain-Of-Function Studies for Molecular-Based Surveillance and Pandemic Preparedness

Davis, C. Todd; Chen, Li-Mei; Pappas, Claudia; Stevens, James; Tumpey, Terrence M.; Gubareva, Larisa V.; Katz, Jacqueline M.; Villanueva, Julie M.; Donis, Ruben O.; Cox, Nancy J.

As coordination of international surveillance activities and global sharing of viruses improve (especially in the wake of the 2009 pandemic and emergence of H7N9 viruses in China), molecularly based surveillance has great potential for rapid risk assessment of samples collected as part of active and passive surveillance systems. Real-time feedback to investigators in the field or authorities making policy decisions related to poultry outbreak containment, clinical intervention, and diagnostic methodology, to cite a few examples, will remain critical in the future. In addition, as building laboratory capacity is prioritized in countries impacted the most by endemic H5N1 virus circulation and the higher incidence of human infection, the ability to screen viruses for amino acid markers or lineage-associated molecular determinants by sequencing, pyrosequencing, mass spectrometry, and real-time reverse transcription (RT)-PCR assays will become the reality for more and more laboratories.